The Insurance Council of Australia (ICA) has responded to concerns raised by the Australian Consumers Insurance Lobby (ACIL) about the use of expert reports in the insurance claims process.
This comes as part of ongoing discussions about reforms to the General Insurance Code of Practice, which ACIL argues needs further strengthening to address key issues around the role and reliability of expert reports.
ACIL, a consumer advocacy group, has raised several points about the recently introduced Expert Report Best Practice Standard, claiming it does not fully ensure accuracy or accountability in expert reporting.
The group alleges that insurers have been slow to adopt the new guidelines and often fail to respond to issues when consumers challenge the findings in expert reports. Therefore, ACIL is pushing for more robust protections to prevent reports from being biased in favour of insurers.
In response, an ICA spokesperson outlined the purpose of the Best Practice Standard, which was created to establish consistent practices for insurers when engaging expert professionals such as engineers, builders, and hydrologists.
The spokesperson highlighted that the standard provides clear instructions on how expert reports should be written and formatted, and specifies that experts must rely on verified facts to support their conclusions.
Addressing ACIL’s claim that insurers might unduly influence expert opinions, the ICA said that the standard requires experts to provide objective reports based solely on the evidence presented. Additionally, the standard includes provisions that require experts to include a statement of objectivity, ensuring their opinions remain independent.
The ICA also said that some of ACIL’s concerns misinterpret the role of the standard, which governs how insurers use expert reports, rather than setting professional requirements for the experts themselves, who operate under separate industry regulations.
Despite these assurances, ACIL believes more needs to be done to improve the standards. They have pointed to several areas where they feel the guidelines fall short:
ACIL also raised concerns that consumers are often financially disadvantaged when disputing expert reports, and argued that there is an imbalance of power in these situations.
The group is advocating for insurers to offer independent avenues for consumers to challenge the findings of expert reports in disputed claims.
The ICA indicated its willingness to work with stakeholders, including ACIL, to address these issues.
However, the ICA stressed that any discussions need to be based on a clear understanding of the Expert Report Best Practice Standard and supported by factual evidence.
“If ACIL have evidence that insurers do not appear to have taken any steps to implement the new standard in the less than two months since its release they should provide it, not engage in vague and unsupported assertions,” the ICA spokesperson said.
The introduction of the Expert Report Best Practice Standard is part of broader efforts to improve the transparency and fairness of the insurance claims process.
