Let’s play Pick the Expert
When a Certificate IV outranks three engineers
By Andrew Crane ·
The insurer gets first pick of who provides the reports that decide your claim. Often, it looks like they just pick the one that suits them. In this claim they chose a tradie who said “pre-existing” over a structural engineer. Most policyholders fold at this point, but in this claim a court has had a look and had a lot to say.
Anchor: ASIC v Hollard [2026] FCA 1487, paragraphs 77 to 84; Flood failure to future fairness (October 2024), Recommendations 6 and 7; ASIC, “Home insurance claims handling improvements need to go further” (5 June 2025); General Insurance Code Governance Committee, Oversight of external experts: follow-up (December 2025).
Background view
When your property is damaged as a result of an insured event, the insurer will use “experts” to answer critical questions. Broadly, the two most important questions are causation and scope. Causation just means what caused the damage; scope refers to the extent, and often the cost, of repairing it.
These experts are meant to be independent. What I’ve found, though, is that there is a huge industry of individuals vying for insurance work as “experts”. It’s competitive because insurers pay reliably and the work can be prolific. Anybody from a roofing contractor to a geotechnical or structural engineer might be regarded as an expert, and in my experience some of them are happy to tell the insurer what it wants to hear, just as long as they get paid. This is a story about just one way the situation with experts can, and often does, go wrong for a policyholder like you.
Three reports said storm
In the Hollard case the insurer held three documents about the roof:
- Expert 1. A plumber’s report (29 November 2021): the wind moved the hot-water service, cracked the tiles, water got in, trusses bowed. “In my professional opinion water ingress is due to resulting damage to roof caused by strong winds during storm” (quoted at paragraph 102).
- The insurer’s own claim manager’s report (6 January 2022): damage “consistent with violent winds and storm damage” (paragraph 36).
- Expert 2. A structural engineer’s report (25 August 2022): “it is our opinion that cause of damage is attributed to the storm event 29/10/21” (paragraph 102).
One opinion said pre-existing
Then a different claim manager, whose qualifications the judgment records as including a Certificate IV in Building Construction, inspected the roof and told the insurer the trusses were “very undersized and not braced adequately” and that the problem was “pre-existing” (paragraphs 78, 81, 82). The insurer wrote to the family: “your truss was not damaged by the Storm, therefore we have obligation to cover this aspect of your claim” (paragraph 101, typo in the original).
Hollard has since admitted it “failed to sufficiently consider” the three reports when it made that call (paragraph 84). AFCA later found for the family. Two more engineers were engaged. Both found the storm was a cause (paragraphs 115 and 116).
It’s a feature of the system, not a bug
This is not one bad file. It is a pattern the people in charge have documented for years. It’s systemic, built into the way things get done.
- The parliamentary flood inquiry recommended the Code require insurers to ensure “the expertise, professionalism and independence” of the experts they appoint, and that the government fund an independent panel of hydrologists for when a policyholder disputes the insurer’s report (Recommendations 6 and 7).
- ASIC, following up its 2023 review, found insurers’ quality checks on expert reports “generally focused on the timeliness of reports, rather than their quality or accuracy”, and that insurers “generally did not review independent expert reports following claims decisions to confirm that the report arrived at the correct outcome” (5 June 2025).
- The Code Governance Committee, the sector’s own monitor, has reviewed expert oversight three times. Its December 2025 follow-up says “the recurrence of these findings across multiple reviews indicates that insurers have been slow to address known weaknesses” (page 11).
Comment
Look at what happened in that file: three reports said storm, one opinion said pre-existing, and the one opinion won. Hollard admitted the three were not sufficiently considered. I wonder whether it would have admitted anything if the regulator had not taken it to court.
Think about the economics for a second. The insurer picks the expert, briefs the expert, pays the expert, and decides whether the expert gets the next job. The policyholder gets a PDF. If they want a second opinion, they pay for it themselves, on top of all the other expenses and stressors they are carrying while trying to cope with a damaged home.
Nobody is saying every panel engineer is bent, and the fault in the system is not always blatant corruption; it’s often subconscious bias. The Royal Commission looked at exactly this question in 2019, and an insurer’s own executive conceded “the potential risk of subconscious bias” where a firm’s income depends on being asked back (Final Report, Volume 2, page 451). The Commissioner called that “entirely plausible”. Fair dinkum, it would be strange if it were not. There are large multi-state businesses built around serving insurers’ needs, and often those needs are in direct conflict with yours. It’s big business.
The fix is not complicated, and an inquiry has already documented the solution: independence, standard formats, a funded second opinion when the first one is disputed. What is missing is the will to do it.
Sources
- ASIC v Hollard Insurance Partners Limited [2026] FCA 1487, paragraphs 32, 36, 44, 77 to 84, 101, 102, 115, 116.
- House of Representatives Standing Committee on Economics, Flood failure to future fairness, October 2024, Recommendations 6 and 7.
- ASIC, “Home insurance claims handling improvements need to go further, ASIC says”, news article, 5 June 2025.
- General Insurance Code Governance Committee, Oversight of external experts: follow-up, December 2025, page 11.
- Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry, Final Report, Volume 2, February 2019, pages 450 to 451.