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Claims conference spotlights expert report shake-up

Expert report improvements and better disaster response communication and co-ordination are among changes that would help policyholders after natural catastrophes, the Claims Convention heard yesterday.

The Insurance Council of Australia has released a best practice standard for expert reports, the independent panel reviewing the industry code of practice has made recommendations and a parliamentary inquiry into the 2022 floods, due to release its findings next month, has heard evidence on shortcomings around the use of specialists and claims handling.

Australian Financial Complaints Authority lead ombudsman for insurance Emma Curtis said the organisation is looking to prepare an approach document early next year on claims handling that would include expert reports and cash settlements.

Ms Curtis said the importance of expert reports that clearly address issues is heightened given consumers may not be able to obtain balancing specialist opinions.

“I support all the recommendations about plain English, potentially standardised formats and joining the dots between the evidence and the underlying recommendation,” she said during a panel discussion at the convention in Sydney.

AFCA must weigh expert reports on one hand and complainant evidence, including eyewitness reports, on the other, she said.

“I think it’s really important for experts to have access to any information that the consumer’s provided or the policyholder has provided and take that into account, and address that in their expert report, otherwise it leaves that issue hanging.”

Sedgwick Australia CEO Diego Ascani said improved co-ordination and collaboration after catastrophes could smooth processes.

“That goes to debris removal, dealing with environmental spillage, temporary accommodation, use of hydrology. I think we can co-ordinate ourselves a little bit better as an industry,” he said.

More standardisation on expert reports would be beneficial and could speed training times, particularly when international adjusters are brought in, while technology advancements will help triage claims, he said.

“Claims go through ebbs and flows and difficulties and it’s the co-ordination between trades, stakeholders, experts to bring finality as quickly as possible. It’s a bit like a relay race, you’ve got to hand over that baton properly to the next runner.”

Mr Ascani urged the government to make visa processing faster and less expensive to help businesses bringing in overseas staff after major events.

Suncorp EM of SME property and short-tail claims Robert Leach said since the 2022 floods the insurer had increased staffing and widened training around identifying vulnerability.

“I think the most important thing in identifying vulnerabilities is to be curious,” he said. “If you’re not asking the right questions, you’re not going to find out what’s going on. A lot of people are pretty stoic, and they don’t want to admit that they’re suffering.”

Mr Leach also called for changed hydrology report processes, with demand for site-specific reports and specialist shortages after the floods causing time frame blowouts.

ICA COO Kylie Macfarlane said the Deloitte report commissioned by the industry had provided a road map that could be applied to extreme weather events.

“How we turn up differently in the future is to ensure that we are collaborating, that communication is open, not just within the industry, but with the stakeholders outside of the industry as well,” she said.

“Whether it’s AFCA, APRA, ASIC state, federal or local government, they’re all important players in the opportunity that is in front of us all to help communities recover and come back to their homes and businesses in the way in which they would want to.”

The best practice standard and the code review were examples of the industry moving ahead on solutions, she said.

“We want to keep the market sustainable, we want to keep it competitive, and being able to lead those solutions is the key to that,” she said.

The Claims Convention, now in its 17th year, is presented by the Australasian Institute of Chartered Loss Adjusters and the Australian and New Zealand Institute of Insurance and Finance.