The report is on the table — and you do not recognise your case in it
You reported the loss, an investigator attended, conversations and measurements followed — and now there is a report. It contains conclusions that to you are incomprehensible: the damage is said to have arisen gradually, the cause is said to lie with you, or worse: there is said to be a suspicion of fraud or intent. The insurer refuses, applies a deduction, or sets further conditions.
At that point it is time for an independent assessment. Not to argue, but to test whether the report meets the standards you are entitled to expect.
How investigation reports come about
Insurers have investigations carried out by specialist firms. Sometimes these are external parties, sometimes they are subsidiaries or firms in which the insurer is a (co-)owner. That is not in itself impermissible, but it does mean that the distance between client and investigator is small. The investigator works regularly for the same client and knows the expectations.
In addition: in the Netherlands anyone may describe themselves as an investigator. There is no statutory protection of the profession. That means the quality of reports varies enormously — from careful, methodically sound work to reports in which a conclusion is drawn on the basis of suspicion rather than evidence.
What we test in a report
1. Methodology
Has the investigator followed a structured, falsifiable approach? In fire investigation that is NFPA 921. In causation investigation the rule is: formulate a hypothesis, test it, exclude alternatives. We assess whether the investigator draws conclusions supported by the evidence — or whether there are leaps from observation to conclusion.
2. Facts versus interpretation
In a good report it is clear what has been observed and what that, according to the investigator, means. Many reports blur those two layers: the interpretation is presented as fact, and alternatives are not discussed. We separate those layers — and that is often the point of attack for refutation.
3. Right of response and procedural care
Were you given the opportunity to respond to draft findings? Has your statement been recorded fully and correctly? Person-focused investigation is subject to the Personal Investigation Code of Conduct (GPO) — a breach of that makes the report (partly) unusable.
4. Expertise of the investigator
Who carried out the investigation, what is that person’s background, and are they sufficiently qualified for this loss? A general causation investigator is not a fire investigator; a fire investigator is not an electrical engineer. Investigation outside one’s own area of expertise is a red flag.
5. Substantiation of exclusions
Where the insurer relies on a policy provision — “gradually occurring damage”, “overdue maintenance”, “fraud” — the report is often the keystone of that reliance. We test whether that substantiation stands on its own, even where the assumptions the insurer reads into it are taken away.
What a counter-report does
Where our investigation shows that the insurer’s report falls short, we produce a counter-report. In it we:
- identify where the original report falls short methodologically;
- supply the additional technical analyses that are missing;
- formulate our own, substantiated conclusion on causation and cause;
- advise on the correct application of the policy.
That counter-report goes to the insurer and, if it does not move, can serve as substantiation in Kifid proceedings or before the courts.
When you should engage us
The moment you receive a report in which you do not recognise what actually happened. Do not wait until you “have to sort it out yourself” with the insurer — substantive assessment of the report is specialist work, and the sooner you engage us, the more scope there is to secure additional factual material.