Dear David: Does an Engineer Need to Consider All the Evidence Available?

Dear David,

Does an engineer need to consider all the evidence available? Whether it’s storm damage, water damage, or even fires we are seeing more engineers being engaged by insurance companies.  Often these visits are brief, and they result in the policyholder receiving a denial letter. 

Dear Engineered Denial,

According to my favorite search engine, Professional Engineers are licensed in all 50 states and the District of Columbia. That being true, licensing brings with it regulations and a standard of professional conduct. Wisconsin’s Administrative Code Chapter A-E 8 spells out Professional Conduct for Architects, Engineers, Designers, and Surveyors.  My personal favorite is A-E 8.06 Professional Obligations. 

The role of an engineer in an insurance claim can be to assess the property for causation or damage or both. In my experience, an engineer will review all the information they receive. That does not mean they will agree with the information. They should note what the information is, their opinion of it, and whether it was a factor in their determination. This assumes they will write an opinion. 

Engineers are limited to the scope of work provided by their client. The client in this hypothetical is the insurance company. If an insurance company directs the engineer or limits the information the engineer receives then under some rules of professional conduct the engineer is not in trouble.  

Common direction from insurance companies on a roof damage claim from hail is to request the engineer to assess the damage to the roof and determine the extent of the damage. The engineer will inspect the roof and look for any signs of damage, such as dents or cracks in the roofing material or damage to the underlying structure. The engineer will also evaluate the overall condition of the roof and determine if any pre-existing conditions contributed to the damage. This is important because insurance companies will typically only cover damage that was caused by the hail and not damage that was already present.

Once the engineer has completed their assessment, they will prepare a report that outlines the extent of the damage and the recommended repairs but only if their client directs them to do so. This report could then be used by the insurance adjuster to determine the amount of the claim or deny coverage. 

Ultimately, the ethical responsibility of the engineer is to provide an honest and accurate assessment of the damage, based on the best available evidence. This may require the engineer to challenge assumptions or beliefs that are not supported by the evidence, even if it is unpopular or contradicts the interests of other parties involved.

Here are some tips in dealing with the insurance company engineer:

  1. Submit any evidence directly to the engineer. Even if the adjuster has the information—never assume the adjuster is providing that information to the engineer. 
  2. Be present for the inspection. Even if the engineer will not speak to you or otherwise engage with you—be there.
  3. Record their inspection—video and audio. Disclose that it is being recorded—especially if required by law.  Offer them a copy of the recording.
  4. As you go through the inspection, look where they look, take photos where they do, point to things, and ask questions.  Even if they do not respond—build a record. (See #3).
  5. Do not assume because you have an opinion that others will share the same opinion.
  6. The policyholder could consider retaining their own Professional Engineer.

Want to have your question, comment, or concern addressed in an article or arrange a private conversation? Send inquiries to: info@advocateclaimservice.com

David Princeton

David Princeton, CPCU, AMIM, AIC, CSRP, is the principal consultant of AdvocateClaimService.com, an expert witness, and contributing author of Be Intentional: Culture. He attends Marquette University Law School and previously served as a director of corporate risk and as a lead claim specialist.

Advocate Claim Service takes the anxiety out of claims. Our mission is the strategic presentation of claims to get policyholders the benefits owed under an insurance policy. Claim consulting services are provided to Policyholders, Brokers, and Attorneys. As licensed insurance professionals, we have over 35 years of insurance claims experience across a wide array of coverage lines. In addition, our Insurance and Risk Management consulting practice is well suited to provide clarity to just about any insurance program before a loss occurs.

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