Home insurance: how does the expertise work?
Verified 29 April 2024 - Directorate for Legal and Administrative Information (Prime Minister)
The law may require the use of expertise in certain cases. In other cases, it is the insurer who decides, following a claim, whether or not an expert opinion is necessary. What is the role of the expert? Is it possible to challenge his findings? We present the applicable rules.
Expertise is not required in the area of home insurance.
But the law can compel the use of expertise in certain cases.
For example, the law provides that expertise is mandatory for claims technological disaster which cause significant damage.
Apart from cases where the law makes expertise compulsory, it is the insurer who decides, following a claim, whether or not an expert opinion is necessary.
In general, the insurer resorts to expert advice when it believes that it will be difficult to reach an amicable agreement on the amount of compensation, or when the value of the damage exceeds a certain threshold.
Indeed, the insurer relies on the expert report to estimate the amount of compensation it will offer you.
If the insurer decides to use the expert opinion, or if it uses the expert opinion to comply with a legal obligation, it will be the insurer who chooses the expert.
But the judge can also order an expert opinion when the dispute over compensation is brought before the courts.
In this case, the judge chooses the expert.
It is then a forensic expert.
The home insurance expert is a person who has extensive technical knowledge in real estate and construction and who is familiar with the legal rules applicable to insurance contracts and compensation mechanisms.
The role of the expert is to ascertain facts or situations, to investigate the causes of the disaster and to assess the damage.
At the end of the mission, the insurer must submit an expert report which indicates, in particular, the following:
- Circumstances of the disaster (events, date, time, persons present, witnesses, etc.)
- Causes of the disaster (fire by electrical short-circuit, water damage by leakage on pipes, etc.)
- Damage noted (electrical appliances, curved parquet, burnt roof, etc.)
- Relationship between loss and damage (already damaged before loss)
- Assessment of damages (adjustment between the purchase price of old goods, price of a new product, etc.)
- Proposal for compensation (repair of a damaged appliance or purchase of a new product)
The timeline for submitting the report depends on the severity of the disaster and the complexity of the engagement.
The expert usually travels to the garage where the accident occurred or to the accident site to make the findings.
But he can also work from photos, without personally going to the scene of the disaster or to the garage in case of a small disaster.
The expert will notify you of his visit and you must give him all the supporting documents that can allow him to evaluate the damaged property or properties. For example, invoices, warrants, or photos of items that disappeared in the claim.
The expert chosen by your insurer is not legally obliged to send you his report.
However, if the insurer uses the expert report to deny you compensation, you can ask to consult.
If the insurer refuses, you can to take legal action to require the judge to require the insurer to provide you with the expert report as part of the proceedings.
If you disagree with the conclusions of the expert appointed by the insurance company, you can request a counter-expertise. For example, if the expert indicates that the loss was caused by your recklessness, but you feel that you have no responsibility.
In this case, you must call on an expert other than the one appointed by your insurer.
The second expert must carry out an amicable assessment contradictory with the insurer's expert. You are the one who has to pay his fees.
If the 2 experts cannot reach an agreement, a new expert must be appointed to carry out a third-party expert study.
The third expert must be appointed by common agreement of the two parties. His fees must be shared equally between you and the insurer.
In case of disagreement, the third expert will be appointed by the president of the court of justice or by the president of the commercial court of the place of the disaster.
The insurer pays the expert he has appointed.
However, if you have requested a second opinion, the contract may provide that the costs of this second opinion be borne by you.
Where an expert is appointed by the judge, the judgment shall indicate who is to pay the costs of the expert's examination.
The cost of home insurance expertise is minimal €800 and may exceed €1000.
FYI
some contracts provide for the guarantee expert fees, which shall reimburse the cost of the expert's report, up to a certain limit.
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National Institute of Consumer Affairs (INC)