Discrepancies with the company: counter-expertise

When the insured does not agree with the company’s position, the Insurance Contract Law provides mechanisms to resolve the discrepancy. One of them is the counter-expertise: an independent expert report that reviews the conclusions of the company’s expert and provides alternative technical criteria.

The counter-expertise does not seek to confront for the sake of confrontation. Its objective is to provide rigor where there have been possible deficiencies, omissions or questionable interpretations.

When does a counter-examination make sense

• The company denies coverage of the loss.
• The proposed compensation is significantly lower than the real cost.
• The company expert’s report omits relevant items.
• Depreciations or exclusions are applied that do not fit the case.
• The technical cause attributed to loss is debatable.

It is not always the best option. In cases of minor differences, direct negotiation may be more efficient. The expert can guide whether the case warrants a formal counter-examination.

What is reviewed

• Complete documentation provided by the company.
• Methodology used by the company expert.
• Actual extent of damage versus recognized range.
• Valuation criteria: prices, depreciations, franchises.
• Compatibility between alleged cause and documented damages.

The report compares point by point and justifies each difference with technical criteria.

Contradictory expert opinion procedure

The Insurance Contract Law establishes a formal procedure when there is disagreement:

• Each party appoints an expert.
• Both experts try to reach an agreement.
• If there is no agreement, a third expert is appointed.
• The joint report or that of the third party is binding in its scope.

In this procedure, having your own well-prepared expert is decisive.

Useful documentation

• Complete policy, with general and particular conditions.
• Cross communications with the company.
• Company expert report.
• Photographs, estimates and invoices of the loss.
• Complaints, reports and official documentation, if applicable.

Coordination with lawyer

Many counter-examinations are part of a broader claims strategy. The legal interpretation of the policy, the claim deadlines and the procedural route correspond to the lawyer. The expert report provides the technical basis on which the claim is built.

Limits of counter-examination

• The content of the contracted policy does not change.
• It does not guarantee a result in court.
• It does not replace legal advice.

Its value lies in technical rigor. If the previous work of the company expert is correct, the counter-expertise must recognize it. If you have deficiencies, you must document them in a verifiable manner.

Next steps

• See full process.
• Review the IRD specialty.
• Contact from contact or help center.