Dispute with claims expert

What we do

A claims expert is responsible for assessing the extent of the damage. In many cases, an insured who suffers damage and makes a claim receives a compensation proposal from the insurer. In some cases, for example if the value of the damage is substantial or if the extent of the damage is uncertain, a claims expert is appointed by the insurer. The insured also has the right to appoint an independent claims expert themselves. If the two claims experts disagree on the extent of the damage, a third claims expert may be appointed or legal proceedings may be initiated in court. We regularly assist insurers and insureds in such disputes regarding damages.

We have the experience and expertise to assume diverse roles, from advisory services to dispute resolution. We have an experienced team of lawyers and legal experts in insurance law. Contact us to discuss the possibilities.

Dispute with a claims expert within insurance law

A dispute regarding the claims expert falls within the broader field of Insurance Law. Unlike a coverage dispute (the question of whether the damage is covered by the policy), this concerns purely the extent of the damage: how much the insurer must pay out. The expert actually assesses the damage, but the surrounding legal frameworks—your right to your own expert, reimbursement of costs, and the binding nature of a third-party assessment—often determine the outcome. We assist both insurers and policyholders, from international corporations to the baker around the corner, with mixed teams of lawyers and in-house counsel.

Your right to your own (counter-)expert

The insured is not obliged to simply accept the report of the expert appointed by the insurer. You may engage your own independent counter-expert to reassess the damage and serve your interests exclusively. Many policies include an expert assessment clause for this purpose (the so-called three-expert rule). It is advisable to legally verify at an early stage whether the policy conditions are being applied correctly and whether the appointment of the experts is proceeding according to the agreed procedure.

Reimbursement of expert fees (Article 7:959 of the Dutch Civil Code)

The costs of determining the damage shall be borne by the insurer pursuant to Article 7:959 of the Dutch Civil Code, insofar as they concern reasonable costs. An important distinction applies in this regard:

• Private individuals: for consumers, Article 7:959 of the Dutch Civil Code is mandatory law (Article 7:963 of the Dutch Civil Code). The insurer must reimburse the reasonable costs of the counter-expert, even if these are higher than the costs of its own expert. The policy may not restrict this right.
• Companies: for business policyholders, the article is not mandatory. The policy conditions then determine what is reimbursed; insurers sometimes limit the reimbursement to the rate of their own expert.

Whether costs are reasonable is assessed using a double reasonableness test: was it reasonable to engage a counter-expert, and are the rates and hours charged in line with market rates? Case law (including The Hague Court of Appeal, 2020) confirms that experts outside recognized expert organizations may also incur reasonable costs. We recover these costs or reject unjustified claims.

The third expert and binding advice

If the insurer's expert and your counter-expert cannot reach an agreement, they jointly appoint a third expert (the arbitrator) in advance. The judgment of that third expert is in principle binding , and the determined amount falls between the two previous valuations. A binding valuation report is not unassailable: it can be challenged if its formation or content is unacceptable according to standards of reasonableness and fairness (Article 7:904 of the Dutch Civil Code). We assess whether there are grounds to challenge a binding third-party expert opinion and litigate on the matter if necessary.

When to go to court or Kifid

If there is no valid expert assessment clause, the insurer refuses to reimburse reasonable costs, or the binding advice is open to challenge, recourse to the courts or – for consumers – to the Disputes Committee of the Kifid available. Often, the interpretation of the policy conditions a role in this, or the dispute borders on underinsurance and broader policy disputes. Our lawyers are familiar with both routes and, together with you, choose the fastest path to a reasonable payout.