Ask an Expert: How does AFCA use expert reports in the context of insurance claim disputes?

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In my experience, one of the most common and difficult aspects of decision-making at AFCA is reviewing expert reports to determine proximate cause; that is, whether a loss is covered or not. Our job as an as an independent dispute...

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Chris Liamos — AFCA Senior Ombudsman, General Insurance

11 May 2026

1 min read

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Ask an Expert: How does AFCA use expert reports in the context of insurance claim disputes?

In my experience, one of the most common and difficult aspects of decision-making at AFCA is reviewing expert reports to determine proximate cause; that is, whether a loss is covered or not.

Our job as an as an independent dispute resolution body is to critically analyse the experts’ key findings, assumptions and evidence.

The key component we look for is quality. Statements made by experts need to be supported. A report that simply provides an opinion is unlikely to be given much weight, particularly if there’s a contradictory report providing a more detailed, reasoned or quantified analysis.

Even though the issue might be very technical, a good expert report will drill down to the basics in a way that any layperson can understand.

We aim to be adaptable, as an approach that’s too rigid can lead to harsh and arbitrary outcomes.