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Ocean Point Claims:denial using engineering reports
Denial Playbook

Denial Using Engineering Reports

When a carrier retains an engineer who finds wear-and-tear, the report often becomes the denial basis. Challenging the report, on methodology, qualification, or facts, is essential.

How carrier engineers work

  • Retained by carrier to assess cause
  • Inspection typically brief
  • Report written to carrier's specifications
  • Often template-based findings

Challenging the report

Methodology

  • Was inspection thorough?
  • Were physical samples taken?
  • Was testing appropriate?
  • Were industry standards applied?

Qualifications

  • Licensed in Florida
  • Relevant specialty (roofing, structural, forensic)
  • No conflicts of interest

Facts

  • Did report consider all evidence?
  • Are conclusions supported by observations?
  • Are alternative explanations addressed?

Potential bias

  • Prior pattern with this carrier
  • Report-shopping history
  • Retained-expert bias

Ocean Point Claims:insufficient documentation denial

Independent engineer

  • Independent expert report
  • Same scope as carrier's engineer
  • Opposing conclusions with specific reasoning
  • Credentials matching or exceeding

Deposition or testimony

  • If litigation, depose carrier engineer
  • Explore methodology, prior reports, relationships
  • Undermine credibility on specifics

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