You’ve filed a claim for wind damage to your roof. The insurer seemed to accept it, sent an adjuster, took photographs. Then, two weeks later, you receive a letter: “After a thorough engineering analysis, we have determined that the damage to your roof was caused by wear and tear and neglect, not covered weather events. We are denying your claim.”
The denial is based on a “forensic engineering report” prepared by—and paid for by—the insurance company. You never had a chance to challenge the engineer’s findings. This is one of the insurance industry’s most effective claim denial tactics.
Quick Answer: How Do Insurers Use Forensic Engineers?
Insurance companies hire forensic engineers to reclassify covered damage (fire, water, hail, storm) as excluded damage (wear and tear, maintenance issues, pre-existing conditions). These engineers are paid by the insurer and have financial incentives to reach conclusions that support claim denials. You have the right to hire your own independent forensic engineer to challenge their findings—and doing so often results in claim approval or significantly higher settlements.
The Forensic Engineer Denial Tactic
Forensic engineering is legitimate science. When done properly, a qualified forensic engineer can investigate the cause of property damage and reach objective conclusions. But the forensic engineers insurers hire work for the insurance company—and insurance companies make money by denying claims.
Step 1: Misclassify the Damage Cause. A hailstorm passes through your neighborhood. Your roof is covered in impact marks. But the insurer’s engineer concludes the damage patterns are “consistent with normal wear and tear” given the roof’s age—conveniently reclassifying covered hail damage as excluded wear and tear.
Step 2: Use Exclusions to Deny Coverage. In a fire scenario, the insurer’s engineer claims deteriorated wiring “may have contributed” to ignition—reclassifying external fire damage as an electrical maintenance issue. In water damage, the engineer notes minor pre-existing foundation cracks and attributes flooding to “ongoing water intrusion” rather than sudden rainfall.
Why This Tactic Works
- Homeowners don’t know how to challenge engineering opinions. When they receive a technical report, they assume it’s accurate.
- The report sounds objective. It’s on letterhead, includes photographs, and uses scientific language.
- Many homeowners can’t afford a counter-engineer. Hiring one costs $2,500-$7,500+.
- The insurance company controls the narrative. The homeowner is playing defense.
- Litigation is expensive. Many people give up rather than fight.
The Hidden Bias Problem
The engineer is hired by the insurance company. If the engineer issues reports that result in successful claim denials, the insurer hires that engineer again. This creates a subtle-but-real incentive to reach conclusions that support denials.
Most forensic engineers are professionals who take pride in objectivity. But confirmation bias is real. When you’re hired by an insurance company, it’s easy to interpret ambiguous findings in a way that supports denial. Add to this the fact that the insurer chooses which areas to examine, which samples to take, and which testing to conduct—subtly guiding the investigation toward denial-supporting conclusions.
Common Forensic Engineer Denial Scenarios
Hail Damage Reclassified as “Wear and Tear”
Your roof has dozens of hail impact marks. The insurer’s engineer reports that damage patterns “may be consistent with granule loss due to weathering” on your 12-year-old roof. The insurer denies the claim as wear and tear. Why this is wrong: Hail impact damage is distinct from age-related wear. An independent engineer would distinguish between the two.
Fire Damage Reclassified as “Electrical Failure”
Wind-blown embers caused your home fire. The insurer’s engineer notes deteriorated wiring that “could have contributed to ignition.” The insurer denies or reduces the claim. Why this is wrong: There’s a difference between deteriorated wiring that might someday cause a fire and wiring that actually caused this fire. An independent engineer examines actual burn patterns and point of origin.
Water Damage Reclassified as “Maintenance Issue”
Heavy rains flood your basement. The insurer’s engineer notes minor foundation cracks and attributes flooding to “deferred maintenance.” Why this is wrong: An independent engineer can establish that flooding was caused by sudden rainfall, not pre-existing problems.
How to Fight Back: Hire Your Own Forensic Engineer
Step 1: Find an Independent Expert. Look for a forensic engineer with PE certification, property damage investigation experience, expert witness experience, no prior relationship with the insurer, and willingness to testify in court.
Step 2: Provide Full Access. Your engineer needs thorough inspection—visual examination, testing (moisture meters, core sampling), photographs, review of building plans, and review of the insurer’s engineering report.
Step 3: Challenge the Insurer’s Report. Your engineer’s report should directly address methodology flaws, unjustified assumptions, alternative explanations, and why the insurer’s conclusions are wrong.
Step 4: Use the Report to Negotiate or Litigate. Armed with an independent opinion, you can send a demand letter, demand appraisal, or proceed to litigation.
Cost Considerations
Hiring a forensic engineer typically costs $2,500-$7,500+ depending on complexity. But if your claim is for $25,000 and an engineer’s report costs $5,000 but allows you to recover $20,000 instead of $0, the investment is worthwhile. In litigation, the court may award your expert fees as part of the judgment.
Why Trust Siddons Law?
Siddons Law Firm represents homeowners across Southeastern Pennsylvania, Southern New Jersey, and the Eastern Shore of Maryland who have had claims denied based on biased forensic engineering reports. Licensed in PA, NJ, MD, and NY, we understand how to challenge these reports under 42 Pa. C.S. § 8371, N.J.S.A. 17:29BB-1, and Maryland Insurance Article §27-1001.
Related reading: Fire Damage Claims | Water & Flood Damage Claims | Hail Damage Claims | Storm & Wind Damage Claims
Frequently Asked Questions
Can an insurance company really use a forensic engineer to deny my claim?
Yes. Insurers can request engineering investigations to determine causation. However, the investigation should be objective and fair. If the engineer’s methodology is flawed or conclusions unsupported, you can challenge the report and hire your own engineer to dispute it.
How much does a forensic engineer cost, and will the insurance company pay for it?
A forensic engineer typically costs $2,500-$7,500+. The insurance company won’t pay for yours. However, if you go to litigation and win, the court may award your expert fees as part of the judgment.
What if the insurer’s engineer and my engineer disagree?
If experts disagree, the dispute is resolved through litigation (a judge or jury decides) or settlement negotiations where you use your expert’s opinion as leverage. Often the presence of competing opinions prompts the insurer to settle rather than risk losing at trial.
More from Siddons Law
- How to Document Your Property Damage Insurance Claim – Protect your claim with proper documentation
- Why You Should Never Give a Recorded Statement Without a Lawyer – Common traps in recorded statements
- The Insurance Lowball Game – Why your insurer’s first offer is never their best
- Hidden Damage: Why Your First Insurance Payout Is Rarely Enough – Supplemental claims for hidden damage
- Bad Faith Insurance Lawyer – Complete guide to bad faith claims in PA, NJ, MD, and NY
Don’t Accept a Denial Without a Fight
If your claim has been denied based on an engineering report, we’d like to help. Call Siddons Law Firm at 610-255-7500 for a free consultation.
Siddons Law Firm
Media, PA 19063
Phone: 610-255-7500 | Website: siddonslaw.com
Don’t accept an insurer’s denial. Fight back with expert evidence.
