The Australian Consumers Insurance Lobby says the industry code watchdog’s follow-up report on oversight of external experts may cover for failures to address problems around assessors’ independence.

Lobby chair Tyrone Shandiman acknowledges “welcome progress” in external expert monitoring and training, along with measures that prevent recommendations for claim approvals or denials.

However, he warns that without tackling structural issues around conflicts of interest, the code governance committee may create “the perception that everything is now OK with expert reports”.  

“While the recent improvements help at the margins, they do not address the core problem – consumers are still reliant on experts who are not genuinely independent,” Mr Shandiman said.  

He has also questioned the training insurers are providing to experts, saying there are concerns that this “becomes a channel for influence rather than independence”.  

“It’s hard not to raise an eyebrow at insurers claiming they are ‘training’ external experts,” he said.

“These are qualified professionals engaged for their specialist expertise – yet insurers position themselves as the ones who know better.”  

The lobby says the code still lacks vital consumer protections, including safeguards against insurer influence on expert findings and transparency requirements for related-party business structures.

ACIL has also called for a ban on insurer performance incentives that favour claim denials or reduced claim payments, and for the establishment of an “accessible pathway for consumers to challenge inaccurate or biased expert reports”.  

“Right now, if a consumer disagrees with an expert report, the most practical option is to fund an alternative report – often [costing] thousands of dollars – at a time when they are already financially vulnerable due to a claim being delayed or declined,” Mr Shandiman said. “This is not a fair or balanced system.”  

The consumer body says that without its suggested reforms, a softening insurance market and improved insurer profitability may create a false sense of progress.  

“If insurers feel less pressure to minimise claim costs, we may naturally see fewer disputes,” Mr Shandiman said. “But that does not mean the system has improved – it simply reflects the market cycle. The underlying risks to consumers will re-emerge in the next hard market.”