Mastering Property Claim Investigations with Subject Matter Experts

Property claim investigations, whether stemming from water damage, fire, construction defects, or premises liability, often require more than just a quick inspection. To ensure accurate, defensible, and cost-effective outcomes, insurance professionals increasingly rely on subject matter experts (SMEs). This article, co-authored by a claims manager and an SME consultant, outlines the essential processes and mindsets needed to manage SME involvement successfully.

Starting with a framework called C3PO—Correct, Clear, Concise, Precise, and Objective—the article emphasizes that SMEs must communicate findings visually and verbally in a way that can be understood in five minutes or less. The authors recommend a structured, multi-level approach to SME analysis, with explicit deliverables at each stage to control costs and avoid surprises. This process encourages deeper pattern recognition and decision-making by claims professionals.

Equally important is ensuring both SME and claims professional are ‘coverage aware’ and ‘litigation aware.’ These roles involve understanding not just the property damage itself but how policies and potential legal outcomes shape the investigation. Whether handling a routine claim or preparing for trial, forensic-level standards and organized, discoverable evidence are critical for credibility and resolution.

From desktop reviews to onsite inspections and detailed repair estimates, the article makes a compelling case for methodical, transparent investigation strategies. When SMEs integrate early hypotheses, document thoroughly, and respect the limits of their expertise, they become invaluable partners in resolving both simple and complex claims.