Insurance claims-handling expert
Expert class library · Insurance · Either side
Evaluates whether an insurer investigated, evaluated, and paid a claim in line with industry practice and fair claims handling rules. Central to bad faith and extracontractual claims.
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Questions this testimony turns on
- Did the insurer investigate, evaluate, and pay the claim in line with industry claims practices?
- How did the insurer's handling depart from those practices, and did the departures matter to this claim?
- Was the insurer's coverage position a reasonable one in light of the information it had?
- What would a reasonable adjuster have done differently?
Methods
- Claim file review
- Industry claims practice comparison
- Unfair claims settlement practices analysis
- Reserve and valuation review
How the testimony is attacked
- Legal conclusions. Experts may describe industry standards and how the insurer's conduct compared, but not tell the jury the insurer acted in bad faith or violated a statute. O'Sullivan and McClure both drew this line.
- Deviations not tied to the claim. A list of departures from ideal practices does not show bad faith unless connected to harm in the claim at issue. 11333 Inc. excluded an expert on this basis.
- Opinions on motive the jury can assess. Opinions about whether an adjuster was financially motivated or acted by mistake may not help the jury. McClure held such opinions improper for an expert.
- Speculation and lack of foundation. Conclusory assertions about how an insurer 'spun' the law, without explanation, are excluded. O'Sullivan excluded portions of the expert's report on that ground.
- Hybrid fact and expert witnesses. A witness who handled the claim may be barred from also giving independent expert opinion that the handling met industry standards. In Phoenix Restoration Group v. Liberty Mutual the court limited such a witness to facts and the opinions that guided his work.
What the public record shows
Courts have filed at least 22 opinions since 2015 that discuss this class of testimony and cite Daubert or Rule 702, as of October 4, 2026. 6 rulings that show how courts handle this class of testimony:
| Outcome | Case | Court | Year | Why |
|---|---|---|---|---|
| Exclusion reversed | Chapman v. Nationwide Mutual Fire Insurance Co.No. 26A-PL-743 | Ind. Ct. App. | 2026 | The Court of Appeals agreed that most of an insured's claims-handling expert report was legal argument and conclusions, but held that striking the whole report at summary judgment was overbroad, because testimony on industry custom and practice in claims handling is a proper subject of expert opinion, and only the deficient parts should have been struck. |
| Excluded | Martinez v. GEICO Casualty Co.No. 24-10641 | 11th Cir. | 2025 | Affirming summary judgment for the insurer on a third-party bad-faith claim, the Eleventh Circuit held that a claims-handling expert's statement that the insurer violated its duty of good faith was a conclusory legal opinion with no probative value and could not displace the court's own conclusion on the facts. |
| Limited | Phoenix Restoration Group, Inc. v. Liberty Mutual Group Inc.No. 18-2121 | D.D.C. | 2020 | The court barred the insurers' accountant, who had worked on the disputed claims, from also testifying as an independent expert to rebut the insureds' claims-handling expert, holding that expert opinion that his own conduct met industry standards would improperly bolster his fact testimony, and limited him to facts and the opinions that guided his work. |
| Limited | McClure v. Country Life Ins. Co.326 F. Supp. 3d 934 | D. Ariz. | 2018 | In post-trial rulings the court upheld limits on the insurer's claims expert, who testified about the reasonableness of the insurer's conduct but was barred from opining on the ultimate question of bad faith or on matters such as the adjuster's motives. |
| Excluded | 11333 Inc. v. Certain Underwriters at Lloyd's261 F. Supp. 3d 1003 | D. Ariz. | 2017 | The court excluded the insured's bad-faith expert because his list of departures from industry claims standards was not connected to any prejudice in this claim and amounted to an invalid strict-liability theory of bad faith. |
| Limited | O'Sullivan v. Geico Casualty Co.233 F. Supp. 3d 917 | D. Colo. | 2017 | The court allowed the insured's claims-handling expert to describe industry practices and how the insurer departed from them, but excluded his opinions that the insurer acted unreasonably, violated the claims statute, or breached the duty of good faith. |
Each case links to the free opinion text on CourtListener.
In federal court: amended Rule 702
In federal court, since December 1, 2023, Rule 702 says expressly that the party offering an expert must show the court it is more likely than not that the testimony meets each requirement: that it rests on sufficient facts or data, uses reliable methods, and reflects a reliable application of those methods to the case. Questions about the basis of an opinion are no longer automatically matters of weight for the jury. For how the circuits have applied the amendment, see the Rule 702 tracker, which follows each court of appeals; for what that means for preparing or attacking this class of expert, see the guide on amended Rule 702.
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Updated October 4, 2026. How this page is built: rulings are found by searching court opinions on CourtListener. The summaries are written by AI working from the full text of each opinion, and every citation and link is checked automatically. Outcomes are labelled by what the court did with the expert’s testimony. No individual expert is named. This page summarises public decisions for orientation and is not legal advice; read the opinion before relying on any ruling. Spotted an error? Tell us.