Your Right to the Assessor Report: What Insurers Must Disclose

Yes, you have the right to request a copy of the assessor's report on your insurance claim. Under the General Insurance Code of Practice (section 7.8), your insurer must provide you with copies of any reports they relied on to make their decision, including loss assessor and expert reports. Request it in writing and cite the Code if your insurer refuses.

Key takeaways

• Under section 7.8 of the Code of Practice, your insurer must provide copies of reports they relied on to make their decision.
• This includes loss assessor reports, expert reports, engineering reports, and medical reports.
• Request it in writing. If the insurer refuses, cite the Code of Practice and lodge an IDR complaint about the refusal itself.
• The report often reveals weaknesses in the insurer's reasoning that you can challenge in your dispute.

When your insurance claim is denied, you deserve to know exactly why. That means seeing the assessor's report the insurer used to make their decision. Despite what some insurers suggest, you have a clear right to access this document, and understanding what it says is often the first step in successfully challenging a claim denial.

Yet many policyholders never see the report. They are told it is confidential, or that it was prepared for internal purposes only. These responses are misleading, and in many cases they breach the insurer's own industry obligations.

What the Code of Practice Requires

The General Insurance Code of Practice 2020 sets out the standards insurers must follow when handling claims. Under Part 8 of the Code, when an insurer denies a claim or does not pay it in full, they must provide you with clear reasons for their decision. Crucially, this includes providing access to the information and documents they relied on to reach that decision.

Paragraph 81 of the Code requires your insurer, when it denies your claim or does not pay it in full, to tell you in writing that you can ask for copies of any service supplier or external expert reports it relied on. Paragraph 82 then requires it to give you those reports within 10 business days of your asking. An assessor's report falls squarely within this. Whether the insurer engaged a building assessor, a hydrologist, an engineer, or any other expert, you are entitled to see what they found and what they recommended.

This obligation is reinforced by the duty of utmost good faith under Section 13 of the Insurance Contracts Act 1984. This duty requires both parties to act honestly and fairly. Withholding the very evidence used to deny your claim falls well short of that standard.

The "Internal Use Only" Excuse

One of the most common responses consumers receive when requesting an assessor's report is that it was prepared "for internal purposes only" and cannot be shared. This is not a valid reason to withhold the report.

If the insurer relied on an assessor's report to make their decision about your claim, that report is not merely an internal document. It is a key piece of evidence that directly affected your rights. The Code of Practice does not distinguish between internal and external reports when it comes to disclosure obligations. What matters is whether the report was relied upon in the decision-making process.

AFCA (the Australian Financial Complaints Authority) has consistently taken a dim view of insurers who refuse to disclose reports on this basis. In multiple determinations, AFCA has found that failing to provide assessor reports to policyholders undermines transparency and can amount to a breach of the Code of Practice. AFCA has also noted that when an insurer withholds a report, it may be reasonable to draw an adverse inference. That means the ombudsman may assume the report does not fully support the insurer's position.

How to Request the Assessor Report

Requesting the assessor's report does not require a lawyer or any special process. Here is how to go about it.

1. Put your request in writing. Email your insurer's claims team and clearly state that you are requesting a copy of any assessor, expert, or service supplier reports relied upon in the decision on your claim. Include your claim number and policy number.
2. Cite your entitlements. Mention that under the General Insurance Code of Practice 2020, paragraphs 81 and 82, you are entitled to copies of the reports relied upon in the claims decision and the insurer must provide them within 10 business days of your request. Note too that under paragraph 163 an insurer may refuse access only in limited circumstances, and even then it must still give you any external expert reports it relied on. You can also reference Section 13 of the Insurance Contracts Act 1984 and the duty of utmost good faith.
3. Set a reasonable timeframe. Give the insurer 10 business days to provide the report. This is consistent with the timeframes AFCA considers reasonable for responding to information requests.
4. Keep records. Save a copy of your email and note the date you sent it. If you follow up by phone, record the date, time, and the name of the person you spoke with.

A simple request might read:

I am writing to request copies of all assessor and expert reports relied upon in the decision to deny claim [number]. I am entitled to this information under paragraphs 81 and 82 of the General Insurance Code of Practice 2020, which require you to tell me of that right and to provide the reports within 10 business days of my request. I also rely on the duty of utmost good faith under section 13 of the Insurance Contracts Act 1984. Please provide these documents within 10 business days.

What to Do if the Insurer Refuses

If the insurer refuses to provide the report, or simply ignores your request, you have several options available to you.

Escalate Through Internal Dispute Resolution

Lodge an Internal Dispute Resolution (IDR) complaint with the insurer. Under ASIC Regulatory Guide 271 the insurer must acknowledge your complaint within one business day, and under paragraph 147 of the General Insurance Code of Practice they must provide a written response within 30 calendar days. In your IDR complaint, specifically state that the insurer has failed to comply with paragraphs 81 and 82 of the Code by withholding the assessor's report. Those paragraphs require the insurer to tell you of your right to the reports it relied on, and to provide them within 10 business days of your request. Paragraph 163 allows an insurer to refuse access only in limited circumstances, and even then it must still give you any external expert reports it relied on.

Lodge a Complaint with AFCA

If the IDR process does not resolve the issue, you can lodge a complaint with AFCA free of charge. AFCA can require the insurer to provide the report, and failure to do so during the AFCA process will likely count against the insurer. AFCA has the power to make binding determinations, and a pattern of non-disclosure is something AFCA takes seriously when deciding whether the insurer has acted fairly.

Report the Breach

You can also report the insurer's conduct to the General Insurance Code Governance Committee (CGC), which monitors compliance with the Code of Practice. While the CGC cannot resolve individual disputes, a breach finding can put pressure on the insurer to improve its disclosure practices and may support your case at AFCA.

Why the Assessor Report Matters for Your Dispute

The assessor's report is often the single most important document in an insurance dispute. Here is why it deserves your attention.

• It reveals the basis for the denial. The report will typically set out what the assessor inspected, what they found, and what they concluded. Understanding the specific reason for the denial allows you to respond with targeted evidence rather than general arguments.
• It may contain errors. Assessors are not infallible. Reports sometimes contain factual mistakes, such as incorrect measurements, wrong dates, or descriptions that do not match the actual damage. Identifying these errors can significantly strengthen your dispute.
• It may support your claim more than you expect. In some cases, the assessor's own findings actually support the policyholder's position, but the insurer has interpreted the report selectively. Having the full report allows you to point to favourable findings the insurer may have overlooked or downplayed.
• It provides a roadmap for your response. Once you know what the assessor found, you can obtain your own evidence to counter or supplement their conclusions. This might include an independent expert report, photographs, maintenance records, or witness statements.

AFCA's Approach to Disclosure Failures

AFCA has addressed disclosure failures in numerous determinations. A recurring theme in these decisions is that transparency is fundamental to fair claims handling. When insurers fail to provide assessor reports, AFCA has found that the insurer did not act consistently with the duty of utmost good faith, that the policyholder was denied the opportunity to meaningfully respond to the reasons for the denial, and that the insurer's decision-making process lacked the transparency required by the Code of Practice.

In practical terms, this means that if your insurer refuses to share the assessor's report, AFCA is likely to view that refusal unfavourably. It can shift the balance of the dispute in your favour, particularly when the insurer cannot offer a legitimate reason for withholding the document.

How The Fair Claims Co Can Help

Navigating the disclosure process and making sense of assessor reports can be challenging, especially when you are already dealing with the stress of property damage or a claim denial. The Fair Claims Co specialises in preparing dispute documents and AFCA submissions for consumers across Australia.

We can help you draft a request for the assessor's report, identify errors or omissions in the report, and build a clear, evidence-based case to challenge the insurer's decision. If you have been denied a claim and are struggling to get the information you are entitled to, get in touch for a no-obligation conversation about your options.

If the assessor report attributes damage to wear and tear, our guide to challenging wear and tear denials explains the legal distinction between genuine gradual deterioration and damage caused by an insured event.