When applied to claim analysis, the scientific method is a process by which the forensic engineer seeks to construct an accurate and consistent explanation of cause and origin while minimizing the influence of bias or prejudice. Sometimes, common sense and logic tempt us into believing that no systematic procedure is needed and that our general knowledge and experience alone provides sufficient foundation on which to draw a conclusion. An appropriate and often quoted reminder is, “Smart people can come up with very good explanations for mistaken points of view.”

The scientific method consists of four steps:

1. Observation and description.
2. Formulation of a hypothesis. In forensic engineering, this often takes the form of a causal mechanism or mathematical relationships.
3. Use of the hypothesis to predict the results of new observations.
4. Performance of experimental tests to verify, refine, or reject the hypothesis.

When analyzing a claim, identifying data and information and recognizing the potential difference between the two is important. Data consists of factual observations and descriptions that are organized for analyzation or used to reason and make decisions. Information is derived knowledge of specific events or situations that has been gathered or received through communication. As derived knowledge, the information already may include bias or conclusions formulated without sound foundation. At the scene of an accident, witnesses often formulate mental pictures that make sense and bridge the gaps between what is observed and the final result. These conclusions of causation often are little more than a general correlation of observations lacking sound logic or scientific foundation and sometimes include inherent contradictions.

Below are some common mistakes made while applying the scientific method:

• Conclusions made based on general knowledge without incident-specific data.
• Ignored or ruled out data that does not support the hypothesis. Additional data should be used to further test the hypothesis.
• Systematic errors. Consistently making the same mistake doesn't make the results correct, just repeatable.
• Conclusion by consensus. Repeated analysis and testing of a hypothesis by multiple independent sources is part of the transition from a hypothesis to a scientific theory, but a conclusion is not valid because a majority believes it to be so.
• Using the lack of evidence as proof.
• Improper foundation, faulty logic, or use of correlation to establish causation. For example, consider the following statement: “Each time it rains, there are umbrellas everywhere. Therefore, umbrellas must cause rain.”

Recognize and avoid common mistakes in applying the scientific method. The following examples were found in actual insurance reports (the term engineering reports may have been used despite the lack of use of engineering principles or methods). In general, it is illegal for individuals or companies to offer engineering services to the public or to use the word engineer, engineering, or other forms of the word unless a registered professional engineer is responsible for the work. The claim circumstances and report results are summarized in the following examples.

Knee Deep in Hot Water

A hot water supply line failed in a 12-story hotel, resulting in a multi-million-dollar water loss incident. The hotel had been completely renovated — including plumbing and electrical wiring — one year prior to the loss. The original report made to the insurance adjuster stated simply that the origin of the event was the 10th-floor ceiling in the east building. The cause of the flood was the joint separation between a two-inch pipe and a T-fitting.

When the water was turned back on to test the replacement of the failed joint, multiple secondary leaks occurred, which the report stated must have been caused by a pressure surge. The analysis of the flood stated a cause (a joint failure) and origin (location within the building) and included approximately 100 photographs that documented the water damage throughout the hotel and three photographs of the actual failed plumbing members and location.

The report did not employ a scientific method to technically answer the questions, “How?” and “Why?” in part because the investigation lacked sufficient observations and data, no analysis was apparently performed, and general conclusions were formed consisting of little more than repeating the introductory information and reporting the detailed problem statement.

As a claim adjuster, how would you proceed if the report also included dozens of annotated pictures and a specific explanation of the causal mechanism of failure of the subject connection? The forensic engineering report related the lack of strength of the cemented joint to improper installation, the influence of over-heated water, and initial pipe stress. The report also said that the piping was unnecessarily subjected to significant stress and strain for numerous reasons, including restrictions that limited thermal expansion, bending of pipe segments against other pipes and structural members, bending of pipe to forcefully align or accommodate improperly cut lengths, lack of proper spacing of pipe hangers, and numerous documented examples of other plumbing code violations at the subject location and throughout the hotel. As a result of the subsequent forensic engineering report, the cost of the insured loss was recovered through subrogation.

Hurricane Damage or Maintenance Issues?

Following two hurricane events in central Florida during September 2004, a hotel reported water damage involving approximately 15 percent of its guest rooms. The hotel owner hired a company to perform a site inspection and determined the cause of the water infiltration, which was submitted along with the insurance claim for a roof replacement and repair of water damage. The buildings were steel framed with EFIS (exterior foam insulated system) wall construction and had built-up modified bitumen roofs with tar and gravel ballast. The following examples from the report show how the failure to apply a scientific method resulted in unfounded conclusions.

General statements of weather conditions associated with the September hurricanes reportedly included 15 inches of rain in some areas and sustained hurricane-force winds up to 108 mph. Analysis of weather data for the subject property from a nearby observation site, as well as Doppler weather data overlaid for the specific location, indicated that the maximum sustained wind speed at the subject location during the month was 51 mph and peak wind gust was 70 mph. The maximum 24-hour rain accumulations were 1.60 inches and 4.28 inches, with a monthly total of 9.25 inches (the normal monthly average was 5.64 inches).

The report for the cause of the loss said, “It is our opinion that, more likely than not, the roof system was fractured under the increased stress from the increase uplift pressure during the storm. Wind-borne debris also could have penetrated the membranes.” The opinion was without foundation or supporting evidence, as shown by another comment that said, “There is no question that the type of damage was caused by roof leaks, yet there was no apparent sign of distress to the roof membranes.”

In the same report, other statements that contradict the wind-uplift conclusion were made. “We consider the water infiltration in the roof system to be a progressive failure, which ultimately worsened over time,” read one of the statements. “Although some pre-existing conditions were identified that may have contributed to the water infiltration problem, we consider these details minor and without consequence to the overall scope of our investigation,” said another. The report selectively ignored evidence contrary to the conclusion and indicated that the cause of the loss was due to a specific hurricane event and was a progressive failure that worsened over time.

Critical data that was not identified during the initial investigation included that the primary roof drains had been capped following the expansion and renovation of the hotel, which eliminated critical storm drainage means. A parapet wall had been added to the full perimeter of the roofs with scuppers added for drainage. The scupper locations coincided with the expansion joints of the roof and provided an ideal leak path under the roof surface.

The 22-year-old roof also showed many signs of prolonged lack of maintenance, including rusted-out condensation drain pans with thick, organic matter growing under the rooftop air conditioning units, rotted-out wood frames at roof access and skylight locations, rusted nails and flashing portions that left open holes, old roofing sections that lacked asphalt with visible fiberglass, and significant evidence of long-term ponding or water-retention problems. An aerial photograph taken two years prior to the loss showed the hotel roof with large wet areas and organic growth similar to fields of green around ponds. The date of the photograph was compared to historic weather data, which indicated no precipitation had occurred in the area for the six days preceding and including the date of the photograph.

CSI – Claim Scene Investigation

What can you do to assure accurate claim analysis and assist the forensic engineer? Beyond the documentation of the accident or loss, focus additionally on details, data, and any potential indication of causation. The following are reminders that may significantly impact a case:

Identify and preserve evidence. During the effort to mitigate damages or clear an accident scene, it is not uncommon for evidence to be removed, lost, or discarded. Instruct those present to secure and maintain potential evidence. Whenever possible, have photographs taken prior to removing anything from the scene. Document stored evidence and maintain a chain-of-custody record.

Photographs and video should give additional attention to the origin and cause. For accidents, include details of the surroundings, fixed reference points, points of view and visibility, debris, road scars, and skid marks. Photographs of the interiors and components within the vehicles involved often are critical in determining occupant dynamics and injuries.

Document everything. Preserve how the loss occurred, those involved, circumstances, conditions, and try to construct a timeline of potentially related events that led to the accident or loss.

Statements: The more the better. Written or recorded statements from witnesses provide valuable information that often is lost through paraphrasing or lack of familiarity of technical terms. Contrived or rehearsed statements, results contrary to laws of science and engineering principles, inconsistent time and event sequences, out-of-place elements, and conflicting data may all be indications of potential fraud.

Check for silent witnesses. Recognize and seek out sources of critical data and information that are silent. Numerous vehicles are equipped with sensor diagnostic modules or crash data recorders containing pre-impact and post-impact data. Look for sources of video monitoring that may have inadvertently or unintentionally captured an event. Many locations such as banks, ATMs, gas stations, hotels, car washes, intersections, and parking lots have video monitoring. Time is of the essence because the recordings often are not maintained very long.

Conduct systematic analyses. Do not assume a conclusion of causation and liability without resolving technical issues of feasibility and understanding how and why. There is more to liability than a traffic ticket. Despite physical evidence at the scene, a traffic citation may not be written for many offenses unless witnessed by the officer. Verbal admissions of fault may be based on a layperson's interpretation and assumption of what must have happened, despite technical evidence or conflicting data.

Ensure that forensic engineering reports are easy to read. The report should be understandable but may need to be included in potential litigation, so be aware that technically precise language often is required. Do not hesitate to ask questions. Engineering reports should provide you with answers and assist the claim professional in effectively and efficiently determining what happened.

Forensic engineers may quickly resolve issues and questions based on their technical understanding and systematic problem solving. The adjuster may seek guidance and explanation, identification and potential for subrogation, analysis of the claims of other carriers, or a full forensic investigation and analysis.

Elliot L. Stern is president of Florida Forensic Engineering in Tampa, Fla. He can be reached at [email protected] or 813-868-3334.