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Health Insurance
There are 9 expert consultants in this category

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Gerald Katz, MSPA, RHU, ALHC, FACFE, DABDA
President & Founder
P.O. Box 266257
Weston FL `
USA
phone: 877-776-3948 or 954-217-8260
fax: 954-217-8241
Gerry Katz is an Expert Witness and Disability Insurance Claim Consultant with more than 40 years experience in the disability insurance arena. He helped a major insurance carrier design their entire portfolio of disability insurance products. Mr. Katz is the 1997 recipient of the Harold R. Gordon Memorial Award for the "Health Insurance Industry Person of the Year," granted by the National Association of Health Underwriters.
10/24/2005 · Disability
Disability Insurance Claims – An Inside View
Those of you marketing disability insurance today will no doubt agree that our choices in competitive contracts have significantly changed and diminished in number during the past 5-8 years

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Gregory G. Wimmer
3400 Pembrooke Parkway South
Colleyville TX 76034
USA
phone: 817-540-3141
fax: 817-540-3795
Gregory G. Wimmer is a veteran of the Life, Health and Annuity Business. Mr. Wimmer has been retained over 100 times in both federal and state courts in 33 states. He has the requisite background to render opinions in:

  • Life Insurance Underwriting
  • Agent and Broker Standard of Care
  • Life Insurance
  • Health Insurance
  • Annuities, Disability Income and related areas.

    Other areas of expertise include:

  • Health insurance
  • Equity Indexed Annuities
  • Variable Annuities
  • Disability Income Insurance
  • Long Term Care Insurance
  • Life Insurance Claims
  • Health Insurance Claims
  • Health Insurance Underwriting
  • Structured Settlements
  • Agents Duties and Standards of Care
  • Company Practices and Training
  • Agent and Agency Practices
  • ERISA plans

    View Expert Cases.
  • 3/21/2012 · Insurance
    Life Insurance: Term, Permanent, Universal and Variable
    Over the years the life insurance industry has been slow to develop new and consumer driven product. Instead carriers chose to offer their own version of a product all other carriers offered and simply compete at price or benefit with competitors.

    Insurance: Structured Settlements
    Structured Settlements are a unique and specific product used in the settlement of claims and lawsuits where there is either a large amount of money and/or a need for the management of funds. The basis of a structured settlement is contained in Section 104 (a)(2) of the IRC. They are simply a means for qualified settlements, usually in personal injury cases, whereby the recipient of a settlement receives their funds in a more flexible and tax advantaged way, rather than in a single lump sum settlement.

    7/27/2011 · Insurance
    Insurance: ERISA, NASD (FINRA) and Variable Contracts
    ERISA has many very specific requirements as it relates to product and producer relationships. If a case involves an ERISA plan, duties of the producer and the carrier can be elevated simply because it is covered under ERISA.

    5/26/2011 · Insurance
    Insurance: Agency And Company Operations
    Every carrier has some system of product distribution. Some have employees; others have career agents who are technically not employees, while still others use a system of independent brokers.

    4/2/2011 · Insurance
    Agent And Broker Standards And Practices
    This category of case is the most common area of consultation. Since the agent, broker or registered representative is the only constant throughout the entire process of soliciting, procuring and completing the application, forwarding it to a carrier for an underwriting decision and servicing the owner of the policy after purchase, he/she is the one participant familiar with the client and the process from start to finish.

    2/22/2011 · Insurance
    Life, Health And Disability Claims
    Most disputes arise in the area of claims. This results because for whatever reason, some sound and others speculative, the claim is denied at the death , disability or sickness of the insured.

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    Peter F. George
    Principal

    P.O. Box 833
    Petersham MA 01366
    USA
    phone: 978-724-0299
    Peter F.
    Healthcare Litigation Support is a team of experts - physicians, healthcare administrators, reimbursement specialists, health organization experts, health insurance experts, and other healthcare personnel - with broad, extensive experience and expertise in medical and administrative malpractice issues, physician practice operations, hospital management, health insurance and TPA issues, Medicare and Medicaid, medical billing and collections, fraud and abuse, managed care and other areas.

    Healthcare Litigation Support is a team of experienced healthcare experts who consult on litigation issues and testify as needed. In addition to the four Principals, there is a larger group of Associates, individuals with specific expertise and areas of knowledge, we include in order to fully serve the needs of the legal community.

    Areas of Expertise:
  • Audit
  • Medical Standards of Care
  • Dental Standards of Care
  • Geriatrics and Nursing Home Care Standards
  • Long Term Care Standards
  • Health Insurance
  • Health Insurer-Provider Relations
  • Managed Healthcare (HMO, PPO)
  • TPA (Third Party Administrator
  • National Accreditation Guidelines
  • Medicare / Medicaid
  • Federal Employees Health Benefits Program
  • CDH (Consumer Driven Health Plans)
  • ERISA, COBRA, EMTALA, HIPAA
  • Physician / Hospital Joint Ventures
  • Qui Tam and False Claims Act


  • Representing Both Plaintiff and Defense, Our Services Include:
  • Review Case for Merit
  • Analyze Medical and Administrative Events
  • Identify Causation
  • Address Standards of Care
  • Research Relevant Literature
  • Interpret Contracts in Light of Industry Standards
  • Evaluate Case Strengths and Weaknesses
  • Develop Deposition Strategy
  • Prepare a Defensible Report
  • Articulate Complex Issues to Triers of Fact
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    L. Lamar Blount
    CPA, FHFMA, CFF
    P.O. Box 2166
    Atlanta GA 30077-2166
    USA
    phone: 770-645-5989
    fax: 404-759-2114
    During 30+ years of serving the Healthcare Industry, Mr. Blount has served more than 300 clients in 30 states in the areas of False Claims, Regulatory Compliance, Reimbursement, Damage Quantification, and Financial Management.

    Mr. Blount is a Fellow and Certified Financial Professional in the Healthcare Financial Management Association, member of the American Institute & Georgia Society of CPAs, and National Association of Health Underwriters, and has been an Arbitrator for American Health Lawyers Association. He has been admitted as an expert in multiple US District and State Courts and Administrative Hearings, and has testified for plaintiffs and defendants, providers, payors and government clients.

    A nationally recognized author, Mr. Blount has co-authored AMA’s best selling "Mastering the Reimbursement Process" book.

    Expertise Includes:
  • Accounting
  • APCs
  • Business Damages
  • Contractual Disputes
  • Cost Reports
  • DRGs
  • ERISA
  • False Claims - Fraud
  • HIPAA
  • ICD & CPT Coding
  • Insurance
  • Rate Setting
  • Self Disclosure
  • Valuations
  • CV and Legal references provided upon request.
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    ALL States
    USA
    phone: 215-736-2980
    fax: 215-736-2986
    Insurance Expert Network, LLC (IEN) is a network which includes over 200 highly qualified, reliable Insurance Experts with Litigation Management, Insurance Industry, and Expert Witness experience. Staffed by Insurance Industry Professionals, they easily discern requisite skills necessary to properly and fully support the Client. IEN is the only referral service providing insurance experts exclusively.

    IEN provides experts for both plaintiffs and defendants

    The experts in IEN are dedicated to their critical role in litigation, whether it be educating counsel on nuances of insurance, assisting attorneys in determining the merit of a case, testing potential evidence or testifying in a deposition or trial.

    IEN provides in-depth knowledge of the Insurance Industry and maintains a listing of over 120 Specialized Insurance Areas. The following is a sample of these areas:

    • Actuary
    • Automobile Insurance
    • Bad Faith
    • Binders
    • Business Interruption
    • Captives
    • Construction Defects
    • Credit Insurance
    • Directors & Officers
    • Excess & Surplus Lines
    • Fidelity
    • Fraud
    • General Liability
    • Insurance Accounting
    • Insurance Business Processes
    • Life & Health Insurance
    • Marine Insurance
    • Misrepresentation
    • Producer Errors & Omissions
    • Producer Standards & Practices
    • Production Development
    • Professional Liability
    • Property Insurance
    • Regulatory Compliance
    • Reinsurance
    • Surety
    • Workers Compensation
    View the Complete List of Specialized Insurance Areas

    The IEN Advantage:
    1. There is no charge for referrals.
    2. Generally, a nationwide search and subsequent referral can be completed within 48 hours.
    3. To assist the attorney with the selection process, IEN provides a case-specific statement of qualification from each potential expert.
    4. IEN personnel are highly experienced and knowledgeable about insurance.
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    Robert Dobson
    Principal, Consulting Actuary
    3000 Bayport Drive, Suite 1050
    Tampa FL 33607
    USA
    phone: 813-282-9262
    fax: 813-282-8276
    Milliman’s Tampa Office provides Health Insurance, Health Care and Employee Benefit Consulting to law firms, insurance companies, hospitals, HMO’s, Blue Cross/Blue Shield plans, employers and government agencies. Our staff is experienced with medical, dental, long-term care, Medicare supplement & critical illness.

    We assist clients nationwide with forensic actuarial work, rate filings, regulatory compliance, reserve projections, valuations, employee benefit analysis and design, mergers and acquisitions, demutualizations, claim cost analysis, and utilization management programs.

    These health care services are used in litigation relating to:
  • Pricing & Underwriting
  • Senior Services
  • Contract Development and Negotiations
  • New Plan Design
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    Daryll W. Martin
    President
    100 NW Loop 410, Ste. 700
    San Antonio TX 78213
    USA
    phone: 210-366-8722
    fax: 210-366-0198
    Daryll W.
    Daryll W. Martin - Unique Professional Experience as a Lawyer, Insurance Broker and Insurance Brokerage Executive. Mr Martin has over 24 years of insurance experience, serving nearly half of that time as corporate counsel for two international brokers, and the other half of that time as a senior insurance brokerage executive.

    Broad Coverage Experience: Property & Casualty; Employee Benefits / Life & Health (qualified and non-qualified); D&O / Employment Practices Liability / Fiduciary; Property / Business Interruption / Boiler & Machinery / Inland & Ocean Marine; Casualty: General Liability / Professional Liability / Workers Compensation / Umbrella / Excess.

    Broad Brokerage Customer Industry Experience: Construction; Energy; Transportation; Manufacturing; Financial Institutions; Health Care; Public Entity / Not For Profit; and, Technology

    Extensive Insurance Industry Operational Experience: Executive officer of nationally ranked insurance brokers; Managed and handled a variety of international, national, and middle market accounts; Self Insurance / Large Retentions / Alternative Risk Transfer Vehicles; Foreign Placements; Wholesale Brokerage; Insurance Underwriting; Reinsurance; Technical Services / Loss Control / Actuarial/Risk Management Consulting; Actuary Services / Actuary Liability; Insurer Solvency / Market Security; Finance and Accounting; Mergers & Acquisitions; Insurance Sales; Client Service Standards; Technology Infrastructure; Human Resource Management; and, Insurer / Broker Relationship Management.
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    Langley and Banack, Inc.
    J.D., CLU, CPCU, CIC
    745 E. Mulberry, Suite 900
    San Antonio TX 78212
    USA
    phone: 210-736-6600
    fax: 210-735-6889
    Langley and Banack, Inc.
    Thomas H. Veitch, J.D., CLU, CPCU, CIC, has been engaged in the practice of law since 1973. His total experience in the Insurance Business exceeds 40 years and encompasses experience in Claims Adjusting, Underwriting, Sales and Field Management Positions, Insurance Defense Work, Agency Consultation in Mergers / Acquisitions and Valuations, Mediation, Expert Witness / Consulting, and similar Insurance Law matters.

    Areas of Focus:
  • Agents or Brokers Errors and Omissions
  • Insurance Coverage Analysis
  • Bad Faith / Misrepresentation
  • Claims Handling Standards
  • Insurance Industry Customs and Practices
  • Insurance Law
  • Mediation
  • Arbitration
  • Consulting / Expert Witness
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    Prof. William J. Warfel, Ph.D., CPCU, CLU
    Professor
    Indiana State University, Insurance and Risk Mgt. Program
    Scott College of Business
    Terre Haute IN 47809
    USA
    phone: 812-237-2122 or 765-653-0662
    fax: 812-237-4374
    Prof. William J. Warfel, Ph.D., CPCU, CLU specializes in Insurance Breach of Contract, Bad Faith, and Agent / Broker Liability Issues. He has been retained in about 58 cases by attorneys who represent policyholders, insurance agents, insurers, and third parties. Prof. Warfel's experience includes actual courtroom testimony. He is also widely published in applied, professional journals.

    Prof. Warfel has been retained in cases involving:
  • Commercial General Liability
  • Personal Auto
  • Homeowners
  • Commercial Auto
  • Commercial Property
  • Business Income
  • Individual Life
  • Medical Expense
  • Disability
  • Professional Liability
  • Employee Dishonesty
  • Worker Compensation
  • Financial Institution Bond
  • Bid Guaranty and Contract Bond
  • Public Official Bond
  • Inland Marine
  • Indemnification Agreements
  • Certificates of Insurance