Health Insurance Expert Witnesses: 12

Wayne Citron has 45 years of experience as an expert in Forensic Reconstruction of Insurance Transactions. He is an insurance expert and consultant.

Litigation Support - Wayne Citron specializes in policy interpretation of the rules, laws, and regulations governing insurance and financial matters. His services are available to attorneys representing plaintiff and defendant and include effective reports, affidavits, depositions, and testimony as needed.

Areas of Expertise:

Insurance Bad Faith Insurance Customs and Practices Insurance Health / HMO / Disability

Insurance - Life & Annuities Property / Casualty Insurance Insurance Agents & Brokers - Standard of Care

Mr. Citron established the Citron Agency and CMC Advisors Inc. in 1972, where his duties included executive and managerial responsibilities, sales, service, compliance with all insurance matters as well as securities laws and regulations. Both firms are leaders in life, health, disability and property and casualty insurance.

Mr. Citron is an expert in all forms of insurance, including:

Life Insurance Health Insurance Property and casualty Insurance Disability Insurance Annuities Retirement, IRAs & Pensions

Flood Insurance Broker Malpractice / Bad Faith Profit Sharing Group Coverage Self-insurance Insurance Laws / Regulations

Mr. Citron has served as an instructor for Prudential Insurance Company Brooklyn Agency (1973) educating personnel in general insurance matters, underwriting, and insurance law. He has worked with companies including Prudential Insurance Company, United States Life Insurance Company, North American Company for Life and Health Insurance, American General Life Insurance Company, William Penn Life Insurance Company, American Life Insurance Company, Chubb Insurance Company, Travelers Insurance Company, Mass Mutual Insurance Company, John Hancock Insurance Company, and American International Group (AIG), among other.

View CMC Advisors' Consulting Profile.

Vera Dolan is an epidemiologist with over 30 years of experience in the life and health insurance industries. She is one of the leading mortality experts in the life insurance industry. She writes underwriting manuals and policy and procedure manuals for life and health insurance companies.

Vera has testified in both state and federal court, and has been retained in over 200 cases since 2006 for plaintiffs and defense on an equal basis. She is very credible testifying in deposition and on the stand.

* Life expectancies that are personalized and accurate to the standards of the life insurance and life settlement industries. Addresses the cases when life expectancies that are simply taken from a life table or estimated by a doctor, actuary or biostatistician are too long, too short, insufficient or not credible. Addresses the cases when a complete insight into the individual's medical conditions and/or personal history of high-risk behaviors is needed to assist the judge or jury in their decision. This information often decides the case, see article for details.

* Expert in bad faith/wrongful denial of life/health insurance claims.

* Expert in life/health insurance underwriting material misrepresentation.

* Expert in medical risk assessment and underwriting issues.

* Expert in life insurance underwriting policies and procedures.

* Expert in epidemiology. Previous cases include infectious diseases, occupational and environmental exposures, pesticides and tobacco.

* Approved life expectancy expert with the U.S. Department of Justice.

* Active consultant to the life insurance industry conducting cohort mortality studies, and writing underwriting and policy and procedure manuals.

* Over 100 articles published on mortality research and underwriting.

* Friendly, clear, concise, objective and quantitative.

* There is no charge for the initial phone consultation.

* There is no charge for travel time.

HLN offers Peer-reviewed methodologies and Appellate court proven testimony by experienced professionals who have provided consulting services and conducted audits and investigations for hundreds of hospitals, physicians and other healthcare providers nationwide. HLN's experts have provided expert testimony in administrative and regulatory proceedings, as well as in state and federal courts for civil and criminal cases, for plaintiffs and defendants.

HLN provides experts in: medical billing, reasonableness of charges, reasonable value of medical services, Medicare & Medicaid reimbursement and compliance, clinical documentation, medical record coding, economic damages, insurance disputes, lost profits and false claims. HLN's founder co-authored two editions of the AMA's best selling Mastering the Reimbursement Process book. 

HLN's Consultants include:

Certified Public Accountants (CPA)  Certified Coding Specialists (CCS and CCS-P) Certified in Financial Forensics (CFF)  Certified in Healthcare Compliance (CHC)  Certified Fraud Examiner (CFE)  Certified Healthcare Chart Auditor (CHCA)  Certified Professional Coder (CPC and CPC-H)  Licensed Insurance Agents RN, MD, DO and DCs Financial Analysts Statisticians

For 34 years, Steven Plitt has represented policyholders / insureds in litigation and trial as well as representing insurance companies in Insurance Coverage and Bad Faith matters. During his career, he has reviewed thousands of claim files from more than 100 insurance companies. He has regularly consulted with all levels of claim department management from claim adjusters, supervisors, branch claim managers, claim-legal personnel and executive level insurance company management.

Mr. Plitt has also consulted with underwriting departments and participated with insurance company product development units and claims-legal to draft insurance policy language. He has reviewed and analyzed a broad spectrum of testimony from claims adjusters, claims management, claims attorneys, underwriters and other insurance company management as well as other insurance experts. He has reviewed an extensive variety of claims manuals, claims guidelines and other claims directives and practices.

Mr. Plitt is a nationally recognized expert witness in insurance claim handling and bad faith cases and has been retained as an expert in hundreds of cases nationally. He has qualified in both state and Federal Courts as a claims handling and insurance expert. He is currently an Adjunct Professor of Law at the University of Arizona where he teaches insurance law.

Areas of Expertise:

Insurance Extra-contractual Bad Faith Claims / Breach of Contract Claims Claims Handling Practices Unfair Claims Practices Policy Interpretation Coverage Denials

Property & Casualty Insurance Personal & Commercial Lines Surplus Lines Excess & Umbrella Insurance Insurance Agent / Broker Errors & Omissions Miscellaneous Coverage

Mr. Plitt has an LL.M. in Insurance from the University of Connecticut. He is the current successor author to COUCH ON INSURANCE 3D where he and his team are rewriting and revising the entire treatise. He has written other books on insurance law. He has published in excess of 320 law reviews and other professional publications on insurance law in addition to his books. Mr. Plitt has been cited by the Supreme Courts in 32 states, the Intermediate Appellate Courts in 23 states, 10 of the Federal Circuit Courts of Appeal, 54 Federal District Courts, the Federal Court of Claims and Federal Bankruptcy Court. Mr. Plitt has been cited in the Code of Federal Regulations. Mr. Plitt has also been cited in 91 scholarly articles.

Steven Plitt has been continuously listed as a top 50 lawyer in Arizona (2007-2014) by SOUTHWEST SUPER LAWYERS®, has been listed in BEST LAWYERS® since 2007 (insurance), and was named the Insurance Lawyer of the Year by BEST LAWYERS® in 2012 for Phoenix. He is a Fellow in the American College of Coverage and Extracontractual Counsel and a Member of the American Law Institute where he is a consultive member on the development of the RESTATEMENT OF LIABILITY INSURANCE.

Kimberly A. Baldwin-Stried-Reich, MBA, MJ, PBCI, CPHIMS, RHIA, CEDS, CPHQ, FAHIMA, has over 30 years of experience in a variety of healthcare settings. She specializes in Healthcare Informatics and HIPAA Compliance.

Ms. Reich holds a Master’s of Business (MBA) from the Lake Forest Graduate School of Management, a Master’s of Jurisprudence (MJ) in Health Law and Policy from the Loyola School of Law - Beazley Institute for Health Law and Policy in Chicago, IL and a Post Baccalaureate in Clinical Informatics (PBCI) from the Johns Hopkins School of Medicine Clinical Informatics Certificate Program.  She is the first Registered Health Information Administrator (RHIA) to complete the Johns Hopkins Division of Health Sciences Informatics Certificate Program and certification in EDiscovery. She is the lead author of the 2012 AHIMA publication E-Discovery and Electronic Records, a first of its kind healthcare e-discovery resources. 

Ms. Reich maintains active membership and participates in The Sedona Conference® for Privacy & Security & Electronic Records Production, American Health Information Management Association (AHIMA), American Medical Informatics (AMIA), Healthcare Compliance Association (HCCA), Society for Corporate Compliance & Ethics (SCCE), Society for Participatory Medicine (SPM), American Society for Healthcare Risk Management (ASHRM), Information Governance Initiative (IGI) and Greater Chicago Health Information Management Systems Society (GCCHIMSS).

Litigation Support - Ms. Reich is an expert witness for both defense and plaintiff legal counsel in matters involving HIPAA, e-discovery, and Electronic Health Records Systems fraud and abuse. Her services include thorough report preparation, depositions, and trial testimony. 

Areas of Expertise:

Electronic Health Records (EHRs) Electronic Medical Records (EMRs) Healthcare Compliance Healthcare EDiscovery / Electronic Data Discovery Health Insurance Portability and Accountability Act (HIPAA) Health Insurance Healthcare Fraud and Abuse

Healthcare Privacy and Security Healthcare Risk Management  Healthcare Quality Improvement Joint Commission Accreditation National Committee Quality Assurance (NCQA) Information Governance (IG) Clinical Documentation

View Kimberly Reich's Consulting Profile.

Mitchell L. Lathrop, has over 50 years of experience in the practice of law, and specialized knowledge in Insurance, Reinsurance, and Lawyers' Professional Responsibility. For the past 30 years, Mr. Lathrop has served as a Mediator, Arbitrator and Expert Witness in his fields of expertise. A seasoned trial lawyer, he brings his many years of practice to alternative dispute resolution. Mr. Lathrop is admitted to practice in California, New York and the District of Columbia, as well as before the U.S. Supreme Court and the U.S. Courts of Appeals for the Second, Fifth, Ninth, Tenth, District of Columbia and Federal Circuits. Mr. Lathrop is a former Presiding Referee of the California State Bar Court. He serves on the National Panel of the American Arbitration Association and is a Distinguished Neutral of the International Institute for Conflict Prevention and Resolution (CPR), as well as a member of the London Court of International Arbitration. He is the author of "Insurance Coverage for Environmental Claims," published by Lexis-Nexis Matthew Bender. He has qualified as an expert in insurance and legal malpractice in both state and federal courts. Areas of Expertise:

• Insurance bad faith and standard of care and conduct
• Reinsurance Law - Property and Casualty insurance
• Treaty and Facultative Reinsurance
• Environmental Insurance
• Complex insurance coverage Issues
• Lawyers' Professional Responsibility

Jeffrey D. Diamond specializes in Insurance Coverage Disputes and Litigation. He has established his law firm as one of the premier Insurance Coverage law firms in the Metro Atlanta area on behalf of policyholders, as well as throughout the State of Georgia and, as he was initially admitted to the State Bar of California in 1978, he serves policyholders in California, as well.

In addition to his full time law practice, Mr. Diamond has served as an Adjunct Professor of Insurance Law since 1995 in both California and Georgia, having joined the Georgia State University College of Law faculty in 2009 as an Adjunct Professor of Insurance Law and, in 2012, he joined Atlanta’s John Marshall Law School in a similar capacity. 

Mr. Diamond is also a law instructor for the National Association of Certified Valuators and Analysts (NACVA), a national educational organization which conducts continuing education programs for financial professionals across the country, teaching in NACVA’s Expert Witness Bootcamp program. Mr. Diamond has been an invited guest speaker on topics of interest at numerous insurance conferences throughout the country.

Over his 37 year career, Mr. Diamond has successfully represented policyholders, and formerly Insurance companies, in a wide variety of insurance coverage and bad faith actions including:

• Business Insurance Litigation
• Homeowners Insurance Litigation
• Construction Defect Litigation
• General Business Property and Liability Claims
• Long Term Disability Claims
• Life Insurance Claims

Litigation Support - Mr. Diamond's experience as an insurance litigator and insurance law professor allows him a unique perspective as an expert witness. His extensive knowledge of insurance law and keen insights into insurance policy interpretation, as well as the covenant of good faith and fair dealing under each State’s insurance related statutes and case law, make him an exceptional expert witness with regard to coverage and bad faith actions. 

Mr. Diamond's services are available to counsel for both Plaintiff and Defense. He has been retained more than 20 times for his expertise in matters regarding Bad Faith, First and Third Party Insurance Coverage, and Insurance policy Interpretation for the following:

Liability & Property Insurance Fire Insurance Life Insurance Business Insurance

Homeowners Insurance Automobile Insurance Disability Insurance

View Jeffrey Diamond's Consulting Profile.

Maurice Lieberman, CLU, ChFC, RHU, LUTCF, has over 40 years of experience specializing in Insurance and Financial Planning.

Mr. Lieberman holds three professional designations from the American College, Chartered Life Underwriter, Chartered Financial Consultant, and Registered Health Underwriter. He is a Life Insurance Training Council Fellow, and a member of the American College of Financial Services Professionals, Forensic Expert Witness Association, and the American College of Forensic Examiners International.

Background Experience - Mr. Lieberman started as an insurance agent for Metropolitan Life and then advanced in his career to manage brokers. He successfully built agencies for Aetna, and Principal Financial Group. He was later promoted to Regional Director for New England Financial, and CSAA Life. Over the years he mentored hundreds of insurance agents, brokers, financial planners and agency managers to build their own successful careers and agencies. He was also a member of the Million Dollar Round Table and utilized his selling and management experience to train insurance agents, brokers and financial planners in advanced areas of estate, business insurance, and financial planning.

Litigation Support - . Mr. Lieberman has utilized his financial planning and insurance industry knowledge to consult with attorneys for over the past 12 years. He consults with attorneys and assists council in trial preparation regarding issues of life insurance and annuity coverage analysis, coverage disputes, and company practices. He has been called upon to be an expert witness in insurance litigation cases for both plaintiff and defendant.

Areas of Expertise:

Life Insurance Coverage Analysis Annuity Coverage Analysis Coverage Disputes Company Practices Life Insurance Products and Services

Contract Analysis Regulations Compliance Best Practice Principles Life Insurance Underwriting Procedures

View Maurice Lieberman's Consulting Profile.

Lezlee Liljenberg, CIC, CRIS, MLIS, PA, MA, entered the Insurance business in 2004 as she started her first agency from ground zero, growing the business to over $6 million in revenue in less than 12 years.

Ms. Liljenberg holds a BA in Journalism/Public Relations and a MA in Political Science/Public Administration from the University of Texas at Arlington. She is a Professional Financial Representative holding licenses as 6 & 63 Securities, a Property & Casualty Agent, Life & Health Agent, Risk Manager, Public Adjuster, and Texas Real Estate Broker.

She is well-known in the insurance and real estate industries for her responsiveness, knowledge, and professionalism in handling situations in both of these industries. Her 36 years of contractual knowledge is extensive and is strengthened by her years as a Commodity Electricity trader during Deregulation in 2001.

Litigation Support - Ms. Liljenberg provides Insurance Expert Witness services to attorneys representing plaintiff and defendant. She offers thorough reporting, depositions, and trial testimony as needed.

Areas of Expertise:

Insurance & Real Estate Agents Errors & Omissions Insurance & Real Estate Bad Faith Life & Supplemental Health Benefit Claims Personal Auto Homeowners Insurance Product Liability Insurance Commercial Auto Insurance Commercial General Liability Commercial Umbrella Professional Liability Insurance

Directors & Officers Liability Product Liability Employment Practices liability Business Interruption Flood Insurance Inland Marine Insurance Boiler & Machinery/Equipment Breakdown Farm & Ranch Owners Watercraft/Boats Personal Umbrella

Mary Wickens, JD, CFE, CHC has over 35 years experience in the Healthcare Insurance, Managed Care, and Compliance Industry. Her experience includes advising and counseling health care providers, insurers, government contractors, and others in compliance, ethics, fraud and abuse, Medicare, Medicaid and Federal Employees Plan, managed care, and other matters. 

Background Experience - Ms. Wickens is a former compliance officer for a major health insurer and former legal and compliance specialist for a CMS Medicare Program Safeguard Contractor. Also a former operations director for government programs (Medicare Part C, Medi-gap, and FEHBP) for a major HMO, she is experienced with government audits and investigations, commercial audits, as well as self-reporting and internal investigations. 

Ms. Wickens has decades of experience as in house counsel to HMOs and health insurers. She has drafted, developed, negotiated, and implemented numerous healthcare provider-payor contracts, and developed and implemented codes of conduct, ethics programs, compliance programs and numerous corrective action plans. 

Litigation Support - Mary Wickens provides litigation support, including skilled expert services, reports and testimony in federal False Claims Act cases, arbitrations, and provider-payer disputes. She is an experienced testifying expert, responsive to the needs of counsel, with excellent report writing skills. Ms. Wickens' services are available to counsel representing both plaintiff and defendant. 

Areas of Expertise:

Medicare False Claims Act (FCA) Health Insurance HMO Medicare Advantage Provider / Payor Disputes Claims Audits and Appeals Federal Employees Health Benefits Plans (FEHBP)

Medicare Part D Government Audits DME Home Health Care Hospice Managed Care Contracting Anti-Kickback Compliance Self-disclosures

View Mary Wickens' Consulting Profile.

Milliman’s Tampa Office provides a variety of Health Insurance, Health Care services, and Pharma consulting services to law firms, health plans, insurance companies, HMO’s, Blue Cross/Blue Shield plans, hospitals and other providers, employers and government agencies. Stuart Rachlin and other staff are experienced actuaries and related consultants.  

We provide support to our clients with all types of health related services including Medicare Advantage and Prescription Drug plans (MAPD), Part D plans (PDP), ACA plans, 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, claim cost analysis, and fee schedule analysis.

These health care services are used in litigation relating to:

• Life care planning
• Contract development and fee schedule analysis
• Pricing & Underwriting
• Senior Services
• New benefit plan design

Prof. William J. Warfel, PhD, CPCU, CLU, specializes in Insurance Breach of Contract, Bad faith, and Agent / Broker Liability issues. He has been retained in 90 cases by attorneys who represent policyholders, insurance agents, insurers, and third parties.

Dr. Warfel is widely published in applied, professional journals. His experience includes actual courtroom testimony, as well as deposition testimony in numerous cases. He has been retained in cases involving: 

Commercial General Liability Personal Auto Commercial Auto Homeowners Commercial Property Business Income Individual Life Medical Expense Additional Insured Endorsement

Builders Risk Insurance Long-Term Care Insurance Disability Professional Liability Employee Dishonesty Worker Compensation Inland Marine Insurance Policies Indemnification Agreement / Additional Insured Endorsement Financial Institution / Public Official / Bid Guaranty / Contract Bonds

View Dr. William Warfel's Business Consulting Profile.