Insurance (General) Expert Witnesses: 35

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 Consulting Profile.

Philip M. Trick, FCA, ACAS, MAAA, is an Actuary with extensive learning in Insurance, Probability, Risk, and Math as part of his actuarial training. Mr. Trick is a Fellow of the Conference of Consulting Actuaries, Associate of the Casualty Actuarial Society, and Member of the American Academy of Actuaries.  He earned his Masters in Economics and Bachelors in Economics and Mathematics from Boston University, Cum Laude.

Background Experience: Mr. Trick's experience includes constructing an Optimization Engine for mortgage loan coverage assignments and share distribution. He has developed and deployed cutting-edge factory resource allocation management tools and reporting systems for tracking, analyzing, and projecting manufacturing performance. He has also designed and applied a mixed-distribution claims simulations to determine the level of risk transfer for a WC reinsurance agreement using industry data based on the projected estimated reinsurer deficit.

Awards and Honors: Mr. Trick has been honored with several distinction through ModelOff, an innovative and challenging annual global online competition for professionals and students to develop and test their Financial Modeling Skills. In 2016, he was a ModelOff Finalist. For multiple years, he made ModelOff Gold Class and Top 50 International Financial Modelers in the world rankings.

Litigation Support:  Mr. Trick provides expert witness services to attorneys in need of data-driven solutions. He offers analytics and analysis to help improve the ability to make strategic and responsive legal decisions. Mr. Trick's services are available to plaintiff and defendant and include developing and writing expert witness reports in addition to serving as support for legal counsel during expert witness depositions.

Areas of Expertise:

Data Analysis Systems Integration and Automation

Financial Modeling and Analysis Data-driven Decision Making

View The Scruggs Group's Consulting Profile.

Michael L. Scruggs, FCA, ACAS, MAAA is an Actuary practicing in the Property and Casualty Insurance space for over 40 years. He gained industry experience working for three insurance companies from1976 to 1987. After that, Mr. Scruggs consulted through two "big-eight" accounting firms until he established his own consulting practice in 1991.

Mr. Scruggs has worked in a variety of fields including Reinsurance, Actuarial, Information System / Information Technology, E-Commerce, Data Mining, Mergers & Acquisitions, Management Consulting, and Business Process Outsourcing. 

His many accomplishments include analyzing loss and loss adjustment expense reserves for regulatory authorities, insurance companies, self-funded non-insurance entities (WC + GL), including a multi-billion, domestic and international, direct and reinsured (inward and outward) book of both traditional and special risks. Clients have also included the Federal Bureau of Investigation and the Office of the United States Attorney.

Areas of Expertise:

Financial Modeling Ratemaking Loss Reserving Data Hygiene

Insurance Administration Systems Product Development Captive Insurers Regulatory Matters

Litigation Support: As a Property and Casualty Insurance Actuary, Mr. Scruggs has been retained in over 30 cases around the country. He provides a broad range of litigation support services to attorneys representing both plaintiff and defendant.  Mr. Scruggs is comfortable providing expert witness services to parties, attorneys, and triers of fact. 

Degrees / Certifications:

• Fellow of the Conference of Consulting Actuaries (2003 – Present) 
• Associate of the Casualty Actuarial Society (1989 – Present) 
• Member of the American Academy of Actuaries (1989 – Present)

Tommy R. Michaels, CPCU, AIC, ARe, ARM is an Insurance Professional with over 45 years of experience in the Property and Casualty Insurance industry.

Mr. Michaels has worked in the Home Office of a large insurance company determining coverage obligation, providing coverage interpretation, and performing functions of an insurance archaeologist. He has taught insurance courses through Robert Morris College, University of Connecticut, and Society of CPCU, Memphis Chapter.

Mr. Michaels' experience in claims includes direct handling, supervision of adjusters and other supervisors, claim office administration and development of a system that integrated various technologies to eliminate paper within the claim office. He has unparalleled claim expertise in property and casualty claims developed from his years of direct handling and supervising claim handlers. Mr. Michaels has handled claims in several states including Arkansas, Connecticut, Mississippi, Oklahoma, Pennsylvania, Tennessee, Texas, and West Virginia. He also directly handled all Fidelity and Surety claims in the State of Oklahoma.

Litigation Support - Tommy Michaels has had the opportunity to do complex claims analysis and negotiate large settlements totaling more than $250,000,000. He has resolved coverage issues, reconstructed decades old policies, and been involved in coverage litigation throughout the United States.

As an expert witness, Mr. Michaels has provided deposition and trial testimony, prepared expert reports in compliance with FRCP 26(2)(B), and has been used as a Consulting Witness. He has given testimony in over 30 depositions in State and Federal Court cases as well as testimony given at trial.

Areas of Expertise:

Claim Handling Standards Bad Faith Conduct Coverage Interpretation Insurance Carrier Duties Claim Settlement Negotiations

General Liability Insurance Automobile Insurance / Uninsured Motorists Homeowner's Insurance Environmental Liability Insurance Professional Liability Insurance

View Tommy Michaels' Consulting Profile.

Steven A. Eisenberg, FSA, MAAA has 50 years of Actuarial experience. He offers litigation support nationwide with regard to personal injury and wrongful death economic damages, appropriate mortality, life expectancy (note: population tables, that have not been modified by an actuary for lifestyle, chronic illnesses, family history, result in unreasonably long life expectancies), interest (discount) rates, future increases in income (note: historical experience indicates that wage inflation rates are lower than discount rates). His litigation support also includes life insurance product design and pricing, COI development and management, compensation, illustrations, administration and management services, policyholder tax issues, and product appropriateness. 

Background Experience - Throughout his career, Mr. Eisenberg worked extensively in litigation support as an expert witness including actuarial design, administration and illustration of various life insurance and annuity products, both traditional and non-traditional, universal life (or excess interest products), and both general account and separate account variable insurance products. His expert work includes pricing these products and developing appropriate actuarial assumptions (e.g. mortality and life expectancy, interest and discount rates, agent or broker compensation and expense assumptions). He is also a co-inventor of several patents dealing with financial derivatives(swaps) relating to longevity and mortality mitigation.

In 1986, Mr. Eisenberg pioneered the development of large case COLI and BOLI and unwind strategies that are still used today. He is a renown expert in designing, developing, and evaluating BOLI and COLI programs for insurance companies, banks, other financial institutions, brokers and litigation clients. This includes developing appropriate actuarial assumptions (mortality and longevity, COI management, lapses and surrenders, expenses, taxes, interest and discount rates, compensation, policy dividends and life insurance company profitability and investment exposure (disintermediation)). He also developed administrative procedures, sophisticated illustration systems (for example, utilization of policy loans and partial surrenders) and insurable interest issues. His expertise includes policy owner tax issues (e.g. Section 264, 7702, 7702A, 1035) and legislative changes. He has evaluated the appropriateness of these products (general or separate account including stable value) for corporate and bank policy owners, including the accounting and financial impact to the policy owners. 

Mr. Eisenberg is a Fellow of the Society of Actuaries (1973) and a Member of the American Academy of Actuaries (1975). He has served as an Instructor of Actuarial Science at Georgia State University and delivers lectures and seminars to associations throughout the United States. His services are offered to clients nationwide.

Litigation Support - Mr. Eisenberg currently provides expert litigation support for all aspects of life insurance and personal injury. He is a renowned expert in:

COLI / BOLI Product Design Assumptions & Contracts Tax History Broker Consultant Third Party Administrator

Marketing and Administration Compensation and Standards of Practice Benefit Funding and Financial Analysis life settlement Loss Determination Personal Injury economic Damages Life Expectancy and Mortality

View Steven Eisenberg's Consulting Profile.

Paul W. Burkett, JD, CPCU, CIC, ARM,CRM, ALCM is an Insurance and Risk Management specialist. President and CEO of Snoaspen Insurance Group, Inc., Mr. Burkett began his career as a Loss Control Representative for SAFECO Insurance Company after serving as an Officer in the United States Air Force. During his career with SAFECO, he served as a Loss Control Supervisor, Loss Control Manager, Commercial Sales Representative, Division Commercial Lines Underwriting Manager, and Regional Workers Compensation Manager.

From Safeco Insurance Company, Mr. Burkett worked for Frank B. Hall & Company as a Vice President in charge of Risk Management Services. He was responsible for design and implementation of alternative insurance programs such as pools, self-insurance, and captives. From Frank B. Hall, Mr. Burkett assisted in establishing the Meadowbrook of Colorado office and focused on developing specialized group programs. Paul assisted in establishing TUITIONGard which specialized in coverage for private student loans provided through banks in the United States.

Mr. Burkett currently provides litigation support services to attorneys for both Plaintiff and Defense. He has been deposed and/or testified approximately 10 rimes in the last five years.

Areas of Expertise:

• Insurance Company Good and Bad Faith
• Agent / Broker Standard of Care
• Insurance Industry Customs and Practices
• Risk Management
• Business Contract Insurance Clause Analysis and Application
• Insurance Coverage Analysis
• Insurance Claims Disputes Analysis

View Paul Burkett's Consulting Profile.

François Sestier, MD, PhD, FRCPC, FACC, DBIM, CIME, is a Cardiologist and Life Expectancy Calculation expert. He has over 40 years of experience in the field of medicine, 29 years as an Adult Cardiologist in the cath lab and 30 years as an Insurance Medical Officer.

Education - Dr. Sestier graduated from medical school in Nancy, France, 1967, where he obtained certification in Cardiology, Pneumology, Occupational Medicine, and Aeronautical Medicine. In Canada, since 1973, he obtained a Quebec certification in cardiology (CSPQ), and a fellowship in cardiology of the Royal College of Physicians and Surgeons (FRCPc). Dr. Sestier also obtained a PhD in Experimental Medicine (McGill, 1977).

Experience - Dr. Sestier has been a staff cardiologist at CHUM, Montreal, medical director of Quebec Blue Cross since 1985 and medical director of PartnerRe since 20219. He received certifications from the American Board of Insurance Medicine (1995) and the American Board of Independent Medical Examiners (2011). As a medical officer for various insurance companies, he has reviewed thousands of applications for life Insurance, giving advice on the Mortality and Life Expectancy associated with the applicant's medical conditions.

Dr. Sestier - Life Expectancy Calculation

Litigation Support - Dr. Sestier's medico-legal advice is available to counsel representing both Plaintiff and Defense. He has performed life expectancy calculations for litigation purposes on topics as diverse as traumatology, traumatic brain injury, cognitive impairment, spinal cord injury, morbid obesity, diabetes, many different cardio-vascular pathologies, sudden death, stroke, cerebral palsy, multiple sclerosis, epilepsy, asthma, chronic obstructive lung disease, sleep apnea, liver cirrhosis, hepatitis B and C, and all kinds of cancers. He follows the actuarial methodology proposed by the American Academy of Insurance Medicine for his LE calculations. 

Areas of Litigation Expertise:

Disability Assessment Permanent Disability Eligibility Medical Liability Insurance Médicine Life Insurance

Health Insurance Travel Insurance Critical Illness Insurance Life Expectancy Calculations Work-Life Expectancy calculation

Book chapter: Vachon P and Sestier F: Life expectancy calculation. In Life Care Planning, PMR clinics of North America, M. Lacerte and C. Johnson, ed., Elsevier publ. New York, August 2013, pp 539-551.

Recent Publication: https://www.canadianlawyermag.com/news/opinion/ethical-issues-are-too-often-ignored-by-medical-experts/275898

View Dr. Sestier's Consulting Profile.

Heather Schwartz Sanderson is nationally recognized as one of the foremost and cutting-edge legal experts in Medicare Secondary Payer Compliance. An avid blogger and national speaker, Heather is a regularly published author and national speaker on MSP compliance. Her articles have been featured in publications such Risk & Insurance, Workerscompensation.com, Defense Research Institute (DRI), and Claims and Litigation Management (CLM) Alliance Magazine.

Since the inception of her career, Heather Schwartz Sanderson, Esq. has been passionately devoted to providing simple and straightforward Medicare Secondary Payer (MSP) compliance solutions, legal strategy, as well as MSP education to the insurance and legal communities.

Heather has 12+ years of dedicated experience in MSP compliance, and has often been referred to as one of the foremost experts in the country on MSP. Prior to launching Sanderson Firm PLLC, Heather served as Chief Legal Officer for Franco Signor for 6 years, a leading national MSP services provider, until its ultimate acquisition by ISO CP in 2020. Prior to her tenure as CLO at Franco Signor, Heather previously served as both Corporate Counsel for Optum as well as Staff Counsel for ExamWorks Compliance Solutions.

Litigation Support - Over the last decade, Heather has served as an MSP expert both in Federal class action litigation as well as in litigated matters at the state level. Heather is an award-winning blogger and national speaker on MSP compliance, and a recipient of a 2018 Business Insurance Break Out Award. She serves an Ambassador for the Women to Watch Foundation, a 501(c)(3) entity serving humanitarian initiatives for women. 

Heather has been an active proponent in Washington D.C. for MSP legislative reform since 2011 and is proud of the industry’s accomplishment of the passage of both SMART Act (2013) and PAID Act (2020). 

David Stegall is the Principal Consultant and Founder of Risk Consulting & Expert Services since January 1, 2007. He has over 40 years of insurance, reinsurance, bond and risk management industry experience. He is a Chartered Property & Casualty Underwriter, an Associate in Risk Management, an Associate in Reinsurance and a Registered Professional Adjuster. He has experience as an underwriter, an agent, a broker, a surety bond producer, a reinsurer, a managing general agent, a third-party administrator, a captive manager, a selfinsured fund executive, a risk management consultant, an expert witness and has been retained as an arbitrator.

Mr. Stegall was President of the Society of Risk Management Consultants in 2017 and continues to serve on the Board of Directors. He is also a member of the Board of Directors of the Alabama Captive Association, a member of the Society of Chartered Property & Casualty Underwriters, the American Association of Insurance Management Consultants, the Society of Registered Professional Adjusters, ARIAS-US, Defense Research Institute, and an Associate Member of the American Bar Association – Tort, Trial and Insurance Section.

Joe L. Williams, CPCU, partner in Pozmantier, Williams & Stone Insurance Consultants, LLC, has over 55 years of experience as an Insurance Agent / Broker and Insurance Consultant. From 1970 until 2007, he was a principal shareholder in a large Houston firm, Wisenberg Insurance + Risk Management, and was Chairman and CEO when the firm was sold to a subsidiary of Wells Fargo Bank. One of the youngest people ever to receive the CPCU professional designation at the age of 23, Mr. Williams is very familiar with all phases of the insurance industry, including consulting on bad faith, customs and practices, and standards of care. He has particular expertise in property coverage, business interruption, non-subscription, and risk transfer techniques. Litigation Support - Mr. Williams provides expert services to counsel representing both Plaintiff and Defense. He offers objective opinions on the following matters:

• Agent / Broker Bad Faith
• Insurance Industry Customs & Practices
• Agent / Broker Standards of Care
• Coverage Terms and Conditions
• Agent / Broker Services
• Insurance Program Design
• Agency / Company Disputes
• Claims Management by Agent
• Insurance Agency Management

View Joe Williams' Consulting Profile.

Panorama Consulting Group specializes in Enterprise Resource Planning (ERP) Systems and has multiple testifying experts for failed software litigation. This high-profile firm is called upon to investigate the feasibility of litigation, provide software expert witness testimony, and build background reporting for some of the industry’s highest-profile software lawsuits. They have worked with organizations ranging from multi-national conglomerates to boutique and large law firms, as well as state offices of the Attorney General.

As independent enterprise software experts, Panorama Consulting Group has hands-on experience with hundreds of software vendors. Their firm is not tied to a single law firm or software vendor, allowing them to focus on all types of clients and industries. 

Bill Baumann on Expert Witness Testimony

Listen to Panorama Consulting Group's podcast episode: What Would Your Failed Enterprise Software Implementation Say if it Could Talk?

Litigation Support: The experts at Panorama Consulting Group work for both plaintiffs and defendants, software vendors and system integrators, and their customers. Their differentiator is using a team-based approach to provide expertise beyond just the testifying expert, which is cost-effective and efficient for their clients. They have multiple software expert witnesses available for provision of reports, depositions, and testimonies.

Allegations Addressed:

Fraud and Misrepresentation Breach of Contract “Off-the-shelf” Software Capability Misrepresentation and Claims Undefined Roles / Poorly Executed Responsibilities (Internal project team, VAR, ERP vendor, ERP consultant, or system integrator) Lack of Skills and Competencies Poor Project Management

Poor Benefits Realization Poor Implementation Planning, Resourcing and Budgeting Errors in Customization Errors in Integration ERP Failure Operational Disruption or  Loss Related to the ERP System

View Panorama Consulting Group's Consulting Profile.

Olie R. Jolstad, SCLA, FACFEI, has worked in the Insurance Industry for more than 37 years. Over the span of his career, Mr. Jolstad has worked with various types of civil litigation involving coverage disputes, claims handling practices, bad faith, unfair and deceptive practices, duties and standards of care regarding the procurement of insurance. In addition, he has worked on forensic insurance policy reconstruction projects on behalf of policyholders. Litigation Support - Mr. Jolstad has been providing litigation support services for approximately 20 years. He has been retained as an expert witness in approximately 200 cases and has been qualified to testify in various state and federal courts. He offers services to attorneys representing both Plaintiff and Defense. Mr. Jolstad has been retained as an expert and consultant where insurance coverage at issue involving:

• General Liability Insurance
• Commercial Property Insurance
• Commercial Property Time Element and Extra Expense Coverage
• Builders Risk / Construction
• Construction Wrap-Up
• Directors & Officers / Employment Practices Liability
• Umbrella and Excess Liability and Duty Triggering Events
• Aviation
• Workers' Compensation

With specific attention focused on:

• Insurance Industry Customs, Practices, and Standards
• Good Faith / Bad Faith Claims Handling Practices
• Insurance Agent and Broker Standard of Care and Duty to Procure Insurance
• Excess and Umbrella Duties / Exhaustion
• Excess and Surplus Lines Coverage and Claims Handling

View Olie Jolstad's Consulting Profile.

Britta M. Moss CPCU, SCLA, AIC-M, is a graduate of The Ohio State University and a 25+ year veteran of the Property & Casualty Insurance industry.  She has claims experience in a wide variety of personal and commercial lines claims as a Claim Representative, Examiner, Supervisor, Trainer and Manager.  

Ms. Moss has handled, supervised, managed and provided training for claims involving auto damage, personal & commercial property damage, bodily injury, personal injury, property damage liability, commercial general liability, uninsured / underinsured motorists, medical payments, personal injury protection, allegations of bad faith and extra-contractual exposure. Experienced expert witness for both plaintiff and insurer defense cases.

Areas of Expertise:

Property & Casualty, Claims Bad Faith Exposure Identification UCSPA Compliance Industry Standards Claim Handling Insurance Coverage Personal Injury Protection (PIP) Bodily Injury (BI) Property Damage (PD) Medical Payments (MP)

Uninsured / Under-Insured Motorist (UM/UIM) Commercial General Liability (CGL) Unfair Claims Settlement Practices Extra-Contractual Large, Complex Loss Policy & Procedure Supervision / Management Corporate Discovery Claim File Auditing Claim Personnel Management & Supervision

View Britta Moss's Consulting Profile.

Michael F. Arrigo is the Managing Partner, Healthcare Practice for No World Borders. They work with health systems, health IT companies, and health plans. His recent retentions have been by the U.S. Department of Justice (DOJ) - drug pricing, patent infringement, medical coding and billing, and Qui Tam False Claims Act and fraud case specialties. 

Mr. Arrigo has in-depth experience in HIPAA mandates, the HITECH Act and Patient Protection and Affordable Care Act (PPACA) and is a published author and regular speaker. He consults to clients including Health IT investors, Health IT companies, and health plans and hospital systems in matters regarding:

 HIPAA Privacy Rule, HIPAA Security Rule, HIPAA Breaches, Revenue Cycle Management, Hospital Liens in Personal Injury Cases without considering insurance as a collateral source.

Medicare fraud, Medicare damages, Managed Medicaid, capitation, rate setting. Federally Qualified Health Centers (FQHC)

• Meaningful Use of Electronic Health Care Records
• Quality Measures for Medicare Advantage Hospital Value-Based Purchasing
• Medicare Advantage HEDIS 5-Star Ratings for Health Plans Mr. Arrigo was recently quoted in the Wall Street Journal Venture Capital Dispatch regarding medical coding standards and Wall Street Journal Health Blog regarding venture-backed information-technology companies that serve hospitals and health insurers.

Thank you for viewing my profile.  Please click this link to view my CV.

2020 07 21 Michael F Arrigo Expert CV and Supplemental Material WATERMARK NOT RETAINED.pdf

Please view a ruling published in Westlaw by U.S. District Judge Ronald S. Lew pertaining to my expert qualifications here:

United States v Pacific Health Corporation.pdf

For more about me, please click here:

https://noworldborders.com/expert-witness/ 

Related posts :

Medical Billing Expert Witness

https://noworldborders.com/expert-witness/medical-billing-expert-witness/

HIPAA Expert Witness

https://noworldborders.com/expert-witness/hipaa-privacy-and-security/hipaa-expert-witness/ 

Healthcare Intellectual and Property, particularly pertaining to insurance claims processing, medical coding, medical billing and information privacy:

https://noworldborders.com/expert-witness/healthcare-patent-expert-witness/ 

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