Edward J. Priz, CPCU, APA, has worked full-time in the Insurance Industry since 1976. In 1982, he also began consulting on commercial property and casualty insurance, and Workers Compensation insurance premium charges, and in 1987 established his own consulting firm to specialize in those fields, as Advanced Insurance Management. Mr. Priz holds the professional designation Chartered Property Casualty Underwriter (CPCU) from the American Institute of Property and Liability Underwriters, as well as the designation Associate in Premium Auditing, from the Insurance Institute of America.
Litigation Support - Mr. Priz has been retained by policyholders, insurance agents and brokers, insurance companies, and a premium audit firm as an expert witness in his field, both as a consulting expert and as a testifying expert. He serves as an expert witness to counsel for Plaintiff and Defense and has testified in federal and state courts and arbitrations in California, Colorado, Connecticut, Delaware, Illinois, Florida, Louisiana, Mississippi, Nebraska, New Jersey, New York, Ohio, Pennsylvania, Tennessee, Texas, and Virginia. He is a member of the Forensic Expert Witness Association and currently serves as Vice-President of the Chicago chapter of that organization. He is also a member of the Society of Chartered Property Casualty Underwriters, and the National Society of Insurance Premium Auditors. Mr. Priz has also consulted on the drafting of legislation pertaining to Workers Compensation insurance in Illinois and has testified on insurance regulation before the Illinois legislature. He is the author of three books on the subject of Workers' Compensation insurance.
One question being asked is whether COVID-19 infections could be the basis for Workers Compensation claims by workers who feel they likely contracted the virus through work. At the moment, the best answer appears to be that’s unlikely for many workers, possible for some, and subject to change depending on future actions by state legislatures.
Employers generally realize that the initial premium they pay for Workers Compensation insurance isn't the final premium for that coverage-Workers Comp is normally subject to an audit after the policy ends, to adjust premium charges based on actual payroll amounts. When the policy starts, after all, payroll amounts can only be estimated for the coming year. So it's routine for employers of any size to undergo a Workers Compensation premium audit, and to receive an audit statement that often seeks some additional premium.
A growing trend for many businesses has been for their customers and prospects to use their experience modification factor as a safety benchmark, requiring a modifier of 1.00 or 1.05 for those bidding on projects. A higher modifier can disqualify a firm from bidding on many projects, particularly governmental projects.
Recently, a former Director of the Illinois Department of Insurance wrote an Op-Ed piece, decrying recently proposed legislation that would require insurers to file changes in Workers Compensation insurance rates with regulators before using those rates with insurers. The proposed legislation would also allow the Department of Insurance to disapprove rates if it was determined they were excessive.
An easy to understand guide, written for a general business audience, that explains in detail how Workers Compensation insurance is priced and audited. The Field Guide explains the classification system used by insurance companies, the audit process, experience modification factors, and how and why overcharges occur. Most importantly, it explains in plain language how employers can protect themselves from the common mistakes the insurance industry makes that cause Workers Comp premiums to be higher than they properly should be.
Many of the rules which determine premiums are understood only by employees in the audit and underwriting departments of insurance companies. The result is a built-in bias in the system which favors higher premiums.
CompControl was written by an industry insider -- a consultant who has saved clients more than $4 million in overcharges. His book reveals how the system really works and how you can make it work for you.
Richard Stripp, PhD, is a nationally recognized expert in Toxicology providing services in all aspects of a Clinical and Forensic Toxicology. He has served as an expert consultant in 100’s of cases in the field of toxicology and pharmacology for attorneys, investigators, and physicians involved in forensic and clinical toxicological evaluations associated with ethanol, drugs of abuse, prescription medications and chemical exposure. Dr. Stripp provides unbiased expert case reviews involving drug effect on human performance, toxicity of iatrogenic/ therapeutic agents, lead and other toxic metals, carbon monoxide and environmental/occupational hazards. These services include, impartial evaluations involving drug impairment, overdose, toxic chemical exposure, medical issues associated with drug therapy, poisoning, and the role of drugs, alcohol, or chemical exposure in civil and criminal litigation. This covers a full breath of forensic medical-legal cases including:
Analytical Toxicology and Laboratory Operations
Review and Interpretation of Toxicology Reports
Assessment of Impairment and the Role of Drugs/Alcohol in fatalities, accidental injury, overdose, MVA / DWI / DUI, criminal and civil litigation
To Serve as an Expert Witness: Experienced in Depositions and Court testimony
Forensic Toxicology Case Reviews
Drug and Alcohol Effects
Environmental/Occupational Chemicals & Toxic Chemical Exposure
Interpretation of Analytical Results and Drug Testing Cases
Paul F. Amoruso, CPCU, has more than 45 years of experience working for several major insurance carriers as a Senior Vice President of Claims and Operations. As a licensed insurance agent in Massachusetts, Connecticut, Florida, an New Jersey and licensed public adjuster, he is uniquely qualified to assist either plaintiff or defense attorneys on insurance related issues on local or national issues.
If you are an insurance company, insured, or law firm and need an independent review of an insurance issue regarding litigation, agency or company operations, practices or procedures, he is available to assist.
Mr. Amoruso has served as an Expert Witness in many states in both State and Federal court . Having worked in all operation areas of the insurance industry he is able to testify to the generally observed and accepted industry practices.
Donald W. Bendure, MBA, CPCU, RPLU, RF, ACI, is an Insurance Expert with a concentration within the areas of Commercial Liability, Captive Underwriting, Professional Liability, Commercial Automobile, and Property Insurance. He has over 40 years of experience and provides services for clients nationwide.
Litigation Support - Mr. Bendure provides unbiased and impartial expert testimony and litigation support services for both plaintiff and defense attorneys. He has currently completed over 350 engagements. Mr. Bendure serves as a Pre-litigation Consulting Expert, a Policyholder Expert Witness, and an Insurance Defense Expert Witness. Mr. Bendure's particular area of expertise in the areas listed below is within the discipline of Underwriting and Insurance Coverage. He possesses specialized knowledge of Captive Insurance and commercial insurance as they relate to coverage issues, particularly within pollution, environment, construction, oil and gas exploration, risk mitigation, enterprise risk management, self-insured and retention programs, and claims made policy language.
Mr. Beringer is the Principal of Beringer & Associates (B&A) and Liability Program Management (LPM). He is an approved consultant by the A.M. Best organization, since 2006, for claims, liJohn-Beringer-Insurance-Management-Expert-Photo.jpgbility, and insurance program management, including matters involving construction, OCIP, TPA, JPA, Captives, Memorandum of Coverage, and insurance coverage analysis. The Cayman Island Monetary Authority approved Mr. Beringer as a licensed captive owner in 2002 for Segregated Portfolio Company Creative Solutions, SPC.
Mr. Beringer holds an LPCS, RPA; is a founding member of CLM, a published author in various publications, and presenter at the CIMA, CPA, A.M. Best, and other conferences.
Mr. Beringer, as B&A, has provided expert services for risk analysis and management services to the insurance, reinsurance, construction, and transportation industry since 2000. Previous to the formation of B&A, he worked in the insurance industry for 30 plus years as a region Litigation Manager with Automobile Club, Industrial Indemnity, Great American, and The Hartford's Speciality Risk Service. Since B&A’s formation, Mr. Beringer assisted Reliance, AIG, Swiss Reinsurance, and Sterling Insurance for review of their insurance programs, analysis, and performance of claims systems and operations.
Mr. Beringer has participated in over 300 mediations, managed handling of over 30,000 cases in federal, state, and local venues on behalf of clients, and provided expert services to plaintiff and defense counsel.
In conducting a legal fee audit, the framework of the analysis considers three primary standards: the rules of professional services provided by the California Bar, the retainer agreement, and applicable court standards. Those three standards reflect a balance between the interests of the attorney's client and the economic interests of the attorney as a professional service provider.
Jane Marie Downey, M.Ed, ARM, has 35 years of experience in Risk Management and Property, Casualty, and Professional Liability Insurance. A well-known risk management consultant, leadership trainer, and frequent public speaker, she provides risk consulting, insurance broker management, outsourced risk management, insurance arbitration, as well as leadership and team training.
Background - Ms. Downey’s corporate experience includes risk management positions with IU International, PaineWebber Group, Inc., and The West Company. She also worked as an Account Executive in insurance brokerage with the Hobbs Group. She taught Risk Management at Temple University's Fox School and Crisis Management at Penn State's Graduate Program. She currently teaches Continuing Educations courses for agents and attorneys for the Institute of Strategic Educational Partners.
Litigation Support - Ms. Downey has provided expert opinions on policy language, coverage disputes, brokerage E&O and standard of care, risk control and risk management standard. She has successfully provided litigation support, testimony, depositions, certifcates of merit and expert opinions in over 60 legal actions. Ms. Downey Jane has represented both insureds and insurers and clients and brokers.
I have been retained as an Insurance Expert or Insurance Arbitrator to confirm the proper calculation of insurance premiums, based on actual exposures, completed by the insurer at audit. In the first case, a large Hotel bought out their partner and inherited a large Wrap-Up Program of Insurance.
Jim Leatzow has 43 of "hands-on" practical, property / casualty insurance agency experience. Leatzow has literally worn "every hat there is to wear in the P/C insurance business. He provides expert & arbitration services nationally & internationally with no charge for travel time. He is articulate, efficient & equally comfortable within the U.S. & in foreign venues. His experience includes:
44 years national Property/Casualty insurance industry experience
30 years national, Property/Casualty insurance Agency Owner
23 years national, Property/Casualty Managing General Agent (MGA)
20 years national, Third Party Administrator (TPA) insurance claim adjuster
26 years Reinsurance experience & Company Founder/President
17 years Certified insurance Arbitrator (U.S. / U.K. / Bermuda)
56 years Licensed Pilot with Commercial, Instrument, Multi & Seaplane Ratings
Still licensed in Illinois (44 years) & Wisconsin (37 years)
Licensed in all states for 20-25 years until 2005 (agency sold)
Rule 26 Report specialization on complex cases
Bad Faith Expert nationally
History of representing plaintiff & defense equally
No charge for travel time "coast to coast"
Leatzow's specialties include: Agent-Broker-MGA standards of care / Bad Faith / Coverage / Agent-Broker E&O Claims / Agent-Broker custom & practice / Professional (E&O) Liability / Claims adjusting Standard of Care / Claims-made coverage / Surplus Lines issues / Underwriting / Licensing / Property / General Liability /Aviation Insurance
Key Coleman, CPA, CFA, CPCU, ARe is Executive Director and Founder of Litigation Economic & Forensic Consulting Group LLC. While his firm is located in Greater Philadelphia, his practice is nationwide. Mr. Coleman focuses on damages analysis and expert testimony in a variety of areas including business breakup, post-acquisition purchase price disputes, employment, lost wages and manufacturing. Mr. Coleman also has a specialty in the Insurance and Reinsurance Industry. Mr. Coleman has over 30 years of experience providing business and financial analysis in the insurance and reinsurance industry. Prior to starting his own firm, he spent the bulk of his career in Chicago where he was a partner at a Big Four accounting firm and subsequently held high-level positions at other nationally recognized accounting and consulting firms. Prior to his consulting career, he spent more than eight years in the insurance and reinsurance industry.
Mr. Coleman is often called upon to perform expert analysis relating to Damages in Insurance or Reinsurance Disputes. He is one of the few experts nationwide who holds both the CPA and the CPCU designations. Mr. Coleman performs expert testimony as an insurance economic damages expert witness both locally and nationwide. In addition, he performs inspections of MGAs, TPAs, ceding companies, and insureds. An abbreviated list of his insurance expert and damages specialties include:
Economic Damages in Commercial Disputes
Lost Profits / Lost Earnings
Post-acquisition purchase price disputes
Lost Wages Analysis
Insurance Damages Expert
Damages Analysis in Insurance and Reinsurance
Agency, Broker, MGA Disputes
Underwriting and Claims Analysis
Force Placed Insurance
Professional Liability / E&O / D&O
Professional Employment Organizations (PEOs)
Accounting, Forenisic Accounting and Investigations
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:
I am the Managing Partner, Healthcare Practice for our firm. We work with health systems, health IT companies, and health plans. My recent retentions 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. He 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
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.
Clinical documentation improvement (CDI) initiatives are underway in healthcare organizations across the country, with the aims of improving care and reducing costs. Are they working? At least one such initiative, at Baptist Health South Florida, is providing solid return on investment.
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
Daryll W. Martin, JD, MBA has a unique professional experience as a Lawyer, Insurance Broker, and Insurance Brokerage Executive. Mr Martin has over 30 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.
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.
Scott Stein, A.R.M., is an Insurance Industry Expert and Property Casualty and Professional Liability Insurance Broker with over 25 years of experience. He has served the last 18 years as an Agency Owner preceded by 7 years at two of the world's largest insurance brokers. Throughout his career, Mr. Stein has been negotiating and placing the broadest and most comprehensive Property Casualty and Professional Liability Insurance with specific emphasis on Legal Malpractice Insurance and Directors and Officers cover; to also include Architects E&O, Accountant Malpractice Insurance, Employment Practice Liability Insurance, Medical Malpractice and Medical Defense coverage, and nearly every other specialty within the Professional Liability Insurance spectrum, as well as Worker's Compensation Insurance. Litigation Support - Mr. Stein provides expert witness services to counsel representing both plaintiff and defendant. He has been engaged in excess of 180 cases as an insurance industry expert in the past 15 years. Never disqualified or challenged as an expert by any Court, Mr. Stein has extensive deposition history and trial testimony experience. His cases involve all areas of Broker and Insurance Carrier Standards of Care and his services include depositions, Written reports, and trial testimony when necessary. Areas of Expertise:
Agent and Broker Procedures
Insurance Agent and Broker Liability
Insurance Errors and Omissions
Broker and Agency Standards of Care
Failure to Procure Insurance
Claims Management and Handling
Insurance Coverage and Placement Issues
Insurance Disputes-Sales Practices and Bad Faith
Risk Management Practices and Procedures
Insurance Contract Review
Insurance Proposals- Brokers, Agents, and Agencies
Umbrella Liability Exposure and Placement
Insurance Compliance- Brokers and Agents
Intermediary and Broker Procedures
Risk Management Analysis
Insurance Company Claims Management and Processing
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.