Expert Witnesses & Forensic Consultants Directory
Health Insurance
Health insurance expert witnesses, profiled in this directory, may consult on disputes in health insurance policies, including the effective date of policies, charges of uncooperative policyholders and of concealment or misrepresentation of a health condition, health benefit plan negligence, personal injury liability of managed care plans, abuse of discretion in denying medical coverage, preemptions under the Employee Retirement Income Security Act (ERISA) and self-funded employee health benefit plans, administrative health plans, state health care liability laws and state managed care patient protection laws, and related issues in denial of claims. These health insurance expert witnesses may also provide expert opinions on matters of claims of health insurance fraud, false claims, ghost patients, kickbacks, up-coding services, bundling and unbundling procedures, claimed lack of medical necessity, false certifications that the services were medically necessary and performed in accordance with applicable rules and regulations, improper financial interest, red-lining (discrimination against persons at risk of serious illness) and related issues of fraud. These health insurance experts may also testify in matters of health management organizations (HMOs), employee health benefit plans, health care plan administrators, state health insurers, and state and federal legislation regulating health insurance.About 24 results (0.12 seconds)
Jim Toole, FSA, CERA, MAAA
Life and health actuary with more than 35 years of experience in US and international markets. Background includes 20+ years of expert and litigation support as well as M&A, product development, financial reporting, audit, and regulatory roles.
Winston-Salem, NC
Brad S. Kanter, CPA/CGMA/CFF, CFE, CFI, CVA/MAFF, EA, FCPA, MAC - FAZ Forensics
Broad based financial forensic services that recognize investigating and examining people and money are both an art and a science in any forensic accounting investigation. The application of behavioral credibility analysis delivers on this methodology.
Oldsmar, FL
Bruce F. Deal — Analysis Group, Inc.
Economics and risk analysis expert witness provides economic analysis in: antitrust, finance and securities matters, damages, business valuation and related matters. Experience in the insurance, technology, telecommunications, and health care industries.
Menlo Park, CA
Areas of Expertise:
Economic Damages
Tel: (650) 853-7201
Limited public information. For more, contact us.
Lori Mote — Sunnybrook Equine Appraisal Service
Professional equine appraiser experienced in many types of civil litigation: horse-related accidents, injuries and deaths; purchases, sales, syndications; insurance policies and claims; contract disputes; undisclosed health or unsoundness problems.
Ione, CA
Areas of Expertise:
Animal Appraisal
Tel: (209) 274-2680
Limited public information. For more, contact us.
Lucinda A. Ehnes, JD
Expert in reasonable and customary billing disputes, health regulatory law, policy and enforcement, managed care operations, insurance, etc. Attorney abd former Director, Calif. Dept. of Managed Health Care. (Oversaw insurance services for 21M enrollees)
Fair Oaks, CA
Areas of Expertise:
Managed Care (HMO)
Tel: (916) 599-5490
Limited public information. For more, contact us.
Medical Consultants Network
MCN provides independent medical evaluations and peer reviews for workers’ compensation, auto/PIP/liability, FMLA, disability assessments, and health insurance. Network includes board certified and active practice physicians - 24,000 options nationwide.
Seattle, WA
Law Office of Walden E. Shelton, Jr.
Expert in insurance matters, Life, Health, Property & Casualty. Twenty-eight years experience.
San Antonio, TX
Areas of Expertise:
Insurance Practices & Standards
Tel: (210) 696-4900
Limited public information. For more, contact us.
James E Alexander, Jr., MD
Medicare Expert, ~35 years experience, acts as an expert witness in medicare and commercial health insurance fraud, abuse, coding and policy. Former contractor Assoc. Medical Director, Blue Cross Blue Shield Texas, Former Medicare Med. Director, Texas.
Cleburne, TX
Areas of Expertise:
Managed Care (HMO)
Tel: (817) 439-9439
Limited public information. For more, contact us.
Gregory G. Wimmer, CLU, ChFC, CSSC
Chartered Life Underwriter, Financial and Structured Settlement Consultant, experienced expert witness (100+ cases) in life and health insurance underwriting, claims practices, agent standards and practices, ERISA plans, life insurance, annuities, etc.
Georgetown, TX
Areas of Expertise:
Annuities
Tel: (503) 670-7772
Limited public information. For more, contact us.
Real Estate Valuation
Provides expert property appraisals, specializing in environmentally contaminated properties: air, soil and water contamination, mold, asbestos. Appraisals note environmental law, insurance and liability issues, public perceptions of health risks. [Non-public Profile Id 47691]
Georgetown, TX
Areas of Expertise:
Real Estate Valuation; Real Estate Appraisal
Limited public information. For more, contact us.
Edward W. Millunchick, MD
Board Certified in Pediatrics acts as an expert witness in general pediatrics, pediatric infectious disease and pediatric emergency medicine, with added expertise in radiology utilization management. Experienced Medical Director of national Health Insurer
Chicago, IL
Mary Wickens, JD, CFE, CHC
Healthcare payment and compliance specialist, 35+ yr industry (in-house counsel to HMOs and health insurers), serves as an expert in federal and state False Claims Acts, Medicare, payor disputes, contracts, audits and appeals, managed care contracting.
East Lansing, MI
David M. Shepherd, FCAS, MAAA
Actuary, 28 yr insurance industry experience, with expertise in risk transfer and loss reserving. Former Executive VP, Chief Underwriting Officer, and Chief Actuary for reinsurer specializing in workers’ compensation, accident, and health coverages.
Peachtree Corners, GA
Areas of Expertise:
Actuary
Tel: (678) 684-4842
Limited public information. For more, contact us.
Ed Dillabough — MAP-Health
Managed Care and Insurance Industry Consultant provides expert witness services, especially in health care cost containment strategy and implementation. Former, (1) President, CEO, United Healthcare, Tampa. (2) Executive Director-CIGNA Healthcare, Tampa.
Saint Petersburg, FL
Areas of Expertise:
Health Insurance
Tel: (727) 573-5737
Limited public information. For more, contact us.
Milliman
Provides expert witness services in health insurance and employee benefit plans matters, including forensic actuarial work, rate filings, regulatory compliance, reserve projections, valuations, employee benefit analysis, claim cost analysis
Tampa, FL
Actuary, Jay Miniati, FSA, MAAA, MBA
Actuary focused on health insurance, specializing in self-funded plans. Expert witness services have related to divorce settlements, disabled life expectancies, and the life expectancies of incarcerated individuals.
Tampa, FL
Linda Bernard, RN, LNC, CCHP-RN
Provides review of Correctional Health Care, medical records for adherence to Standards of Care, medical chart summary, determining case merit, utilization review, and Legal Nurse Consulting to attorneys, jails, prisons and insurance carriers.
Hastings, PA
Areas of Expertise:
Prison-Correctional Medicine
Tel: (814) 932-9695
Limited public information. For more, contact us.
Insurance Practices & Standards
Former insurance executive and senior litigation counsel for two international brokers serves as an expert witness in issues of insurance coverage, bad faith, agent/broker professional liability, property and casualty, life and health insurance. [Non-public Profile Id 58278]
Pittsboro, NC
Areas of Expertise:
Insurance Practices & Standards
Limited public information. For more, contact us.
Paul Esposito, CIH, CSP
Health and Safety expert, 34+ yr experience, in nuclear, power, construction, engineering, airports, services and manufacturing, including DOD, DOE, EPA, USCG Shipyard, insurance firms, in safety management systems, risk assessments, OSHA compliance
Arnold, MD
Areas of Expertise:
Health & Safety
Tel: (410) 218-8451
Limited public information. For more, contact us.
Ernest G Bertha MD, MBA, FAAP
Medical-legal and insurance reviews, and peer-review for all cases involving pediatrics and/or pediatric emergency medicine. Over 25 years of experience. Previously certified and experienced as a Florida State Mediator and Guardian Ad Litem.
Coral Springs, FL
Areas of Expertise:
Health Insurance
Tel: (954) 344-3100
Limited public information. For more, contact us.
Faye Albert, FSA, MAAA — Albert Associates
Actuary, 39 yr, provides litigation support and expert witness testimony in actuarial matters, including: insurance-mortality, life and health expectancy, life settlements, underwriting lives with health issues, substandard mortality, divorce valuations.
Miami, FL
Areas of Expertise:
Family Law Valuation; Family Law Valuations
Tel: (305) 662-5840
Limited public information. For more, contact us.
Michael Boyle — Investigative Consultants International
Provides fraud investigations, background searches, criminal background checks, insurance fraud, health insurance fraud, plaintiff injuries, business fraud investigations, corporate fraud, personal injury investigations, marital investigations,
Westfield, NJ
Areas of Expertise:
Insurance Fraud
Tel: 9085786396
Limited public information. For more, contact us.
Douglas Hartman, ARM — Montclair Risk Advisors, Inc.
Commercial Property/Casualty and Health Insurance and Risk Management Consultant provides expert witness services, in wrongfully denied claims, damages and premium disputes, errors and omissions, negligent claims, and processing and regulatory issues.
Upper Montclair, NJ
Areas of Expertise:
Risk Management
Tel: (973) 746-5993
Limited public information. For more, contact us.
Mark L. Friedman, MD — Medical Billing & Coding
Consulting / expertise in medical billing, coding and cost containment as well as medical care / malpractice.
Newbury, NH