Articles Posted in Expert Witness News

In Clinical Standards in Medicine medical expert witness Barry E. Gustin, MD, MPH, FAAEM, writes:

Forces both inside and outside of medicine are responsible for the trend towards the development of clinical standards. Physicians have been motivated by their desire to establish acceptable levels of care within the various specialties. This ultimately homogenizes and standardizes the basic approach to patient’s problems, is patient-centered, allows for the development of quality assurance and improvement programs, and demonstrates to the public that physicians as a group are concerned about the quality of care they provide to their patients.

Forces outside of medicine, however, are probably more potent than these internal forces at bringing increasing pressure to the issue of standards development. Malpractice carriers see the creation of widely-accepted clinical standards as one route towards reduced malpractice losses. Ditto for several states, including Maine and New Jersey, which have mandated the development of clinical standards because of their involvement in underwriting malpractice insurance plans.

In Discussion of Insurance Capital as a Shared Asset, actuarial expert witness Robert Bear discusses what he describes as Donald Mango’s ground breaking work Insurance Capital as a Shared Asset:

Mr. Mango differentiates between consumptive and non-consumptive use of an asset. A consumptive use involves the transfer of a portion or share of the asset from the communal asset to an individual, such as in the reservoir water usage and fishery examples. Nonconsumptive use involves temporary, limited transfer of control which is intended to be non-depletive in that it is left intact for subsequent users. Examples of non-consumptive use indude boating on a reservoir, playing on a golf course or renting a hotel room.

While shared assets are typically used in only one of the two manners, some shared assets can be used in either a consumptive or non-consumptive manner, depending on the situation. Mr. Mango gives the example of renting a hotel room. While the intended use is benign occupancy (non-consumptive), there is the risk that a guest may fall asleep with a lit cigarette and burn down a wing of the hotel (clearly consumptive).

In Discussion of Insurance Capital as a Shared Asset, actuarial expert witness Robert Bear discusses what he describes as Donald Mango’s ground breaking work Insurance Capital as a Shared Asset:

Actuaries frequently allocate capital to line of business or individual risk in an effort to calculate risk loads or evaluate profitability by calculating a risk adjusted return in the form of a return on equity (ROE) metric. Concerns have been expressed about ROE methods, especially the fact that the value inherent in the unallocated surplus is ignored (the entire surplus supports each and every risk). In 2005 ASTIN Donald Mango’s paper on “Insurance Capital as a Shared Asset” has introduced a method that eliminates the need for allocation of capital which he believes is more grounded in insurer realities.

Donald Mango treats insurance capital as a shared asset, with the insurance contracts having simultaneous rights to access potentially all of that shared capital. Shared assets can be scarce and essential public entities (e.g., reservoirs, fisheries, national forests), or desirable private entities (e.g., hotels, golf courses, beach houses). The access to and use of the assets is controlled and regulated by their owners; this control and regulation is essential to preserve the asset for future use. The aggregation risk is a common characteristic of shared asset usage, since shared assets typically have more members who could potentially use the asset than the asset can safely bear.

In What the Defendant Can Do Wrong,

security management expert witness Ira Somerson, BCFE, CPP, CSC, writes that “failing to preface your security plan with a risk assessment would violate standard security industry practices. If your risk assessment lacks sufficient qualitative (unscientific) or quantitative (scientific) analysis, it probably will be below a standard security industry practice.”

Risk Assessment is the art and science of identifying security vulnerabilities, measuring the likelihood that each vulnerability will occur (foreseeability), the opportunity for each to occur, measuring each event’s impact upon the organization’s assets (criticality) and prioritizing each identified vulnerability in comparison to all others (queuing).

Insurance fraud expert witness Barry Zalma shares this from Reports of Convictions From the Coalition Against Insurance Fraud:

The sisters should’ve at least coordinated their stories before making their insurance claims.

Jackeline Morales and Gloria Perez claimed they crashed into each other at Interstate 495 South, in Haverhill, Mass. But neither remembered the color of the other’s car, prosecutors say. Nor could they remember if the crash happened while they were getting onto or off the highway, or other details.

In Site Security Planning and Design Criteria, security expert witness Randall Atlas Ph.D., AIA and Anthony DiGreggario of Atlas Safety & Security Design, Inc. write on security layering: the Onion Philosophy (part 2):

New developments in blast curtains, window films, and break resistant and bullet resistant glazing provide the designer with more choices for protection. Yet, a building that is resistant from an exterior bomb blast may be in conflict with the threat of an interior bomb blast and having no ability for decompression or blast out walls. Inside the building, zones or layers of security may be established with various types of access control devices reinforcing physical separations. Protected work stations are critical in many occupations, and safe rooms for CEO protection. Building design should also contribute to or ease implementation of operational security policies and procedures.

The site perimeter is the first, not last, line of defense. The State Department seeks setbacks of at least 100 feet for new buildings, and even that distance is difficult to obtain in most urban settings. While most perimeter fences and walls are designed to discourage intruders, they are of little use against a determined person or bomb vehicle. Designs are now available for vehicle-stopping capabilities. However, the bomb of the future may be delivered by a moped or pedestrian, thus rendering truck bombs unnecessary.

Auto insurance expert witnesses will be testifying in New Mexico cases that cover multiple insurance fraud schemes. The NM Senate passed a bill that would increase insurance fraud penalties by empowering courts to combine the insurance money stolen by multiple schemes into one larger dollar amount and longer sentences. ClaimsJournal.com reports:

State Sen. Carroll Leavell sponsored SB 117, which passed Feb. 17, 2009. A staged-accident ring, for example, might bilk several auto insurers out of hundreds of thousands of dollars with dozens or more fake injury claims. Combining these claims into one larger dollar sum for sentencing purposes can greatly magnify the final penalty, according to the Coalition Against Insurance Fraud. Several states permit courts to aggregate stolen insurance money when sentencing swindlers. Some laws fall under the state’s insurance codes, and others under their general criminal code.

In Site Security Planning and Design Criteria, security expert witness Randall Atlas Ph.D., AIA and Anthony DiGreggario of Atlas Safety & Security Design, Inc. write on security layering: the Onion Philosophy:

The first layer is the outside skin of the onion which translates to the site perimeter of the property. The building skin of the architecture is the next layer. Sensitive areas within a building are deeper layers requiring protection, and finally special persons,

information, or property may require point protection or the center of the onion. The site perimeter is the first, not last, line of defense. The State Department seeks setbacks of at least 100 feet for new buildings and even that distance is difficult to obtain in most urban settings. While most perimeter fences and walls are designed to discourage intruders, they are of little use against a determined person or bomb vehicle.

In 8 & 15 Years Jail for Auto Arson in Idaho, Insurance fraud expert witness Barry Zalma writes:

On January 21, 2009, the Idaho Department of Insurance reported that Spencer Jay Maschek and Patrick Anthony Morrissey, 23 were convicted of arson to their vehicles. In February, 2008, Jerome County Sheriff’s Department found a burning vehicle belonging to Maschek. Maschek subsequently filed a claim with his insurance company. Farm Bureau Insurance contacted the Department of Insurance about the suspicious nature of the claim. Twin Falls Police Department discovered that Maschek had asked Morrissey to set the vehicle on fire. Department of Insurance Investigator Jan Heinz gathered information and assisted Twin Falls County Sheriff’s Department and Farm Bureau Insurance in the investigation. Arson and Conspiracy to Commit Arson are felonies punishable by up to 25 years in prison and a $100,000.00 fine.

Morrissey was found guilty of two felony charges, Conspiracy to Commit Arson in the First Degree and Arson in the First Degree. He was sentenced August 5, 2008, to 15 years, five years fixed, for each crime. The sentences will run consecutively. Morrissey was also ordered to pay restitution. Maschek pleaded guilty to Conspiracy to Commit First Degree Arson, a felony. He was sentenced January 12, 2009, to eight years in jail.

In Site Security Planning and Design Criteria, security expert witness Randall Atlas Ph.D., AIA and Anthony DiGreggario of Atlas Safety & Security Design, Inc. describe design criteria:

Threat: Tactics; weapons, explosives, tools Assets Levels of protection Constraints The result of the assessment will be a set of recommended countermeasures that may be priced and presented to the owner in a priority order so selections may be made of those recommendations that are prudent and cost effective. In the case of the government standards, the assessment results in the assignment of a defined Level of Protection (LOP) with specified countermeasures. When the LOP is defined, the specified countermeasures are priced and again the owner may select appropriate measures depending on a prudent level of protection and the cost effectiveness of the measure.