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Insurance fraud expert witnesses may consult and testify on insurance claims, the insurance industry, insurance class actions, and associated topics. On its website, the California Department of Insurance offers search capability back to 2001 in their Formal Enforcement Actions.

Use this page to find pleadings and other legal documents related to formal enforcement actions that the Department has taken against insurance companies, agents, brokers and other Department licensees. Examples of documents you may find include Accusations, Orders to Show Cause, Notices of Non-Compliance, Final Decisions and Orders of the Commissioner and Appellate Orders. See insurance.ca.gov.

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Trucking accidents expert witnesses may provide reports regarding the Department of Transportation (DOT), trucking computer systems, crash-worthiness, trucking insurance, trucking safety, and correlated topics. In the news, Bendix is delivering repair kits for a faulty brake valve to truck manufacturers. Bendix is replacing faulty ATR-6 valves on its commercial vehicle brake systems.

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Auto insurance claims expert witnesses may opine on automobile insurance rates, auto insurance companies, and related matters. On its website, the California Department of Insurance offers Studies & Reports including the Automobile Complaint Composite report. The report includes 50 large automobile insurers licensed to conduct business in California.

Read more: insurance.ca.gov.

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Courthouse News service reports a forensic pathology expert witness will not testify that repeated police Tasering contributed to the death of a schizophrenic man. U.S. Magistrate Judge William Wall ruled in the wrongful death case against Southampton, Suffolk County (NY), police officers and Taser International.

Read more: courthousenews.com.

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In the news this week, insurance experts commented on proposed legislation by California Insurance Commissioner Dave Jones regarding self insured plans for small employers. The Self-Insurance Industry Institute of America defines self insurance:

Self-Insurance (also referred to as self-funding) is an alternative risk transfer strategy used by tens of thousands of employers across the country to finance their group health care and Workers’ Compensation liabilities. Self-Insurance has become an increasingly attractive option for many employers due to the rising costs associated with health care and Workers’ Compensation commercial insurance.

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Stop loss contracting expert witness Stephen C. George, MBA-HA, President of Provider Risk, explains “stop loss”:

Stop loss is an insurance which provides reimbursement for catastrophic medical claims incurred by a self-funded employer’s employee or by a capitated HMO member. There are two primary types of medical stop loss – employer stop loss and provider stop loss (provider excess loss).

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Risk management expert witness Stephen C. George, MBA-HA, President of Provider Risk, explains “capitation”:

A capitation is a fixed dollar amount per plan member per month paid to providers regardless of medical utilization. The payment structure shifts the financial risk from the insurance company to the physician or hospital accepting payment. Physicians and hospitals buy stop loss to limit any potential catastrophic medical financial loss on any one member per year.