Expert Witness Blog

In The Advantages of Strategic Advisory Boards For Agency Owners insurance agencies expert witness Andres Barile, MBA, CPCU, writes:

Carrier Relationships

• Negotiating existing insurance carrier agency agreements – Your retail insurance agency has just received the bad news that your largest carrier is leaving the state because of reinsurance costs and insurance product pricing. As the owner of the agency, you turn to your strategic advisory board to come up with a solution to delay the carrier’s withdrawal from the state. In fact, the strategic director would be aware of the carrier withdrawal before it makes the decision to withdraw. Experienced strategic directors know all the signs because they have experienced this before in their younger years. Delaying the withdrawal means commission dollars saved, and value added;

In A Comparison of Self-Funded and Insured Health and Welfare Plans, health benefits expert witnessMark Johnson, J.D., Ph.D., ERISA Benefits Consulting, Inc., writes:

Employee welfare benefit plans can be either fully insured, or self-funded. This article explains and compares the differences between the two types.

Most companies have a fully insured employee benefit plan, where the employer arranges for health coverage from an insurance company. The insurance company assumes the risk for payment of claims based on an actuarial analysis of the policy terms and covered group. The insurance company collects a monthly premium, which is typically shared by the employer and the employee, and pays for claims based on the policy terms. The covered employee is responsible for any deductibles and co-payments.

Indemnity expert witnesses may opine on indemnification, indemnity health insurance, and associated matters. ProfessionalIsuranceIndemnity.org writes:

The term professional indemnity has many definitions ranging from a sum of money paid for damages caused by a professional in the course of his or her work to a legal exemption for liability for damages. Irrespective of the definition, however, professional indemnity insurance covers you for any financial claims made against you for your actions carried out in the course of your professional duties.

What if you were not personally responsible for any errors made by your employees, or even contractors employed by you to carry out certain work? What then? Are you still liable in law? In a simple word, yes! So who comes under the umbrella of ‘professional”?

Insurance industry expert witnesses may write reports and testify on property insurance, insurance regulations, casualty insurance, and long term care insurance. On its website, the National Association of Insurance Commissioners offers a free newswire service with daily insurance news delivered to your email.

Subscribe to the NAIC NewsWire here: http://www.naic.org/newswire_archive.htm

In Guaranteed Maximum Contracts construction expert witness Paul Gogulski explains the the G-Max contract:

There is another reason for using the G-Max contract system: It is the best vehicle for recovering cost when pricing on extras becomes unreasonable. The fact that owners have tremendous leverage on extras is not often mentioned among users, perhaps because it is a business advantage. Consider once again the outrageous cost for a new door. Assume that the contractor wants $1,500 to cut the hole and install a new door, plus another $50,000 to relocate the 4-inch gas pipe that nobody knew existed. Assume also that the true cost of the piping relocation is only $10,000, but the contractor will not back off his estimate. The work must start and he demands approval.

Under lump sum contracts owner’s haven’t got much choice, but under the G Max system, even if you agree to the $50,000, all you’ve given away is the difference in fees, or $2,400 instead of $40,000. Once the work is complete and true cost is known, even this can be adjusted. There’s a strong incentive here to be honest. Nothing like it exists with any other format. Cost plus contracts claim to be the same, but in reality they do not have any incentive for shared savings or efficiencies.

In The Advantages of Strategic Advisory Boards For Agency Owners insurance agencies expert witness Andres Barile, MBA, CPCU, writes:

Forming an agent-owned captive insurance company – Your retail insurance agency has been writing errors and omissions on real estate appraisers with a consistent 25 percent loss ratio, and you want to recapture some of the underwriting profit into your own agent-owned captive insurance company. You require a complete feasibility study, and want to raise the capital for the captive insurance company through a private placement memorandum. The technical task of structuring the feasibility study for the agent-owned captive can be delegated to the strategic advisory board. Should you use Arizona or Vermont, or even Hawaii as your domestic domicile? Do you want to own a Cayman Island agency captive, or Barbados? What are the advantages and disadvantages of each domicile, or shore and offshore? The strategic advisory director has all the answers to let you proceed with this concept to enhance value.

Read more: insuranceexpertnetwork.com.

In The 21st Century Benefits Challenge Health, health benefits expert witness Mark Johnson, J.D., Ph.D., ERISA Benefits Consulting, Inc., writes:

As the baby boomer generation begins to enter retirement, the competition for qualified talent from a shrinking workforce intensifies.

* Health benefits are increasing in cost and complexity * The employer will continue to be a vital part of the retirement income security puzzle * Benefits are vital to attract and retain the best employees * Social Security and Medicare are under siege and being changed * Membership associations are growing as benefits sources for individuals and employers * Mergers, acquisitions or spin-offs frequently present unexpected benefits-related issues

Business income claims expert witnesses may write reports and testify on risk management, business interruption claims, and related issues. In Business Income Claims: Simplified!, How to Document and Calculate Loss, Robert M. Swift, CPCU, CIPA, CBCP, writes:

Business Income claims are the most frustrating part of insurance and cause the majority of E&O lawsuits. Business owners do not understand the coverage, so post loss they receive an education about their insurance policy language resulting in hard feelings and lawsuits. Insurance companies unnecessarily spend approximately $2,500 per claim in loss adjustment expenses hiring forensic accountants to show the insured how to calculate and document their claim. Agents and brokers devote many hours of non-billable time hand-holding, talking to the adjuster, and explaining the policy to the insured. Undoubtedly, this unnecessary time and expense could be better utilized properly preparing and adequately protecting the insured which would eliminate nasty surprises.

Read more: bisimplified.com.

Indemnity expert witnesses may opine on indemnification, indemnity health insurance, and associated matters. ProfessionalIndemnityInsurance. org writes:

The right level of insurance professional indemnity is essential to offer you peace of mind in the event of individual, corporate body or governmental department making a claim for damages, injury or negligence against you, your business or any members of your staff. Any professional business or individual, irrespective of the professional services they provide, must be certain that they are covered for anything that could occur in the course of their business that could do damage or cause loss to their clients.

Read more: insuranceprofessionalindemnity.org.

Disability insurance expert witnesses may opine on disability income insurance and disability insurance claims, among other topics. On their website, the Council for Disability Awareness discusses the The 2011 Council for Disability Awareness Long-Term Disability Claims Review:

CDA Survey Findings: Summary of Key Findings from Proprietary CDA Member Company Data

* $8.3 billion in long-term disability insurance claim payments were made in 2010 by CDA member companies that participated in this year’s study. This represents a 1% increase over payments made in 2009.