Health Insurance Expert Witnesses
Health insurance expert witnesses and consultants listed here may be able to form expert opinions, draft expert witness reports, provide expert witness testimony at deposition and/or trial as or serve as consulting (non-testifying) experts on health insurance. The health insurance expert witness listings on this page are typically from fields/areas of expertise such as: Economics, Emergency Medicine, Family Medicine, Financial, Geriatrics, Health Informatics, HIPAA, HMO, Insurance, Internal Medicine, Legal, Medical Management, Nurse Practitioner, Preventive Medicine, and Statistics.
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Daniel G Fink, CIC, CRM, CPCU, CRIS, AAI
Insurance Expert Witness
Phoenix, Arizona
Insurance
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Insurance Producer Standard of Care, Insurance Bad Faith, Agents E&O, Insurance Coverages and Claims, Insurance Claim handling standards, Workers Comp, Auto Insurance, UM & UIM Insurance, Home Insurance, Insurance Disputes, Life Insurance, Health Insurance, P&C, Umbrellas, etc
Daniel Fink, danielgfink@gmail.com, is an active insurance producer and instructor, as well as an Insurance expert witness, with over 40 years of insurance industry experience. He has earned the CIC, CRM, CPCU, CRIS, & AAI insurance certifications. As an insurance instructor, he teaches continuing education & certification classes for the CIC, CISR, and CRIS programs and speaks on many insurance topics to insurance and industry groups. Daniel is a national faculty member and education writer for The National Alliance for Insurance Education and Research. Daniel is a good communicator (BA in Journalism and English) combined with an extensive background in insurance. He served as President of the IIABAZ (Independent Insurance Agents and Brokers of Arizona) as well as head of its education committee. Daniel teaches insurance associations (Big I and PIA) in many states. Daniel serves as a member of the Independent Insurance Agents & Brokers of America’s (IIABA) “Ask an Expert” Pane...
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Neal Bordenave, JD, CPCU, RPLU, ARM, AIC
Broker/Agent Standard of Care + Claims Practices
RiskPro Insurance Services, Inc.
Arizona
Insurance, Insurance
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Broker/Agent Standard of Care, Bad Faith, Insurance Industry Customs and Practices, Property & Casualty, Life, Annuities, Excess & Surplus, Managing General Agent, Health, Surety, Professional Liability, Underwriting, Claims Practices
More than 35 years experience in the insurance industry. President/CEO of RiskPro Insurance Services, Inc.,
Professor of Risk Management and Insurance at California State University Chico (Retired 2022)
Established Expert Witness Practice in 2009. As of January 2025, more than 500 retentions and testifying in Deposition, Trial and Arbitration more than 100 times.
Education includes Juris Doctor (JD), BS Business Administration/Finance.
Chartered Property Casualty Underwriter (CPCU)
Registered Professional Liability Underwriter (RPLU)
Associate in Risk Management (ARM)
Associate in Claims (ARM)
Licensed Insurance Broker/Agent since 1988
Licensed Oregon Claims Adjuster
Primary States for expert work include, California, Arizona, Nevada, Oregon, Washington, Utah, Colorado and Texas
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Sean Dilweg
A former Insurance Commissioner & Executive
Dilweg Consulting
The Sea Ranch, California
Insurance, Financial
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Bad faith claims, State Regulation, Receivership, Health, Med-Malpractice Insurance, claims practices, Annuity, Life, Consumer Complaints, Property Casualty, Commercial Lines, Personal Lines, Cannabis Regulation, Credit Rating methodologies
Expert Witness Profile – Insurance Regulation, Claims Practices, Financial Analysis, and Structured Finance
Former Wisconsin Insurance Commissioner and senior insurance executive with 20+ years of experience across insurance regulation, insurer operations, financial analysis, and corporate governance. Recognized expert in insurance industry standards, claims handling practices, bad faith, regulatory compliance, and insurer financial condition. Provides expert witness services in state and federal courts, including depositions, jury trials, and litigation support.
Areas of Expertise
• Insurance Expert Witness
• Insurance Bad Faith & Claims Handling
• Insurance Regulatory Compliance (State & Federal)
• Insurance Company Financial Analysis & Solvency
• Property & Casualty Insurance Practices
• Life Insurance & Annuities
• Health Insurance & Managed Care
• Mortgage Insurance & Financial Guaranty Insurance
• Insurance Receivership & Run-Off
• Reinsurance & Risk Transfer
• St...
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Philip J. Cross, Ph.D.
Class action, antitrust & economic damages expert
Kenyon Consulting LLC
California
Economics, Statistics
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Lost wages, Antitrust, Class certification, Lost profits, Breach of contract, Damages, Liability, Platform economics, Conjoint surveys, Health insurance, Class action, Economic damages, Discrimination, Wrongful termination, Wage and hour, Industrial espionage, Lanham Act, Defamation, Statistical sampling, FLSA
Phil Cross is Kenyon Consulting’s principal and founder. He has over twenty-five years’ experience as an economist and statistician in academia, government and consulting.
His consulting experience includes opining in large class-action litigations, high-profile arbitrations, antitrust matters, breach-of-contract matters, wage-and-hour matters and employment discrimination matters.
He is widely recognized as being an effective testifier, able to break down complex economic ideas and empirical findings into plain English for judges and juries.
Phil has his Ph.D. in Economics from the University of Wisconsin, has taught at Georgetown, Johns Hopkins and the University of Melbourne and has published in top academic journals.
Phil has a wide range of experience, including opining on video game distribution, health insurance provision, health-care worker markets, higher education finance, automotive supply distribution, mining, probationary service provision, health care, financial se...
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Neal Bordenave, JD, CPCU, RPLU, ARM, AIC
Broker/Agent Standard of Care + Claims Practices
RiskPro Insurance Services, Inc.
California
Insurance, Insurance
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Broker/Agent Standard of Care, Bad Faith, Insurance Industry Customs and Practices, Property & Casualty, Life, Annuities, Excess & Surplus, Managing General Agent, Health, Surety, Professional Liability, Underwriting, Claims Practices
More than 35 years experience in the insurance industry. President/CEO of RiskPro Insurance Services, Inc.,
Professor of Risk Management and Insurance at California State University Chico (Retired 2022)
Established Expert Witness Practice in 2009. As of January 2025, more than 500 retentions and testifying in Deposition, Trial and Arbitration more than 100 times.
Education includes Juris Doctor (JD), BS Business Administration/Finance.
Chartered Property Casualty Underwriter (CPCU)
Registered Professional Liability Underwriter (RPLU)
Associate in Risk Management (ARM)
Associate in Claims (ARM)
Licensed Insurance Broker/Agent since 1988
Licensed Oregon Claims Adjuster
Primary States for expert work include, California, Arizona, Nevada, Oregon, Washington, Utah, Colorado and Texas
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David G. Campbell, PhD
Economic Damages, Antitrust, and Stat. Sampling
Wicomico Analytics Group LLC
California
Economics, Statistics
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Damages, Antitrust, Statistical Sampling, Class Certification, Healthcare, Health Insurance, Medicare Fraud, Intellectual Property, Patent, Insurance Coverage, Securities Fraud, Environmental Disputes
David is a versatile economist who has worked in private consulting for 25+ years. He served in government as Chief Economist at the Federal Maritime Commision. He has been an Economics professor at several Southern California colleges, where he taught economic theory, econometrics, statistics, and finance. For several years he led an Antitrust Seminar in the joint Law School/Business School program at Pepperdine.
David's research is well-cited; his article on Productivity Dynamics has over 1750 citations on Google Scholar.
David has been retained as an economic and statistical expert in litigation matters in both U.S. District courts and state courts. He has opined in antitrust, medicare fraud, environmental, and intellectual property matters.
In addition to his expert witness testimony, David has consulted for a wide variety of corporate and government clients. Notably, he served as chief statistician for the first-ever audit of the US Navy.
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Philip J. Cross, Ph.D.
Class action, antitrust & economic damages expert
Kenyon Consulting LLC
Washington, District Of Columbia
Economics, Statistics
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Lost wages, Antitrust, Class certification, Lost profits, Breach of contract, Damages, Liability, Platform economics, Conjoint surveys, Health insurance, Class action, Economic damages, Discrimination, Wrongful termination, Wage and hour, Industrial espionage, Lanham Act, Defamation, Statistical sampling, FLSA
Phil Cross is Kenyon Consulting’s principal and founder. He has over twenty-five years’ experience as an economist and statistician in academia, government and consulting.
His consulting experience includes opining in large class-action litigations, high-profile arbitrations, antitrust matters, breach-of-contract matters, wage-and-hour matters and employment discrimination matters.
He is widely recognized as being an effective testifier, able to break down complex economic ideas and empirical findings into plain English for judges and juries.
Phil has his Ph.D. in Economics from the University of Wisconsin, has taught at Georgetown, Johns Hopkins and the University of Melbourne and has published in top academic journals.
Phil has a wide range of experience, including opining on video game distribution, health insurance provision, health-care worker markets, higher education finance, automotive supply distribution, mining, probationary service provision, health care, financial se...
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David G. Campbell, PhD
Economic Damages, Antitrust, and Stat. Sampling
Wicomico Analytics Group LLC
Washington, District Of Columbia
Economics, Statistics
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Damages, Antitrust, Statistical Sampling, Class Certification, Healthcare, Health Insurance, Medicare Fraud, Intellectual Property, Patent, Insurance Coverage, Securities Fraud, Environmental Disputes
David is a versatile economist who has worked in private consulting for 25+ years. He served in government as Chief Economist at the Federal Maritime Commision. He has been an Economics professor at several Southern California colleges, where he taught economic theory, econometrics, statistics, and finance. For several years he led an Antitrust Seminar in the joint Law School/Business School program at Pepperdine.
David's research is well-cited; his article on Productivity Dynamics has over 1750 citations on Google Scholar.
David has been retained as an economic and statistical expert in litigation matters in both U.S. District courts and state courts. He has opined in antitrust, medicare fraud, environmental, and intellectual property matters.
In addition to his expert witness testimony, David has consulted for a wide variety of corporate and government clients. Notably, he served as chief statistician for the first-ever audit of the US Navy.
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Maria T. Santi
Health Insurance Expert
Health and Medicine Law Firm
Miami, Florida
Legal, HMO
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Health Insurance, Health Maintenance Organization, Affordable Care Act, Preferred Provider Network, Medical Insurance, ERISA
Maria T. Santi, Esq, is a Legal advocate for Patients and Physician Directed Healthcare in Florida. She is a native Miamian and the founder of the Health and Medicine Law Firm. She obtained her JD with a certification in Health Law from Nova Southeastern University—Shepard Broad College of Law. Maria is actively involved with the Florida Bar serving on the Government Advocacy Committee, and as a member of the Health Law section. She is admitted to practice in Florida, Washington DC and the US Supreme Court. Her legal practice is focused on healthcare law, including legal disputes against Health Insurance Companies, Health Insurance Litigation for denied treatment and prescriptions, Medicaid and Medicare representation for appeals and administrative hearings for medical treatment denials, medical bill disputes and negotiations, and health insurance appeals. She also handles legal action under the Employment Retirement and Security Act ("ERISA"). She is also a Certified Human Rights C...
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Kim A Reich, MBA, MJ, PBCI, RHIA, CPHIMS, CEDS, CPHQ, FAHIMA
KBS Consulting & Expert Witness Services
Lake Forest, Illinois
Health Informatics, HIPAA
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Electronic Health Information Systems, (CPHIMS) Medical Records, Healthcare EDiscovery, (CEDS) Information Governance, Electronic Health Records, Health Insurance, Healthcare Compliance, Clinical Documentation, CEDS, RHIA, Quality Improvement (CPHQ)
Kimberly is a credentialed (MBA, MJ, PBCI, RHIA, CPHIMS, CEDS CPHQ, FAHIMA) healthcare ediscovery, HIPAA, information governance, quality management, and compliance professional with over 30 years of experience in a variety of healthcare settings. She is a national speaker and author on the topics of health information operations, including HIPAA, e-discovery, information governance and healthcare compliance. Kim has been an active member of the Health Level Seven (HL-7) Working Group responsible for review and development of the Records Management and Evidentiary Support (RM-ES) profile for the design and development of the functional profile for Electronic Health Record (EHR) systems since 2006. She has also been an active member and contributor in AHIMA task forces and working groups related to electronic discovery. Kim holds a Master’s of Business (MBA) from the Lake Forest Graduate School of Management, a Master’s of Jurisprudence (MJ) in Health Law and Policy from the Loyola S...
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DANIEL K. BIXLER, MD, MMM
Physician, Broad Experience - Med/Product/Criminal
HT2 MedSolutions, LLC
Kansas
Emergency Medicine, Internal Medicine
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Emergency, Internal Medicine, Pediatrics, medical negligence, product injuries, criminal defense, personal injury, disability, practice management, medical group management, medical director, health insurance, maritime medicine, travel medicine, cruise ship
Emergency medicine - 3O+ years;
Primary care practice - 10 years;
Cruise ship physician, part time - 25 years;
Medical group management - 5 years;
Health insurance management - 5 years;
Board certified: Emergency Medicine, Internal Medicine, previously Pediatrics;
Trauma center experience - Level I, II, III;
Urban, suburban and small town Emergency;
Educator for medical students at two universities;
ATLS instructor;
Certified mediator training and experience.
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Jennifer LeBlanc, MSN, ANP-BC
Laplace, Louisiana
Nurse Practitioner, Geriatrics
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Clinic Management, Wellness Visits, Health Insurance, Telemedicine, Standards of Care, HR Needs, Preventative Medicine, Health Policy, Training, Nursing Home, CMS Guidelines, Hospice, N95 Fit Tester, HCC/HEDIS, ICD 10 Coding, Medical Documentation
I am a 2001 graduate of Southeastern Louisiana University where I received my MSN to become an Adult Nurse Practitioner. Accomplished, Award-winning Nurse Practitioner with a combined 30 years of experience in —Nursing Home — Hospice Care —Renal Disease — OB/GYN — OR/PACU. I am presently in a —Market Management role with a health insurance company overseeing a staff of Nurse Practitioners working with Medical Assistants conducting comprehensive wellness assessments. Highly skilled and knowledgeable in proper standards of care, policy and procedure, team management and training. Proven ability to support success in a results-oriented profession. Experience in leading a multi-disciplinary team with expected high-quality productivity. Recipient of the 2023 SAGES Award for Clinical Excellence.
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DANIEL K. BIXLER, MD, MMM
Physician, Broad Experience - Med/Product/Criminal
HT2 MedSolutions, LLC
Lee's Summit, Missouri
Emergency Medicine, Internal Medicine
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Emergency, Internal Medicine, Pediatrics, medical negligence, product injuries, criminal defense, personal injury, disability, practice management, medical group management, medical director, health insurance, maritime medicine, travel medicine, cruise ship
Emergency medicine - 3O+ years;
Primary care practice - 10 years;
Cruise ship physician, part time - 25 years;
Medical group management - 5 years;
Health insurance management - 5 years;
Board certified: Emergency Medicine, Internal Medicine, previously Pediatrics;
Trauma center experience - Level I, II, III;
Urban, suburban and small town Emergency;
Educator for medical students at two universities;
ATLS instructor;
Certified mediator training and experience.
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James B Robertson, MD, FACS, CPE, AME, HIMS AME
Montana Medical Solutions, PLLC dba Gallatin Urology & Aviation Medicine
Bozeman, Montana
Urology & Urological Surgery, Medical Management
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Diagnosis and treatment of kidney/bladder/prostate/ureteral cancer, sarcoma, complications of surgery, stones, bladder injury, trauma, general urology, general pediatric urology, health insurance, health policy, guidelines, credentialing & privileging, regulatory & legislative affairs
Dr. Robertson is a Diplomate of the American Board of Urology, and a board-certified urologist with 30+ years of clinical and surgical experience in a community setting. He is well-versed in all aspects, surgical and non-surgical, of general urology and brings the unique perspective of the community surgeon to the medical-legal arena. Dr. Robertson received a BA degree from the University of Houston and an MD degree from the University of Texas Southwestern Medical School. He completed urology training at Vanderbilt University Hospitals and has practiced in Bozeman, MT and central Virginia since. He is a published author and has written booklets for the layman on prostate cancer and prostate brachytherapy. Dr. Robertson is a clinical instructor in the WWAMI program of the University of Washington Medical School. He is a Certified Physician Executive with the American Association for Physician Leadership and an aviation medical examiner for the FAA. He has held numerous positions in...
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Wayne Goodwin, JD (Juris Doctor)
State Insurance Commissioner Expert Witness
Seaboard Strategic Consulting, LLC
Raleigh, North Carolina
Insurance, Legal
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insurance regulator, health insurance, liability, licensure, Insurance Commissioner, homeowners insurance, claims practices, Model Laws, best practices, workers compensation, ethics, property & casualty, captive insurance, NAIC, life insurance, automobile insurance, ratemaking, consumer protection, fire marshal, DMV Commissioner
Wayne Goodwin is the *former* North Carolina INSURANCE COMMISSIONER with an extensive background in insurance regulation, government, law, politics, and public policy. He is also President/CEO of Seaboard Strategic Consulting, LLC.
A native of rural Hamlet, North Carolina, Wayne rose from a challenging family life of modest means to become a statewide elected official and serve in other prominent roles in the Tar Heel state.
Goodwin received both the Morehead Scholarship and US Senate/William Randolph Hearst Scholarship before graduating both with honors in Political Science and then with his juris doctorate from the University of North Carolina at Chapel Hill.
Wayne launched his law practice back home where he represented injured workers and helped families with insurance claims. In addition to serving as an attorney, he helped solve problems both as a court-appointed mediator and arbitrator. Further, he taught Business Law, American Government, and Criminal Justice at the loca...
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Neal Bordenave, JD, CPCU, RPLU, ARM, AIC
Broker/Agent Standard of Care + Claims Practices
RiskPro Insurance Services, Inc.
Bend, Oregon
Insurance, Insurance
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Broker/Agent Standard of Care, Bad Faith, Insurance Industry Customs and Practices, Property & Casualty, Life, Annuities, Excess & Surplus, Managing General Agent, Health, Surety, Professional Liability, Underwriting, Claims Practices
More than 35 years experience in the insurance industry. President/CEO of RiskPro Insurance Services, Inc.,
Professor of Risk Management and Insurance at California State University Chico (Retired 2022)
Established Expert Witness Practice in 2009. As of January 2025, more than 500 retentions and testifying in Deposition, Trial and Arbitration more than 100 times.
Education includes Juris Doctor (JD), BS Business Administration/Finance.
Chartered Property Casualty Underwriter (CPCU)
Registered Professional Liability Underwriter (RPLU)
Associate in Risk Management (ARM)
Associate in Claims (ARM)
Licensed Insurance Broker/Agent since 1988
Licensed Oregon Claims Adjuster
Primary States for expert work include, California, Arizona, Nevada, Oregon, Washington, Utah, Colorado and Texas
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Sandra Guerra, MD, MPH
Exec Doctor: Public Health, Insurance & Medicine
San Antonio, Texas
Preventive Medicine, Family Medicine
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Health Insurance, Utilization Management, Government Contracts, Quality, Outbreak, Communicable Diseases, TRICARE, Medicare, Medicaid, HIV, LGBT care, Migrant Care, Non-profit or indigent care, Correctional facility care, Denial/Appeals, Academic health, Population health, Tuberculosis, Non-Profit
Executive Physician and former Chief Medical Officer with extensive leadership experience across public health, health insurance, complex health systems, government agencies, and nonprofit organizations. Brings deep clinical, administrative, and policy expertise to cases involving population health, disease prevention, standards of care, health plan operations, and organizational oversight.
Areas of Expertise
Public Health • Preventive Medicine • Family Medicine • Population Health • Health Insurance and Health Plan Operations • Clinical Oversight and Standards of Care • Utilization Management, Denials, Case and Disease Management • Outbreak and Contamination Response • Disaster Health • Clinical Quality Improvement and HEDIS Attainment • Accreditation and Certification • Clinical Safety • Provider Network Credentialing • Social Determinants of Health • Health Equity • Government Health Programs (Federal, State, Local) • Clinical Analytics, Metrics, AI and Predictive Analytics • Pub...
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Carol E Schultz, FSA, MAAA
Health Actuary
White Pine Actuarial Consulting
Austin, Texas
Insurance, Health Informatics
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Actuary, Actuarial, Health Insurance, Medicare, Finance, Medigap, Medicare Advantage, Medicare Supplement
I am a health actuary with over 20 years of experience. I am a Fellow of the Society of Actuaries (FSA), and a member of the American Academy of Actuaries (MAAA). Most of my work experience is related to Medicare, but I know the general health insurance industry and can work on a variety of insurance-related topics. I am an excellent public speaker and writer. I can easily translate the complex topics of my work to a non-technical audience and have an approachable countenance. I worked for three major health insurance carriers for a total of 18 years before launching my own consultancy to work on a variety of health-related projects in 2024. I greatly enjoy the variety of projects I am exposed to as a consultant. I look forward to serving as an expert witness, as it will give me the opportunity to explore even more health insurance topics, and lend my expertise in legal cases. I am good at explaining technical concepts in reports, talking about the concepts of my work to peo...
