Insurance Expert Witnesses in Texas

Insurance, Legal - Property & Casualty Claims, Casualty Insurance, P&C Claims, Insurance Claims, Insurance Bad Faith, First, Third, Industry Standards, Common Practices, Insurance Coverage, Investigation, Insurer Defense, Personal Injury, commercial, personal, auto, homeowner, bodily injury, property damage, uninsured

Independent professional providing consulting services to law firms representing plaintiffs and insurer defendants involved in disputes or litigation related to property and casualty insurance claims. Over thirty (30) years of experience as a property and casualty insurance claim professional. Experience as Claim Representative, Litigation Examiner, Supervisor, Trainer, Manager, and Consultant. Expertise include coverage analysis, investigation, liability determination, damage evaluation, negotiation, and settlement of personal and commercial lines claims. Experienced in claims involving bodily injuries, property damages, and related damages under personal and commercial auto policies, homeowner/condominium/rental policies, commercial property damage policies, commercial general liability policies, and businessowner policies. Claim types include auto accident, premises liability, auto damage, personal & commercial property damage, bodily injury, personal injury, property da...

Insurance, Risk Management - Insurance Broker Standard of Care, Insurance Federal Cases, Rule 26, Insurance Pollution, Umbrella Insurance, Excess Insurance, Insurer Bad Faith, Insurance Coverage, Construction Defect Insurance, Insurance Manuscript Policies, Insurance Custom and Practice, Property Casualty Insurance

Trusted by 32 of the Top 100 Insurance Law Firms Bob began his career as a casualty underwriter for Pacific Indemnity Company (Chubb) and later for Industrial Indemnity Company. Bob also served as president, chief executive officer, and chairman of the board of well-known Anderson & Anderson Insurance Brokers. Over nearly 30 years, he built Anderson & Anderson from a four-person company to the fifth-largest brokerage firm in California until the time of its sale to AON Corporation. At Aon, Bob was the president of the Aon Advantage Group which advised 20 industry practice leaders such as the Hospitality Group which insured Hotels, Resorts, and Casinos. Bob attended the Harvard Business School’s OPM program which is similar to its MBA program. He earned his CPCU (Chartered Property Casualty Underwriter) designation in 1970 from the American Institute for Property and Liability Underwriters, Inc. Areas of expertise include, but are not limited to; • ADR (Arbitration/Mediation) Cove...

Insurance, Risk Management - bad faith, claims, claim handling, reserves, bad-faith, unfair claims settlement practices, third party administrator, reinsurance, notice, asbestos, extra contractual, receivership, claims management, liquidation, environmental, property and casualty, reserve adequacy, market conduct examination

Throughout his career, Mr. Bingham served as a senior claims manager for 3 major property casualty carriers: CNA, the Hartford, and USF&G. As a seasoned senior level Insurance, Reinsurance, Regulatory and Run-Off Practitioner with 4 decades of industry, consulting, and receivership experience, Mr. Bingham possesses a demonstrated ability to analyze complex insurance-related matters in fast paced and evolving environments. Mr. Bingham’s credentials as subject matter expert have been accepted in both state and federal courts across the country. Mr. Bingham has demonstrated an understanding and command of claims handling practices, reinsurance policies, and regulatory and run-off issues of the highest complexity. His wealth of experience in the handling of claims, claims management, regulatory compliance, drafting expert reports, and testifying in complex litigation have made him an asset to businesses and attorneys throughout the United States. As a past recipient of the Cert...

Texas

Medical Genetics, Insurance - Wrongful birth, Birth defects, Prenatal genetic testing, Genetic testing, Down syndrome, Congenital anomalies, Metabolic disorders, Pharmacogenomics, Newborn screening, Teratology, Cancer, Life insurance, Mitochondrial disease, Life insurance, Genetic counseling, Developmental delays, Infant death, SIDS, Prior authorization, Insurance

Dr. Sajel Lala Kana is a distinguished clinical geneticist with extensive expertise in genetics and pediatrics. She is residency-trained in Pediatrics and is fellowship-trained in genetics. She is board-certified in Genetics by the American Board of Medical Genetics and Genomics (ABMGG). With over 15 years of experience in academia and clinical practice, Dr. Kana has successfully led numerous research projects, contributed to high-impact publications, and presented her work at prestigious conferences. She is a Fellow of both the American College of Medical Genetics and the American Academy of Pediatrics. She also has a passion for biotechnology and has consulted with numerous start-ups and industry giants. She has contributed her expert witness services to multiple successful outcomes collectively worth $500 million+ USD in damages collected. Key Achievements: - Chief architect for a first-of-its-kind automated managed care product for genetics, acquired by Centene Corporation for...

Austin, Texas

Insurance, Health Informatics - 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...

Texas

Medical Billing, HIPAA - Medical billing expert, Patents trade secrets, electronic medical records, Medicare fraud, medical billing fraud, qui tam false claims act, Meaningful Use Electronic Health Records, HITECH Act, Affordable Care Act, Medicare Advantage, Medicaid, insurance, EMTALA, HIPAA, rebut life care, Usual Customary Reasonable (UCR), damages

Writer, speaker, published peer-reviewed works as an expert in the field recent Federal court rulings as a qualified expert published in Westlaw • US COURT OF APPEALS considered expert opinions, VACATED AND REMANDED • Two DOJ retentions, $155 million settlement • Healthcare IT patents intellectual property Technical Expert, Medicare Damages Expert • Medical coding medical billing, claims, usual customary and reasonable charges in personal injury and medical malpractice cases, Lifecare plan rebuttal under ACA on the future cost of care, trauma • Electronic medical record forensics / electronic health record forensics, E.H.R, practice management IT, medical, prescription charges, workman's compensation, insurance fraud • genetic testing, novel genetic sequencing, esoteric testing, laboratory testing • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Healt...

McKinney, Texas

Medical Billing, Insurance - Managed Care, HMO, PPO, Medicare, Medicaid, Reasonable Value, Audit, Hospital, ERISA, Usual and Customary, Reimbursement Disputes, Claims Denials, Athena Billing, Out-of-Network, Balance Billing, Fee Schedule Analysis, Expert Testimony, Medical Necessity, Multi-State, Healthcare Reimbursement

I have over 35 years of experience in medical billing, reimbursement, and managed care systems, with expertise spanning provider operations, payer methodologies, and claims adjudication practices. My work focuses on evaluating medical billing accuracy, reimbursement methodologies, usual and customary charges, and payer denial practices. Practice includes multi-state reimbursement analysis, with extensive experience in California managed care systems, including HMO, IPA, and risk-based reimbursement structures, as well as Medicare Advantage and national payer methodologies. I have served in multiple roles, including claims examiner, billing manager, revenue cycle executive, and founder of a national medical billing and audit firm. This multidisciplinary experience allows me to analyze disputes from both the provider and payer perspectives. Experience includes analyzing billing system workflows and claims processing issues across platforms such as Athenahealth. My expert work includ...

Houston, Texas

Insurance, Actuarial - P&C, L&H, reinsurance, insurance agency standards, insurance underwriting, insurance archaeology, bad faith, actuarial, property & casualty insurance, life & health insurance, risk management, insurance broker standards

Robert Hughes Associates, established 1979, is a group of insurance experts with a wide range of experience and backgrounds -- former insurance company executives, agents, brokers, underwriters, Workers Compensation specialists, D&O and E&O expertise, risk managers, claims managers, adjusters, actuaries and captive management specialists. Degrees include Masters and PhDs. Certifications include CPCU, RPLU, RF, ACE, ACAS, MAAA, CLU, CEBS, FCAS, SCLA, ChFC, RHU, LLIF, CRPS, FLMI, and CSSC. Robert Hughes Associates is an internationally recognized insurance, risk management and actuarial consulting company.

Texas

Construction, Premises Liability - Defects, personal injury, insurance, codes, commercial, residential, accidents, falls, asbestos, ADA, sewer, water, liability, damages, general contractor, fire, flood, contracts, subcontractors, engineer

Highly experienced construction and premises expert. Specializes in large commercial and multi-residential construction disputes and serious bodily injury claims. Has served on over 300 cases as an expert witness and dozens of cases as an arbitrator. 30+ years’ experience as a general contractor and owner/developer focusing on condominiums, roads, sewers, subdivisions, offices and other major construction. Summa Cum Laude/Phi Beta Kappa graduate of the University of North Carolina. Consultant (2008-Present): Georgia, North Carolina, Florida, Alabama, Mississippi, and Tennessee. Cases include commercial defects and delays, serious personal injuries, multifamily, sewers, roads and drainage, retail, insurance, professional liability, and construction business practices. Approximately equal representation of plaintiffs and defendants. General Contractor - President of Buckhead Classic (2006 – presen): Projects include defective construction repair, new construction, fire and flood...

San Antonio, Texas

Property Damage, Insurance - Appraisal, Appraiser, Umpire, Cost Estimation, Property Loss Causaton, Estimator, Fire Damage, Mitigation, Windstorm Damage, Water Damage, Hail Damage, Construction Defect, Tornado Damage, Multifamily, Roofing, Commercial Residential, Restoration, Mold Loss, Remediation, General Contractor

An OSHA and Haag Certified, State of Texas and Florida Licensed Public Adjuster and State of Florida Certified General Contractor with more than 22 years of experience directly related to the renovation and consulting of losses from disaster afflicted homes and businesses. Haag Certified Roof Inspector, IICRC and BESI Certified General Contractor, Appraiser, Umpire, Estimator, Renovator, Remediator and Expert Witness / Consultant. State of Florida Certified (Licensed) General Contractor CGC1509420 BESI Certified Defective Drywall Remediator (CDDR) BESI Certified Defective Drywall Consultant (CDDC) NuAire Windows and Doors Certified Installer Dryvit E.I.F.S. Certified Installer IICRC Certified Water Restoration Technician (WRT) IICRC Certified Advanced Structural Drying (ASD) State of Texas Licensed Public Adjuster TDI#1840149 State of Florida Licensed Public Adjuster Haag Certified Roof Inspector OSHA 10 Certified Has completed 1,000's of property and roof damage inspections a...

Houston, Texas

Insurance, Real Estate - Auto Insurance, Bad Faith, Standard of Care, COI, Hurricane Insurance, Homeowners Association Insurance, nonsubscriber Insurance, Marine Insurance, Control of Well Insurance, O&G, Oil & Gas Insurance, Directors & Officers Insurance, Hotels, Pollution, E&O, Errors & Omissions, Surety, Property & Casualty, Environmental, Umbrella

Mr. Margraves started his second career as a full-time expert witness in 2020, backed with over thirty-three years commercial property & casualty insurance experience. Mr. Margraves has been designated as an expert witness in 22 case assignments: 19 State cases and 3 Federal cases. Case assignments are divided between 12 for Defense and 10 for Plaintiff, including Arkansas, Colorado, Illinois, Louisiana, New Mexico and Texas. He is an insurance industry expert that brings extensive experience in all aspects of property & casualty insurance interpretation, policy forms, applications, claims, safety programs, and contract integration. Expertise includes Bad Faith, Agency E&O, Standard of Care, Marine, Environmental, Surety & Bonds, CYBER, and Certificates of Insurance. He is the Principal Consultant and Founder of Gulf Coast Risk Management, LLC (GCRM). GCRM provides consulting services to attorneys, property owners, asset managers, and general contractors regarding insurance placemen...

Houston, Texas

Insurance, Financial - Annuity suitability violations, Annuity sales practices, Elder financial abuse, Annuity marketing practices, Annuity disclosure failures, Insurance agent misconduct, Insurance elder financial abuse, Annuity churning abuse, Annuity twisting abuse, Insurance Replacement Harm, Insurance sales misconduct

Michael Schellinger, RICP®, CLTC®, NSSA®, EA, is a Registered Investment Advisor Representative (Series 65) and Enrolled Agent with over 25 years of experience in insurance and financial services. Licensed in life and health insurance since 1999 and Series 65 registered since 2019, he specializes in annuities, life insurance, and the tax implications of financial products. He is recognized for his expertise in annuity and insurance sales practices, suitability, misrepresentation, fiduciary duties, disclosure obligations, and compliance oversight, with advanced designations in retirement income planning (RICP®), long-term care (CLTC®), and Social Security (NSSA®). Mr. Schellinger has trained and supervised agents, developed compliance procedures, and reviewed countless cases involving annuity and life insurance sales. His unique dual background as an investment advisor and Enrolled Agent enables him to analyze both the financial planning and tax dimensions of insurance and annuity ...