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, Financial, Health Informatics, HIPAA, Insurance, Internal Medicine, Medical Management, Public Health, Statistics, and Urology & Urological Surgery.

Neal Bordenave, JD, CPCU, RPLU, ARM, AIC RiskPro Insurance Services, Inc.

Arizona
Insurance - 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 30 years experience in the insurance industry. President/CEO of RiskPro Insurance Services, Inc., Professor of Risk Management and Insurance at California State University Chico. Established Expert Witness Practice in 2009. As of January 2022, more than 300 retentions and testifying in Deposition, Trial and Arbitration almost 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) Primary States for expert work include, California, Arizona, Nevada, Oregon, Washington, Utah, Colorado and Texas

David R. Mitchell, CPCU, CIC, MBA, MA.HR, SPHR, SHRM-SCP Ideal Insurance Agency

Surprise, Arizona
Insurance - insurance standard of care, insurance coverage, insurance bad faith, workers compensation, human resources, property and casualty insurance, life insurance, health insurance, disability insurance, long term care insurance, cyber insurance, auto insurance, home insurance, business insurance
David has been a licensed practicing insurance producer for 39 years. He understands the reasonable care, skill and diligence from not only academia but experience. He has been an insurance agency owner for 37 years. To date he has consulted in over 50 court cases as a consultant/expert. His consultant/expert work is split at about 45% Plaintiff and 55% Defense. David has testified in several depositions and at jury trial with a successful outcome. David is a CPCU. In addition, he has been a Certified Insurance Counselor since September of 1992. The Family Agency in which he is a partner has won both community and industry awards. David has reviewed the Arizona State Licensure Exams since 1998. He has taught various insurance courses through The National Alliance since 2002. He has taught several continuing education courses in Arizona. Since 2002 he has taught various business courses collegiately. Currently has been an adjunct professor at Glendale Community College teaching in...

Neal Bordenave, JD, CPCU, RPLU, ARM, AIC RiskPro Insurance Services, Inc.

Chico, California
Insurance - 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 30 years experience in the insurance industry. President/CEO of RiskPro Insurance Services, Inc., Professor of Risk Management and Insurance at California State University Chico. Established Expert Witness Practice in 2009. As of January 2022, more than 300 retentions and testifying in Deposition, Trial and Arbitration almost 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) Primary States for expert work include, California, Arizona, Nevada, Oregon, Washington, Utah, Colorado and Texas

David G. Campbell, PhD Wicomico Analytics Group LLC

California
Economics, Statistics - 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 20+ years. 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 1400 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, and intellectual property matters. In addition to his expert witness testimony, David has consulted for a wide variety of corporate and government clients. Last year, he served as chief statistician for the first-ever audit of the US Navy.

David G. Campbell, PhD Wicomico Analytics Group LLC

Washington, District Of Columbia
Economics, Statistics - 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 20+ years. 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 1400 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, and intellectual property matters. In addition to his expert witness testimony, David has consulted for a wide variety of corporate and government clients. Last year, he served as chief statistician for the first-ever audit of the US Navy.

Kim A Reich, MBA, MJ, PBCI, RHIA, CPHIMS, CEDS, CPHQ, FAHIMA KBS Consulting & Expert Witness Services

Lake Forest, Illinois
Health Informatics, HIPAA - 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...

Thomas J. Dawson, III TD&P Consulting Inc.

Silver Spring, Maryland
Medical Management, Public Health - Health Insurance, Health Policy, Healthcare Pricing, Healthcare Delivery & Financing, Reasonable Value Analysis, Medicaid & Medicare, Affordable Care Act
Thomas (Tom) J. Dawson III, ESQ., MPH, MA is the founder and CEO of TD&P Consulting, Inc., a health policy firm focused on health reform and its impact on private and public health insurance markets. With over 23 years in healthcare policy, Mr. Dawson has served on Capitol Hill, at the Department of Labor, and with for-profits and non-profits in the private sector. Before entering the private sector, Mr. Dawson served as the Health Care Counsel to the U.S. House of Representatives Committee on Small Business. In this role, he provided guidance on healthcare reform, Medicare and Medicaid reimbursement policy and commercial health insurance markets. Mr. Dawson also provided policy guidance to the Congressional Hispanic Caucus (CHC) Health Care Task Force and drafted legislation relevant to the health science industry and small businesses. From 2001 to 2007, Mr. Dawson served as a pension law specialist with the U.S. Department of Labor’s Employee Benefits Security Administration (EB...

DANIEL K. BIXLER, MD HT2 MedSolutions, LLC

LEES SUMMIT, Missouri
Emergency Medicine, Internal Medicine - Emergency, Maritime Medicine, Internal Medicine, Pediatrics, management, medical director, health insurance
30 years in emergency medicine- 15 part time, 15 full time 25 years cruise ship physician, part time 10 years private practice, primary care 3 years medical group management 5 years health insurance management Board certified in Emergency medicine, Internal medicine, previously in Pediatrics Level I and II trauma center experience Urban, Suburban and small town ED experience ATLS instructor Certified mediator training and experience

James B. Robertson, MD

Bozeman, Montana
Urology & Urological Surgery, Medical Management - 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 licensed urologist with 25 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 leaders...

Charles W. Bowden, CLU, ChFC FSP

Smithville, New Jersey
Insurance, Financial - Life Insurance, Health Insurance, Disability Insurance, Financial Planning, Life Insurance Funding, Policy Valuation
Following graduation from Lehigh University, Charlie entered the insurance industry as an Employee Benefit Specialist. In addition to his thirty plus years of experience, he has achieved both industry recognized designations of Chartered Life Underwriter (CLU) and Chartered Financial Consultant (ChFC). As a Qualified Continuing Education Instructor, he teaches other licensed insurance professionals about the changing structure of the income and estate tax code, and planning strategies. Additionally, Charlie uses his experience to provide expert testimony in State and Federal Court. Charlie is a member of the Society for Financial Service Professionals, as well as a past member of their Board Authority of Directors. He maintains registration with the Financial Industry Regulatory Authority (FINRA). He is an investment Advisor Representative (IAR). Securities Offered Through TFS Securities, Inc. Member of FINRA/SIPC, A Full Service Broker-Dealer Located at 437 Newman Springs Road, L...

Frank Seigel, CPCU Ringwood Consulting Group, Inc.

Allamuchy, New Jersey
Insurance, Financial - Agent/Broker, Broker Duties, Agent/Broker Duties & Responsibilities, Agent/Company Relations, Bad Faith, Errors & Omissions, E&O, Coverage Disputes, Excess/surplus, Surplus Lines, Casualty, Property, Life, Health, Disability, Coverage, Contractual Disputes, Arbitration, Mediation, Standards of Care
PROFESSIONAL ACTIVITIES • Past President, New Jersey Chapter Society of CPCU • Current and Past President, Independent Insurance Agents of Essex County, Inc. • Past President, Surplus Lines Association of New Jersey, Inc. (NJSLA) • Former Member, New Jersey Department of Insurance Committee Education • Former Member, Grading Panel for the Insurance Institute of America • Former Arbitrator for the American Arbitration Association. • Panelist, ABA Conference on Banking and Insurance • Attendee, New Jersey Conference on ECRA • Guest Speaker and Presenter for various professional, academic, and civic groups including New Jersey Chapter CPCU, Independent Insurance Agents, Seton Hall University Continuing Education Department, National Association of Insurance Women (NAIW), Local Rotaries, and Insurance Service Office (ISO) • NJ State Approved Volunteer Mediator for Municipal Court Matters • Member, Professional Liability Underwriting Society (PLUS) • Member, National Association of Prof...

Neal Bordenave, JD, CPCU, RPLU, ARM, AIC RiskPro Insurance Services, Inc.

Oregon
Insurance - 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 30 years experience in the insurance industry. President/CEO of RiskPro Insurance Services, Inc., Professor of Risk Management and Insurance at California State University Chico. Established Expert Witness Practice in 2009. As of January 2022, more than 300 retentions and testifying in Deposition, Trial and Arbitration almost 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) Primary States for expert work include, California, Arizona, Nevada, Oregon, Washington, Utah, Colorado and Texas

Frank Seigel, CPCU Ringwood Consulting Group, Inc.

Pennsylvania
Insurance, Financial - Agent/Broker, Broker Duties, Agent/Broker Duties & Responsibilities, Agent/Company Relations, Bad Faith, Errors & Omissions, E&O, Coverage Disputes, Excess/surplus, Surplus Lines, Casualty, Property, Life, Health, Disability, Coverage, Contractual Disputes, Arbitration, Mediation, Standards of Care
PROFESSIONAL ACTIVITIES • Past President, New Jersey Chapter Society of CPCU • Current and Past President, Independent Insurance Agents of Essex County, Inc. • Past President, Surplus Lines Association of New Jersey, Inc. (NJSLA) • Former Member, New Jersey Department of Insurance Committee Education • Former Member, Grading Panel for the Insurance Institute of America • Former Arbitrator for the American Arbitration Association. • Panelist, ABA Conference on Banking and Insurance • Attendee, New Jersey Conference on ECRA • Guest Speaker and Presenter for various professional, academic, and civic groups including New Jersey Chapter CPCU, Independent Insurance Agents, Seton Hall University Continuing Education Department, National Association of Insurance Women (NAIW), Local Rotaries, and Insurance Service Office (ISO) • NJ State Approved Volunteer Mediator for Municipal Court Matters • Member, Professional Liability Underwriting Society (PLUS) • Member, National Association of Prof...

Frank L Brown, Jr, MD, FACP, FACEP, FRSM, FCP(E)

Bluffton, South Carolina
Medical Management, Insurance - Accountable Care Organizations (ACO), Health Insurance, Grievances, Pharmacology, Provider Credentialing, Medical Management, Medical Necessity, Medicare, Medicaid, Healthcare Fraud & Abuse, Medical Billing & Coding, Medical Utilization, Utilization Review, Qui Tam
Senior physician executive in the health insurance industry, with licensure in Kentucky, North Carolina, Pennsylvania, and Virginia. Certified as Health Insurance Executive. National insurance companies worked for include Oxford Healthplans, Blue Cross & Blue Shield, Wellpoint, Anthem, and Cigna. Responsibilities have included case management, fraud and abuse, physician credentialing, peer review, physician grievances & appeals, patient grievance & appeals, and patient safety. Board-certified in both internal medicine, and emergency medicine. Holder of multiple patents. Experienced public speaker. Chief Medical Correspondent WVGB-FM in Beaufort, South Carolina. Yale-educated, NIH trained. Conducted over 5,000 physician credentialing reviews; over 5,000 medical necessity/utilization management reviews; patient & physician appeals, & hearings; and over 2,000 committee and in-person patient grievance & appeal reviews. Served as an Examiner for the Malcolm Baldrige National Quality...