Expert Witness Blog

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

Employers usually hire an administrator to process the claims. Self-funded plans are generally not subject to state laws and regulations, which means that state-mandated benefits, state prompt payment rules, or standards of network adequacy do not apply. Normally employers contract insurance companies or third party administrators (TPAs) to keep track of contributions, process claims, manage enrollment and other administrative functions. This can be confusing because a self funded plan may look like insurance but it is not; and the claims processor is functioning as a TPA, not as an insurance company. Therefore, it and the plan are not subject to state regulation.

Licensed engineers expert witnesses may write reports and testify on issues involving engineering risk assessments, registered professional engineers, and engineering document responsibility. In Consumer Guide to Professional Engineering and Professional Land Surveying, the California Board for Professional Engineers, Land Surveyors, and Geologists writes:The (CA) law requires all licensed engineers and land surveyors to use a written contract when providing their professional services. The written contract must include at a minimum the following information:

1. A description of the services to be provided by the licensed engineer or land surveyor;

2. A description of any basis of compensation applicable to the contract and the method of payment agreed upon by the parties (such as a fixed fee cost, an hourly rate charge, or an hourly rate charge with a maximum fee, as well as the method and schedule for billing and payment);

Commercial motor vehicles expert witnesses may opine on truck drivers, truck driver qualifications, motor carrier safety, and correlated issues. In Effective Commercial Truck and Bus Safety Management Techniques, the Federal Motor Carrier Safety Administration explains:

Many commercial motor vehicle (CMV) safety managers are former drivers who have moved up “through the ranks” to a management position. Many progressed from being independent owner-operators to owning and managing their own fleet. Safety, proficiency, and productivity as a driver are likely to be factors that enable these individuals to progress to fleet ownership or a management position. The lessons they have learned on the job are applied to their management of others. However, many CMV safety managers have not had formal training in management, system safety, or the human factors of driving safety. Thus, their effectiveness as safety managers is likely to vary widely, with gaps in their knowledge of various safety problems or available management solutions. A necessary step toward making such knowledge available to carrier safety managers is the systematic compilation of information relating to CMV safety management and the establishment of a common body of knowledge to serve as the basis for improved training for managers or other means of disseminating safety management information to them.

Read more: http://www.fmcsa.dot.gov/facts-research/research-technology/tech/Truck-and-Bus-Safety-Management-feb-2007.pdf

Credit risk expert witnesses may opine on risk assessment, risk management, and risk analysis. In the news, CoreLogic debuted the new product, CoreScore Credit Report. According to Tim Grace, senior vice president of Product Management and Analytics for CoreLogic:

By blending the unique data from CoreLogic with the analytic expertise of FICO, we will be able to deliver a new and more predictive credit score with our recently launched CoreScore Credit Report. Together, this new credit report and credit score will provide the mortgage industry with increased visibility into consumer credit behavior and improved credit risk analysis. We envision this score as the first in a series of new scoring solutions that FICO and CoreLogic will create for use in the mortgage industry and beyond.

Trucking expert witnesses may testify on transportation charges, fuel charges, fuel surcharges, truck fleets, and associated topics. In the news this week, a Virginia truck driver was arrested after using a device to hide his license plate as he passed through tolls in New York. The driver rigged up a cable to retract his license plate to avoid paying $65 at the George Washington Bridge.

The Port of Authority of New York and New Jersey approved a plan in August to more than double truck tolls by 2015 at tunnels and bridges into New York City.

Combustion expert witnesses may write reports and opine on explosions, flammable materials, and explosive limits. Research in this area may be found at The National Institute of Standards and Technology Engineering Laboratory which now offers public access to their new online repository Disaster and Failure Study Data:

For more than 40 years, scientists and engineers at the National Institute of Standards and Technology (NIST) have studied structural failures caused by natural disasters, fires and man-made factors, and used the lessons learned to improve building and fire codes, standards and practices. With the launch of the Disaster and Failure Events Data Repository, NIST has begun to make this valuable information accessible more easily online.

The repository will ensure that data collected during and after a disaster or failure event, as well as data generated from related research, is organized and maintained to enable study, analysis and comparison with future severe disaster events. It also will serve as a national archival database where other organizations can store the research, findings and outcomes of their disaster and failure studies.

Professional engineering expert witnesses may write reports and testify on issues involving engineering risk assessments, registered professional engineers, and safety and hazard analysis. In Consumer Guide to Professional Engineering and Professional Land Surveying, the California Board for Professional Engineers, Land Surveyors, and Geologists writes:

For a home or other building that has been damaged by natural forces such as earthquake, wind, flood, or fire, consultation with a civil or structural engineer is recommended to determine if the building is safe to occupy and can safely be repaired or rebuilt. Civil and/or structural engineers can judge whether or not damage has made a building unsafe to live or work in, or if its condition endangers nearby buildings or the public. Sometimes a geotechnical or soils report is necessary. If so, both civil and geotechnical engineers can provide this service. It is also possible that a survey would need to be done to relocate your property boundaries.

Read more: http://www.pels.ca.gov/pubs/index.shtml.

Bodily injury coverage expert witnesses may opine on bodily injury claims, bodily liability insurance coverage, and related issues. allinsuranceinfo.org explains:

Claims for Bodily Injury Liability Insurance include medical bills, pain and suffering and loss of income. In case you are sued for damages and injuries to persons, the legal fees can be so high that they can easily lead you to bankruptcy if you are not properly covered. Even if all your valuable assets are your car and your home, and the court would not normally require you to sell them in order to satisfy judgement against you, there will be placed a judgement lien against your home, which may wait till you eventually sell your home. This judgement lien may remain effective for as long as 20 years. Therefore it is vitally important to have Bodily Liability Insurance to be protected in court as well.

Read more: allinsuranceinfo.org.

Liability insurance expert witnesses may testify on personal liability insurance, automobile liability policies, and more. In Liability Insurance or Personal Umbrella Liability Policy, InsuranceLocal.com explains:

There are many factors to consider when calculation a premium: the state in which you live, the number of liability exposures you have (cars, drivers) etc. Usually the best rates occur when the customer insures both auto and home with the same insurance company and the personal umbrella liability policy. This is a requirement for many insurers offering umbrella coverage.

Read more: InsuranceLocal.com.

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

Finding new insurance company markets – As the owner of a wholesale agency, you have put aside a specific budget for searching for new carriers and even investing in initial public offerings of newly-formed insurance holding companies. The strategic advisory director can help in identifying new insurance carriers that have just received their “A” rating, and are looking to build a new distribution system. This expertise is not with the owner of the agency, whether it be retailer, wholesaler, or managing general agency. The dedication to search out newly-formed insurance companies is an expertise, starting with knowing state insurance department officials. Your strategic advisory director can find new carriers better than you, the owner of the agency, can;

Read more: insuranceexpertnetwork.com.