Health Insurance Expert Witnesses

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Health Insurance expert witnesses practice in a variety of fields, including claims handling, underwriting, and policy administration. Some of the most common specialties include bad faith, coverage disputes, ERISA plans, billing practices, and utilization review. They can opine on the effects of claim denials, policy rescission, regulatory violations, and industry standards of care.

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Average Health Insurance Expert Witnesses Court Fees

Review Fee

Deposition Fee

Court Fee

Health Insurance Experts

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  1. Financial Services & Insurance Expert Witness

    Review Fee
    $550/hr
    Deposition Fee
    $550/hr
    Court Fee
    $550/hr

    This expert has over 30 years of experiences with securities, investments, and insurance at the financial advisor, supervisory, and managing principal level. He has his producer's license in life, accident, and health insurance, is a certified financial planner, a chartered financial consultant, and a chartered life underwriter. He is also a member of numerous prestigious organizations in the insurance and financial services fields. This expert is is a former agency manager at John Hancock Financial Services, former managing principal at Waddell and Reed and a former Adjunct Professor in the department of finance at the University of Connecticut. He is currently an adjunct professor in financial management at a top university and the founder/consultant at a securities, insurance, and financial services expert witness and litigation consulting firm.

    President, An association for securities experts

    Bachelor of Science (BS), Southern Connecticut State University

    Bedford,

    New Hampshire

  2. Patient Access & Healthcare Expert Witness

    Review Fee
    $250/hr
    Deposition Fee
    $300/hr
    Court Fee
    $300/hr

    This expert is a well experienced health insurance expert, as she has been involved in multiple company's Revenue Cycle Management programs for the past 15 years. She has been involved with negotiations with pharmacies and physicians, and has in depth knowledge of how to work with the Pharmacy Benefit Managers group to effect drug pricing.

    Consultant, Private consulting group

    Bachelor of Science (BS), Auburn University

    Montgomery,

    Alabama

  3. Valuation & Economic Damages Expert Witness

    Review Fee
    $650/hr
    Deposition Fee
    $750/hr
    Court Fee
    $750/hr

    This highly qualified expert has provided valuation and corporate finance consulting services since 1987. He is a Chartered Financial Analyst (CFA) and he is a member of several prestigious associations including the Healthcare Financial Management Association and the American Society of Appraisers. He previously worked as the Senior Managing Director of American Appraisal Associates Inc where he was the Chair of Healthcare Industry Practice. Currently, this expert works as Managing Director in a global consulting firm in Illinois. He specializes in the valuation of a wide variety of businesses and business interests, fairness and solvency opinions, consulting with corporations with respect to corporate finance issues, and estimating economic damages. He has provided opinions of value, fairness, and solvency for many purposes such as acquisitions, divestitures, business and strategic plan reviews, business unit performance measurement, SEC filings, US GAAP and other financial reporting requirements, US federal, state, and non-US tax reporting requirements, regulatory compliance, various dispute resolution and litigation procedures and general advisory purposes. This expert has worked with clients across a wide variety of industries such as business and consumer services, construction, engineering and real estate development, construction materials, banking, financial institutions and insurance, healthcare services and managed care.

    Managing Director, A Valuation Services Firm

    Master of Business Administration (MBA), DePaul University

    Chicago,

    Illinois

  4. Healthcare & Health Insurance Expert Witness

    Review Fee
    $500/hr
    Deposition Fee
    $500/hr
    Court Fee
    $500/hr

    This expert has over 30 years of experience with healthcare and health insurance. She gained her PhD in sociology and health policy at the University of California, Santa Cruz and directed research at the Institute of Health and Aging at UC San Francisco before leading the White House's Health Care Reform Task Force. Since, she has continued to contribute to the private and public sectors, working as a principal at William M. Mercer, Inc, the vice president of the Lewin Group, an associate professor of research at UC Santa Cruz, and the consumer representative to the Medicare Coverage Advisory Committee. Her most recent roles include consulting for Watson Wyatt Worldwide, the Center for Medical Technology Policy, and Bain & Company. Currently she is an independent health care consultant.

    Consultant, A healthcare consultancy in California

    Doctor of Philosophy (PhD), UC Santa Cruz

    Westlake Village,

    California

  5. Insurance Expert Witness

    Review Fee
    $350/hr
    Deposition Fee
    $350/hr
    Court Fee
    $350/hr

    This expert began his career in underwriting in the 1960's, managing a regional general agency with broad underwriting authority specializing in property real and personal coverage, running the gamut from simple auto and homeowners’ policies to complex property, inland marine, manufacturer’s output and ocean marine policies. When he sold his agency in 1988, he had 60 employees and annual revenues in excess of $10,000,000. His career also includes a wealth of claims experience, personally having draft issuing authority to settle claims for a number of different insurance carriers. He currently manages a consultancy dedicated to standard of care issues special realationships underwriting and claims handling issues.

    Principal, An underwriting and claims consultancy in CO

    Bachelor of Arts (BA), State University of New York at Farmingdale

    Boulder,

    Colorado

  6. Health, Life & Property Insurance Regulation Expert Witness

    Review Fee
    $450/hr
    Deposition Fee
    $500/hr
    Court Fee
    $550/hr

    This highly qualified expert has nearly 40 years of experience in insurance. He earned his BBA in accounting from Hofstra University before beginning his career in insurance with the New York State Insurance Department and the New York State Department of Financial Services. During his 35 years working for the New York State Insurance Department, he held several prominent positions, including director of policy initiatives and assistant chief examiner of the property bureau. He has years of demonstrated experience dealing with health, life, and property insurance regulations. Currently, this expert serves as the principal for an insurance and regulatory consulting firm in New York.

    Principal, An insurance and regulatory consulting firm in NY

    Bachelor of Business Administration (BBA), Hofstra University

    Bayside,

    New York

  7. Healthcare Management Expert Witness

    Review Fee
    $270/hr
    Deposition Fee
    $350/hr

    This highly-qualified expert has over 30 years of experience in healthcare management. He earned his BA in political science from the American University and completed graduate coursework in health care public policy at the University of Chicago. Throughout his career, he has been highly involved in health care forums, having a hand in healthcare changes such as successfully lobbying Congress to include kidney transplantation in HR 1 in the 1970s. He has formerly served as the program director for the American Kidney Fund and the director of development for the National Kidney Foundation. He also served as the evaluation director of the Mayor's Office Model Cities Anti-Poverty Programs during the Daley administration in the city of Chicago. Currently, this expert serves as the CEO of two healthcare consulting firms and the president of a healthcare staffing organization.

    President, A healthcare staffing organization

    Bachelor of Arts (BA), The American University

    Evanston,

    Illinois

What Can a Health Insurance Expert Witness Opine On?

FAQs for Health Insurance Expert Witnesses

What is a health insurance expert witness?

A health insurance expert witness is a specialist who explains insurance policies, coverage, and industry standards in legal cases. They assist by reviewing records, analyzing claims, and testifying to clarify complex insurance issues.

What types of cases may benefit from the insights of a health insurance expert witness?

A health insurance expert witness supports disputes involving coverage denials, policy interpretation, billing and coding, medical necessity, ERISA claims, fraud, bad faith, and reimbursement.

How can a health insurance expert witness assist in interpreting complex policy provisions?

A health insurance expert witness can clarify complex policy provisions by explaining coverage terms, exclusions, and industry standards in clear, legally relevant language.

What specific training and credentials should a health insurance expert witness possess?

A health insurance expert witness should have advanced insurance or healthcare degrees, industry certifications (e.g., RHU, CEBS), and extensive claims, underwriting, and regulatory experience.

How does a health insurance expert witness evaluate claim denials for litigation purposes?

A health insurance expert witness evaluates claim denials by reviewing policy language, medical records, billing codes, and insurer procedures to assess compliance with industry standards.

What is Expert Institute’s process for selecting health insurance expert witnesses?

Expert Institute delivers a tailored approach to connect you with top-tier experts. We identify actively practicing professionals who meet your exact criteria for specialty, experience, litigation background, fee structure, credentials, location, and more.

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