Insurance Fraud Expert Witnesses

Insurance fraud refers to the act of making an insurance claim based on false pretenses, which is illegal. Insurance fraud expert witnesses are experienced with various facets of the insurance industry, as specific details of a proposed policy may be manipulated to create insurance fraud. Any type of insurance, such as marine insurance, aviation insurance, disability insurance, workers compensation, homeowners insurance, life insurance, property insurance, auto insurance, and medical insurance, is at risk of being the subject of insurance fraud.

Insurance fraud expert witnesses often have backgrounds in the codes and compliance each party of the policy must adhere to, since both the claimant or the insurance company may commit fraud. Any situation in which false information is used to secure benefits would be a case of insurance fraud, meaning that a background in accounting, finance, securities, annuities, claims, bad faith, underwriting, or any other related area may be highly relevant when selecting an insurance fraud expert witness for a case.

Insurance fraud expert witnesses are called upon for their knowledge of the industry and whether the proper insurance industry customs and practices have been exploited as a means of gaining benefits. Requesting claims and loss damages as a result of misrepresentation would be substantial grounds for a lawsuit. Insurance fraud expert witnesses are also experienced with contract preparation and management in relation to insurance policies.

ForensisGroup has provided attorneys with highly qualified insurance experts with consistent success. Call our office today or submit an expert request form to find the right fraud expert witness.

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"We were very happy with both ForensisGroup and the referred expert -- very knowledgeable and pleasant to work with. We will definitely use their services again."

- Mike Ertle, Esq.

DRINKER BIDDLE & REATH

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Expert 529347 - CA(S)

Expertise Description

I have over 35 years experience in Law Enforcement with expertise in Financial Crimes Investigation, involving complex internal investigations, financial due diligence, Insurance fraud, elder abuse, identity theft matters, revenue protection, and embezzlement investigative work. I have prior expert witness experience with consultations, depositions, and courtroom testimony.

Expert 521330 - PA

Expertise Description

I have over 20 years of experience in healthcare coding and over 15 years as a compliance expert, forensic coding expert, and consultant. My expertise includes healthcare service coding, documentation and compliance, statistical error rate prediction methods and health insurance fraud involving E/M coding, diagnostic testing and physical medicine services on behalf of both healthcare providers and insurance carriers. I have more than 15 years experience working as a medical billing expert witness in Pennsylvania by providing deposition, consultations and courtroom testimony.

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Expert 520253 - OK

Expertise Description

My career of over 40 years working with law enforcement investigation skills has involved the origin and cause investigation of fires and explosions with expertise in fire investigations, public fire education, fire suppression and interviewing techniques. I have additional expertise in interviewing and counseling juvenile fire setters, workers compensation; courthouse records searches, personal injury accidents, slip and falls, thefts, insurance fraud and fire subrogation. I have also been providing services as a fire investigation expert witness in Oklahoma for over 35 years by providing consultations, deposition, and courtroom testimony.

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Expert 515720

Expertise Description

I have more than 25 years of experience in the automotive industry. Currently I am consulting with regard to regulatory compliance and I do vehicle inspections. I have previous experience doing smog checks, and investigations of automotive repair fraud with surveillance and covert undercover sting operations. I also have experience with the investigation of complaints of insurance fraud. I have prior expert witness experience with consultation and deposition.

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Expert 515267 - TX

Expertise Description

I have more than 45 years of experience as an Insurance Agent and Broker. My particular expertise is in insurance coverage analysis, and I am very familiar with all phases of the insurance industry, including consulting on bad faith, customs and practices, and standards of care. I have over 30 years of expert witness experience with consultations, deposition, and courtroom testimony.

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Expert 502425 - AL AK AZ AR CA(N) CA(S) CO CT DE DC FL GA HI IA ID IL IN KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WY WI

Expertise Description

I have more than 20 years of experience as a property and casualty actuary, and am a member of the American Academy of Actuaries since 1998. This experience includes insurance companies, brokers, and a national insurance rating bureau. I have developed actuarial analyses and presented and defended them before industry-wide review committees over 50 times. For nine years I served on a joint committee that composed examinations to test and qualify actuaries. I have served on numerous committees. My service includes the Workers Compensation and the Property Lines subcommittees of a Casualty Practice Council. I have written 16 research papers and articles on actuarial and insurance subjects.

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Expert 165064 - CA(N)

Expertise Description

I have more than 40 years of wide-ranging experience in the insurance industry. My expertise includes: insurance, risk management, insurance fraud, property insurance, life insurance, disability insurance, excess and surplus lines insurance, homeowners insurance, and workers compensation. My additional expertise includes: aviation insurance, marine insurance, yacht insurance, liability insurance, errors and omissions insurance, bad faith, insurance claims, excess and umbrella insurance, offshore insurance, duty of care insurance, and custom and practice insurance. I have prior expert witness experience with consultations, deposition, and courtroom testimony.

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Expert 502178 - MA

Expertise Description

I have more than 50 years experience in the field of Insurance with expertise in Risk Management. I have experience with related property and casualty insurance; fairness of premium charges; services provided by agents, brokers and insurers; and risk financing techniques. I have performed risk management and insurance studies, including enterprise risk management assessments and merger and acquisition due diligence. I have over 35 years expert witness experience with consultation, deposition, and court testimony.

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Expert 505053 - AL AK AZ AR BC CA(N) CA(S) CO CT DE DC FL GA HI IA ID IL IN KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA QC RI SC SD TN TX UT VT VA WA WV WY WI

Expertise Description

I have more than 30 years experience in investigations both as a sworn law enforcement officer and as a civilian licensed private investigator. As a retired police sergeant, my areas of expertise are in police investigations, investigative interviews, use of force, police policy and procedure, racial profiling, domestic violence, women

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Expert 42142 - CA(N)

Expertise Description

S.A.M.S., N.A.M.S., I.A.M.I. – Consulting expert specializing in marine survey / investigation. Has more than thirty-five years of experience as a commercial vessel owner / operator. Expertise includes: condition and valuation of vessels, trip and tow surveys, salvage and recovery, offshore and onshore facilities / construction, heavy lifts, anchor handling, deep water moorings, ships management systems, oil spill response, recovery, and containment, Hazardous Materials (H.A.Z.M.A.T.), tank barges, ship handling, insurance fraud, loss prevention, damage assessment, and hurricane catastrophe teams. Member, Society of Accredited Marine Surveyors (S.A.M.S.). Member, National Association of Marine Surveyors (N.A.M.S.). Certified Marine Investigator, International Association of Marine Surveyors (I.A.M.I.). Prior expert witness experience. Consultations, depositions, and courtroom testimony.

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Expert 128664 - TX

Expertise Description

I have 55 years experience in practice focusing on litigation services, as well as federal tax services and practice management consulting for professional firms. I have more than 40 years of experience as a practicing public accounting. My expertise includes forensic investigations, lost profits issues, accounting and legal malpractice matters involving federal taxation and GAAP issues; estate and probate matters; alter ego matters; accounting records and financial statement reconstructions; claims of fraud on business transactions; insurance agency and agent errors and omissions matters; construction claims; hospitality industry matters; bankruptcy matters; C.P.A. and C.F.E. professional standards of care matters; and other types of disputes requiring long-time business and financial expertise. I have prior expert witness experience with consultations, deposition, and courtroom testimony.

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Expert 134935 - CA(S)

Expertise Description

I have more than 35 years experience in the field of Forensic Document Examination. My areas of expertise include development and decipherment; photocopier classification and identification; typewriting classification and identification; signature and handwriting identification/analysis; document dating and anachronism; detection of altered documents; computer-generated documents; decipherment of obliterations; photocopy manipulations; ink and paper analysis; and counterfeit detection. I have prior expert witness experience with consultations, deposition, and courtroom testimony.

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Expert 57976 - TX

Expertise Description

I have over 25 years specializing in Forensic Accounting, with an emphasis on measurement of financial damages related to business interruption, business valuation, commercial litigation, construction claims, delays and defects, consequential damages, contractual disputes, economic damages, first party property claims, fraud and fidelity losses, insurance claims, intellectual property, inventory losses, marital dissolution or divorce, loss of earnings, loss of income or profits, partnership disputes, personal injury, product liability, property damage, shareholder derivative actions, shareholder disputes, subrogation, third party liability claims, unfair business practices, wrongful death and wrongful termination. I have prior expert witness experience with consultations, deposition, and courtroom testimony.

Expert 97183 - FL

Expertise Description

I have over 40 years experience as a criminal investigator specializing in background / drug / fraud / money-laundering / and Ponzi / pyramid schemes. My expertise includes: asset identification / investigation; investigations (background / civil litigation / conspiracy / drugs / financial / fraud / money-laundering / narcotics / etc.); federal asset seizure laws; federal money laundering statutes; industrial security; and interview / surveillance techniques. I have more than 20 years expert witness experience with consultations, deposition, and courtroom testimony.

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Expert 55404 - NC

Expertise Description

I have over 30 years experience as a professional engineer specializing in electrical and computer engineering. My expertise includes: agency standards (CE, CSA, FCC, IEC, UL); data encryption hardware; data networks; electrical devices engineering / safety / systems; electronic design / failure analysis / manufacturing; electronic / electrical hardware design engineering; EMC design / analysis / testing; fire cause and origin investigations; forensic engineering; grounding; industrial automation / controls (national electrical code / product liability / product testing / safety evaluations); insurance fraud investigations; lightning / surge analysis; residential wiring; semiconductors; and telecommunications. I have prior expert witness experience with consultations, deposition, and courtroom testimony.

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Expert 46349 - AZ CO NM TX

Expertise Description

I have over 15 years experience in areas of industrial workplace safety and training, especially in mining, tunneling, construction, and explosives. I have experience in trucks and trucking, including general maintenance and air brakes; surface and underground mining; tunneling; construction; general safety; and Cal/OSHA. I have conducted safety training in all phases of mining for employers, employees, and contractors in the mining and tunneling industries, and safety training in explosives, tire, welding, and other associated industries. I have administered examinations for blasting, gas quality testing, explosion cause and origin, and safety representative licenses in the mining and construction industries. I have more than 5 years expert witness experience.

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Expert 8860 - CA(S)

Expertise Description

I have over 30 years experience as an appraiser. My appraising expertise includes: antiques, residential contents, as well as fine and decorative arts for collectors, museums, businesses, accountants, attorneys, insurance, municipalities, and individuals. I have experience with wood identification and dating, review of appraisals, documentation of fraud, cataloging of collections, inventory and condition reports, damage and loss claims, diminution of value, acquisitions and divestments, estate planning, tax and probate, charitable contributions, and dissolution of marriage / division of property. I have prior expert witness experience.

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Expert 501861 - NJ

Expertise Description

I have more than 20 years experience in the field of Risk Management with expertise in the provision of practical, technically oriented insurance operations assessment, business process engineering for insurers, self-insured and captives. I have experience with organization design and functional analysis of claim operations, independent case reserving valuation, cost management strategy, litigation management, claim operations design and implementation, and settlement strategy. I have additional experience with internal control assessment, fraud detection, regulatory financial examination analysis, merger/acquisition due diligence and post-acquisition integration, and claim benchmarking. I have prior expert witness experience with consultation, deposition, and courtroom testimony.

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Expert 501495 - CO

Expertise Description

I have many years experience in the field of Property and Casualty Insurance with expertise in reinsurance. I have experience with claim handling; appropriate underwriting disclosures, claims and loss damages, and compliance with contract terms. I have additional knowledge of bad faith, duties of insurers and agencies; property/construction defect; underwriting, arbitrator, duty to defend, and suspected fraud. I have over 20 years expert witness experience with consultation, deposition, and courtroom testimony.

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Expert 426910 - AL AK AZ AR CA(N) CA(S) CO CT DE DC FL GA HI IA ID IL IN KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WY WI

Expertise Description

I have more than 35 years experience in the fields of commercial insurance, insurance brokerage, and claims handling industry. My expertise includes catastrophic claims handling, coverage disputes, broker responsibilities / duties and standard of care, and historical policy forensics. I have additional knowledge of general liability, commercial property, directors and officers liability, employment practices liability, construction and builders risk, business interruption, broker ethics, unfair claims, and contingent business interruption. I have over 10 years expert witness experience with consultations, deposition, and courtroom testimony.

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Expert 432435 - DC VA

Expertise Description

I have more than 30 years in the field of Insurance and Third-Party Administration. My expertise includes bad faith, coverage denial, adjuster standards-of-care, extracontractual liability, insurance disputes, benefit claims and appeals, claims and loss damages, assessment of insurance claim practices, insurance industry custom and practice, and claims-handling for policyholders and insurers. I have over 10 years expert witness experience with consultations, deposition, and courtroom testimony.

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Expert 413654 - AR

Expertise Description

I have over 10 years experience in the field of Insurance Regulatory Consulting. My extensive experience includes national and international mergers and acquisitions, expansion, multi-state licensing, market conduct, rate and form filing, insurance regulatory, lobbying / legislative matters, licensing / registration, policing, criminal investigation and prosecution of fraud, risk management inspection and consumer protection. I have prior expert witness experience.

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Expert 359686 - CA(S)

Expertise Description

I have more than 20 years experience in life and disability insurance matters, and I specialize in death claims, disability claims, underwriting, agent standard of care, supervision, insurance industry standard practices, insurance industry custom and practice, suitability, and complex transactions. I have been directly involved in the recovery of over $35 million of death claims from several dozen carriers. As an employee of a major life insurer for 13 years, I hired, trained, and supervised the sales activities of 200 agents. I have underwriting experience and am well acquainted with industry standards and practices. I have been an active insurance agent since 1991. I am designated as one of only a few Life and Disability Analysts. As an expert witness I have been named in over 80 matters, testified in several courts, never been disallowed, and have given many depositions.

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Expert 340709 - AZ

Expertise Description

I have more than 30 years professional experience with Computer, Technology, and Digital Forensics, specializing in Acquisition, Preservation, Recovery, and Analysis of Data as Evidence. I am highly experienced with computer systems, cell phones, digital media, digital cameras, database management, email, electronic mail, fax machines, GPS systems, databases, software applications (custom & commercial), hacking events, intrusions, accounting systems, photo copiers, black boxes – Engine Control Unit (ECU), Event Data Recorder (EDR), Engine Control Module (ECM), etc., printers, documents, medical systems, photos and images, internet browsing history, software design & development, password cracking, and source code analysis. I have hands-on experience with various computer and technology forensics hardware. I have written blockers, data extractors, and data reading devices. My comprehensive background includes forensic applications, computer / data systems consultations, and several programming languages. I have prior expert witness experience.

Expert 342366 - AZ CA(S)

Expertise Description

I have over 30 years experience in Document Examination and Forensic Handwriting Analysis. My expertise includes digital signatures; real estate transactions; corporate investigations; general civil litigation; medical malpractice; immigration matters; anonymous letters; sexual harassment; probate matters; criminal; family law; criminal defense; insurance fraud; development & decipherment of indented writings; photocopier classification & identification; signature & handwriting identification; signature & handwriting identification; document dating & anachronism; detection of altered documents; computer-generated documents; decipherment of obliterations; photocopy manipulations; ink & paper analyses; and counterfeit detection. I have prior expert witness experience.

Expert 354588 - CA(N) CA(S)

Expertise Description

I have over 50 years claim experience, from claim rep to supervisor. I am experienced in insurance claim, coverage, and bad faith. I have more than 35 years as a coverage and bad faith defense lawyer with over 20 published and unpublished appellate cases. I have experience with qualified trial testimony in over 100 trials involving first and third party claims, underwriting, legal malpractice, coverage, rescission, reformation, cancellation coverage, and advice of counsel. I have experience with testimony for both policyholders and insurance companies. I have more than 25 years expert witness experience with consultations, deposition, and courtroom testimony.

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Expert 128590 - CA(N) CA(S)

Expertise Description

I have more than 25 years experience in Insurance and Finance. My expertise includes: standard of care involving representations, presentations, sales and placement of life insurance products by licensed agents and Registered Representatives (who sell life and annuity products qualifying as “securities”); supervision issues of broker dealers and their registered representatives; suitability issues surrounding the sale of securities by registered representatives; assessing and evaluating life insurance policy illustrations for sustainability of the underlying insurance products; stochastic analysis (“Monte Carlo”) of variable life and annuity products; inappropriate sale of financial plans utilizing life insurance products, such as so-called welfare benefit plans (419(A)(f)(6)) and fully insured pension plans (412(i)); illustration and use of “premium financing” to support large premium / death benefit policy sales; “Stranger Owned Life Insurance” sales; and “Life Settlement” sales. I have over 15 years expert witness experience with consultations, deposition, and courtroom testimony.

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Expert 340642 - CA(S)

Expertise Description

I have more than 50 years of experience with the insurance industry and claims handling. My experience includes working as a field adjuster, claim examiner, claim supervisor, and claim manager. I have additional experience as a corporate officer and as an independent insurance adjuster handling a variety of different types of claims. I organized and chaired a claim committee to review coverage issues, claims denials, insurance industry custom and practice, and evaluation of high value cases. I am able to evaluate the claims handling for compliance with manuals, the Fair Claims Practices Act, and acceptable industry standards. I have prior expert witness experience.

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