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Insurance Claims Regulatory Audits Automobile Homeowners Property General Liability Expert Witness

Provides Opinion & Testimony In:

Insurance Claims, Regulatory Audits, Automobile, Homeowners, Property, General Liability, Garage Keepers, Life Policy, Health Policy, California Fair Claim Practices, Settlement, Liability Claims, Insurance Coverage, Automobile Coverage, Hail Damage Repair, Auto Theft, Insurance Fraud, Security Breaches, Disability Insurance, Property Damage, Auto Property Damage, General Liability, Bodily Injury, Insurance Settlements, National Disaster Claims,

Expert Witness No. 532

California

Education

Bachelors in Communications, Arts and Sciences
University of Southern California

Associate in Insurance Management (A.I.M.) Designation, 2002
Insurance Institute of America

A designation awarded based on a two-year study program for insurance line managers. Program focused on techniques to increase productivity, establishment of meaningful goals, and the reduction of talent acquisition cost through strategic human resource management.

Associate in Claims (A.I.C.) Designation, 2004
Insurance Institute of America

A designation awarded based on a two-year study program specifically for commercial property and casualty claims. Topics covered included; technical claim handling skills, communication and negotiation skills, good-faith claim handling, in-depth policy knowledge, reduction of time and cost, customer satisfaction and retention, and litigation avoidance techniques.

Associate in Insurance Services (A.I.S.) Designation, 2005
Insurance Institute of America

A designation awarded based on a two-year study program for insurance line managers. Program focused on techniques to improve service quality, data analysis techniques to improve productivity and efficiency, and techniques to ensure consistent service by learning how to effectively monitor and adjust to change.

Additional Courses and Seminars in Insurance

Auto Claim School, State Farm Insurance, 1990
Basic Claims Courses, Courses 1, 2 and 3, State Farm Insurance, 1990
Photography for Adjusters Training, Polaroid Corp., 1991
Regional Claim Training, State Farm Insurance, 1991
Automobile Damage Estimating Training, State Farm Insurance, 1992
Injury Claim Training, courses 1, 2 and 3, State Farm Insurance, 1993
Special Disaster Training for Wind and Hail Training, State Farm Insurance, 1993
Basic Claims Course III, State Farm Insurance, 1994
Litigation Management Seminar, Knapp, Petersen and Clark, 1992, 1994,
California Fair Claim Settlement Practices, State Farm Insurance, annual training, 1994 – 2000
Claim Negotiations Training, State Farm Insurance, 1992, 1994, 1997
Automobile Coverage Training, State Farm Insurance, 1995
Unibody Auto Repairs Course, State Farm Insurance, 1996
Automotive Refinishing Basics Course, State Farm Insurance, 1996
Hail Damage Repair Course, State Farm Insurance, 1996,
Auto Theft Basics, State Farm Insurance, 1997
A Portrait in Fraud, State Farm Insurance, 1997
Western Regional Litigation Forum, The Hartford, 2002
Claim Supervisory Training, The Hartford, 2003
Commercial Coverage School, The Hartford, 2004
California Fair Claim Settlement Practices, The Hartford, annual training 2000 – 2006
Consumer Services Market Conduct Regulation Training, California Dept of Insurance, 2006
Market Regulation Data Resource Training, National Assoc of Insurance Commissioners, 2007
Workers Compensation Regulations, California Department of Insurance, 2007
Market Analysis and Insurance Market Standards Training, California Department of Insurance, 2007
Consumer Services Market Conduct Regulation Training, California Dept of Insurance, 2008

Current Employment

Investigative Auditor
A Company

Mar 2010 – Current
As an Investigative Auditor in the Civil Prosecution Unit, Expert investigates complaints filed by Qui Tam plaintiffs involving price fixing and kick back allegations against medical laboratories. Expert conducts investigations to determine the nature and magnitude of cases by directing and conducting interviews of clinic personnel, lab employees, doctors and lab owners. An important part of his investigations includes identifying and gathering pricing data to support damage models. Expert works closely with several Deputy Attorney Generals in evaluating settlements and assisting in settlement negotiations.

Work History

Internal Auditor
California Lottery

Mar 2009 – Mar 2010
Expert performed internal audits of Lottery operations to improve performance, reduce cost and ensure compliance with State laws and regulations. Expert planned, organized and lead audits involving security breaches and whistle blower complaints.

Compliance Officer
California Department of Insurance

2006 – 2009
Expert lead regulatory compliance audits examining property and casualty, life, health, workers compensation and disability insurance carriers licensed in the state of California. Expert is adapt in reviewing electronic and paper claim files, procedure manuals and insurance policies to assess the timeliness and accuracy of claim payments. Expert is highly respected in the industry and amongst his peers for being thorough but fair when performing audits. Expert’s prior industry knowledge provided him with uncanny ability to indentify situations where contractual provisions were not applied resulting in hundreds of thousands of dollars in refunds to consumers. Expert worked closely with company officials to resolve non-compliant issues and made recommendations on ways to resolve compliance issues.

Claim Supervisor
The Hartford

2000 – 2006
Expert supervised claim units in The Hartford’s Western Regional Commercial Auto Property Damage and Liability Divisions. Expert hired, trained, motivated and lead adjusters in a fast- paced streamlined approach to handling claims. Expert performed weekly/monthly regulatory and performance audits to measure and monitor performance. Expert provided direction to a staff of six to eight highly specialized adjusters in the handling of commercial fleet, garage keepers, truckers and general liability claims involving care, custody and control issues. Expert was also responsible for supervising litigated injury claims.

Claim Specialist
State Farm Insurance

1990 – 2000
Responsible for the adjudication of auto property damage and bodily injury claims. Performed timely liability investigations, determined coverage and made prompt settlements of both BI & PD claims. Handled high value and litigated claims. Collaborated with legal counsel on litigation strategies and cost containment measures. Served two years on the company’s national disaster team adjusting property claims resulting from earthquakes, floods and hailstorms.


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