Insurance Claims and Claims Investigation Consultants: 19

MCS Associates is a nationally recognized consulting group that has provided financial, operations and regulatory/compliance consulting services nationwide to financial institutions, insurance companies and regulatory agencies as well as real estate and financial services organizations for over 40 years. Expert Witness and Litigation Consulting are a primary focus of our services. We undertake expert witness assignments throughout the United States and our clients include several hundred leading law firms around the country, working on behalf of both plaintiff and defendant financial institutions, borrowers, depositors, investors, developers, insurance companies and their insured, securities/insurance/real estate brokers/agents, regulators and government agencies, and individuals. 

Together with MCS Associates’ specialized resources in banking, financial services and real estate, we also draw on key strategic alliances in insurance, economics, academia and the securities industry to meet a wide range of expert witness needs. Our litigation experts include experienced bankers, lenders, consultants, regulators, managers, brokers & agents in insurance, real estate, and securities; insurance claims and underwriting managers; economists, accountants, appraisers, real estate analysts, and academics. 

Areas of Expertise Include:

• Banking Operations/Administration
• Check Fraud
• Lending Policies, Custom and Practice
• Loan Underwriting & Credit Administration
• Loan Securitizations & Servicing
• Bankruptcy, Foreclosures and Workouts
• Trust & Fiduciary Issues / Operations
• Securities Brokerage & Investments
• Valuations & Damages Analysis
• Forensic Accounting
• Employment / Compensation
• Real Estate Brokerage & Management
• Title Insurance & Escrow
• Real Estate Appraisal & Transactions
• Insurance Industry Custom & Practice
• Insurance Coverages / Claims Handling
• Insurance Bad Faith

 Allan Windt specializes in the areas of Insurance Coverage, Duty to Settle and Bad Faith. In over 30 years in the insurance business, he has handled more than 10,000 claims for more than 70 insurance companies and hundreds of insureds in all 50 states. Mr. Windt has served as an expert witness in dozens of states. He is the author of Insurance Claims & Disputes, Representation of Insurers and Insureds, West, 1982 first edition, 1988 second edition, 1996 third edition, 2001 fourth edition, and 2007 fifth edition. Mr. Windt's books have been cited as authoritative by more than 300 courts throughout the country.

Paul F. Amoruso, CPCU, has more than 45 years of experience working for several major insurance carriers as a Senior Vice President of Claims and Operations. As a licensed insurance agent in Massachusetts, Connecticut, Florida, an New Jersey and licensed public adjuster, he is uniquely qualified to assist either plaintiff or defense attorneys on insurance related issues on local or national issues.

If you are an insurance company, insured, or law firm and need an independent review of an insurance issue regarding litigation, agency or company operations, practices or procedures, he is available to assist.

Mr. Amoruso has served as an Expert Witness in many states in both State and Federal court . Having worked in all operation areas of the insurance industry he is able to testify to the generally observed and accepted industry practices.

Areas of Expertise:

• Insurance Customs and Practices
• Company Policies
• Management Involvement
• Proper Staffing
• Coverage Denial
• Agency and Insurance Company Relationships
• Case Evaluation
• Reserve Policies
• Workers Compensation
• Liability Personal or Commercial
• Commercial and Personal Property Losses
• Authority Level
• Industry Ethics and Norms
• Bad Faith
• Claims Handling Practices
• Insurance Company Operations

Archuleta & Associates Investigative Services, a Division of Archuleta & Associates, Inc., has been providing investigative services within various industries since 1982. They are the overwhelming leaders within the CA Central Valley. The clientele of Archuleta & Associates, Inc. consists of every level of business, from both the private and public sector. Due to the wide range of services provided and their 25 years within the industry, they have worked with an extremely diverse and vast clientele base, from the largest of litigation firms to the smallest of personal clients. 

Robert A. Archuleta launched his career as a Private Investigator in 1983, after five years as an officer, investigator and sergeant for the Lodi Police Department, followed by stints as an engineering contractor and a deputy U.S. Marshal. Among his other clientele, Mr. Archuleta has been as an Expert Witness for the Department of Consumer Affairs for the State of California. 

Services Include:

Accident Reconstruction AOE / COE Civil Litigation Copyright Infringement Criminal Defense Criminal Prosecution General Engineering GPS Location / Tracking

Insurance Bad Faith Insurance Defense Seminar Training Surveillance Traffic Reconstruction Video Evidence Voice Stress Analyzation Workers Compensation

CMC Advisors Inc. (CMC) provides expert Insurance Consulting and offers clients the upper hand in managing their assets and liabilities. They assist clients in managing investment portfolios by helping to determine if current Financial Retirement plans such as IRA, Roth IRA, Rollover IRA, 401(K), Keogh Plans, Pensions and Profit Sharing Plans are meeting retirement goals. Consulting Areas:

Annuities Life Insurance Term Insurance Single Premium Variable Insurance

Retirement Disability Insurance Consultant Expert Witness Services

Wayne Citron has 45 years of experience as an expert in Forensic Reconstruction of Insurance Transactions. He is an insurance expert and consultant. Mr. Citron established the Citron Agency and CMC Advisors Inc. in 1972, where his duties included executive and managerial responsibilities, sales, service, compliance with all insurance matters as well as securities laws and regulations. Both firms are leaders in life, health, disability and property and casualty insurance. Mr. Citron has served as an instructor for Prudential Insurance Company Brooklyn Agency (1973) educating personnel in general insurance matters, underwriting, and insurance law. He has worked with companies including Prudential Insurance Company, United States Life Insurance Company, North American Company for Life and Health Insurance, American General Life Insurance Company, William Penn Life Insurance Company, American Life Insurance Company, Chubb Insurance Company, Travelers Insurance Company, Mass Mutual Insurance Company, John Hancock Insurance Company, and American International Group (AIG), among other. Mr. Citron recently volunteered for Ocean County Long Term Recovery Group (OCLTRG) to reopen Super Storm Sandy flood claims and examine National Flood Insurance Policies, as well as deal with FEMA in these matters (2015 & 2016). View Wayne Citron's Expert Witness Profile.

Vera Dolan is an epidemiologist with over 30 years of experience in the life and health insurance industries. She is one of the leading mortality experts in the life insurance industry. She writes underwriting manuals and policy and procedure manuals for life and health insurance companies.

Vera has testified in both state and federal court, and has been retained in over 200 cases since 2006 for plaintiffs and defense on an equal basis. She is very credible testifying in deposition and on the stand.

* Life expectancies that are personalized and accurate to the standards of the life insurance and life settlement industries. Addresses the cases when life expectancies that are simply taken from a life table or estimated by a doctor, actuary or biostatistician are too long, too short, insufficient or not credible. Addresses the cases when a complete insight into the individual's medical conditions and/or personal history of high-risk behaviors is needed to assist the judge or jury in their decision. This information often decides the case, see article for details.

* Expert in bad faith/wrongful denial of life/health insurance claims.

* Expert in life/health insurance underwriting material misrepresentation.

* Expert in medical risk assessment and underwriting issues.

* Expert in life insurance underwriting policies and procedures.

* Expert in epidemiology. Previous cases include infectious diseases, occupational and environmental exposures, pesticides and tobacco.

* Approved life expectancy expert with the U.S. Department of Justice.

* Active consultant to the life insurance industry conducting cohort mortality studies, and writing underwriting and policy and procedure manuals.

* Over 100 articles published on mortality research and underwriting.

* Friendly, clear, concise, objective and quantitative.

* There is no charge for the initial phone consultation.

* There is no charge for travel time.

Frederick J. Fisher, JD, is the President of Fisher Consulting Group, Inc. and was the Founder of E.L.M. Insurance Brokers, a Wholesale & MGA facility specializing in Professional Liability and Specialty Line risks. He is a Member of the Editorial Board for Agents of America; a Faculty Member of the Claims College, and Member of the Executive Council, School of Professional Lines sponsored by the Claims & Litigation Management Association and a course designer and webinar Instructor for the Academy of Insurance. 

Consulting - Since his career began, Mr. Fisher focused on one vision: providing financial security to the client. The result was a successful 40 year career in Specialty Lines Insurance which have resulted in substantial cost savings for clients. He provides consulting and audit services in all areas of Professional Liability, D&O, and EPLI Insurance. This includes Processes, Underwriting, Claims, and Product Distribution. 

Background - In 1975, Mr. Fisher began his career on the service side, as an Independent E&O claims adjuster. In 1982, he bought the Company and increased annual billings by 400% in only 4 years. In 1995, he formed what is now known as ELM insurance Brokers, a firm that has acted as an MGA and Wholesale Broker of Professional Liability Insurance and Specialty Lines. From nothing, the firm grew rapidly to a $30 Million dollar facility when sold in 2008. 

Author and Speaker - Frederick Fisher has lectured extensively on professional liability issues since 1978, and authored over 64 articles in trade journals and periodicals. He is the author of BROKER BEWARE, Selling Real Estate within the Law. Mr. Fisher remains a Special Materials Expert for several RPLU courses and is the Senior Technical Advisor for The Professional Liability Manual, first published by the International Risk Management Institute in 1990. He has taught over 100 CE classes and lectures. Mr. Fisher can be reached at: fjfisher@fishercg.com

View Frederick Fisher's Expert Witness Profile.

Gulf Coast Risk Management (GCRM) provides research, analysis, and advice to commerce, industry, government and individuals, property managers, and general contractors regarding Insurance Placement, Interpretation, and Recommended Contractual Insurance Requirements, while explaining the relationship and alignment with indemnity and insurance provisions. 

GCRM operates COIs R Us, a certificate of insurance (COI) compliance and tracking company. COIs R Us compares the contractual obligations of a lease agreement with the COI. COIs R Us processes thousands of COIs for landlords and general contractors for compliance annually.

Business Consultant Services

Certificate of Insurance Tracking and Compliance Insurance Renewal Negotiations

Risk Manager Services Start Up Business Services

Certificate of Insurance Tracking - No More Excel

Scott S. Margraves, CIC, has over 32 years of Commercial Property and Casualty Insurance experience. He is the Principal Consultant and Founder of GCRM.  Mr. Margraves is well-versed in the placement of insurance policies from an insured's perspective. As a front-line producer, he weathered five major hurricanes, three “five-hundred-year floods” and multiple catastrophic fire claims. 

Agency roles include insurance broker, claims supervisor, agency partner, and risk manager. He is Past President of the Independent Insurance Agents of Houston, Past Vice Chairmen of IIAT IMPACT Region 10, Member of Insurance Academy, and Lifetime Committeemen for the Houston Livestock Show and Rodeo.

Mr. Margraves started his second career as a full-time consultant in 2021. He is an insurance industry expert that brings extensive experience in all aspects of property casualty insurance interpretation, policy forms, claims, safety programs, HR coordination and contract integration.

View Scott S. Margraves' Expert Witness Profile.

Ivan E. Cohen, RF, ARM, CRM, CIC, AIC, AAI, MLIS, CRIS, is a nationally recognized Insurance Expert with 44 years of Insurance and Risk Management experience.

In 1979, he opened his own agency where he still serves as president. Mr. Cohen has also been an Insurance educator for 41 years, serving as a senior adjunct professor at Westchester Community College in the Banking, Insurance, and Real Estate curriculum, and also on the curriculum advisory committee. He has taught for the Risk and Insurance Management Society, The National Alliance, Professional Insurance Agents of New York, Connecticut and New Jersey, Independent Insurance Agents and Brokers of New York, and provides training and continuing education courses for agencies and companies. 

Mr. Cohen is a member of the Global Risk Management Institute, an associate member of the Risk and Insurance Management Society and holds the distinction of being a RIMS Fellow and has been a contributing insurance columnist for Risk Management Magazine.

Mr. Cohen delivers presentations and seminars throughout the country on topics including: 

Errors & Omissions - Agency Management - Risk Management - Law & Ethics - Casualty Coverage - Property Coverage

View Ivan Cohen's Expert Witness Profile.

Jim Leatzow has 46 years of "hands-on" practical, property / casualty insurance agency experience. Leatzow has literally worn "every hat there is to wear in the P/C insurance business. He provides expert & arbitration services nationally & internationally with no charge for travel time. He is articulate, efficient & equally comfortable within the U.S. & in foreign venues. His experience includes:

• 46 years national Property/Casualty insurance industry experience
• 30 years national, Property/Casualty insurance Agency Owner
• 23 years national, Property/Casualty Managing General Agent (MGA)
• 20 years national, Third Party Administrator (TPA) insurance claim adjuster
• 26 years Reinsurance experience & Company Founder/President
• 17 years Certified insurance Arbitrator (U.S. / U.K. / Bermuda) 
• 55 years Licensed Pilot with Commercial, Instrument, Multi & Seaplane Ratings 
• Still licensed in Illinois (46 years) & Wisconsin (38 years) 
• Licensed in all states for 20-25 years until 2005 (agency sold)
• Rule 26 Report specialization on complex cases 
• Bad Faith Expert qualified nationally 
• History of representing plaintiff & defense equally
• No charge for travel time "coast to coast"

Leatzow's specialties include: Agent-Broker-MGA standards of care / Bad Faith / Coverage / Agent-Broker E&O Claims / Agent-Broker custom & practice / Professional (E&O) Liability / Claims Adjusting Standard of Care / Claims-made coverage / Surplus Lines issues / Underwriting / Licensing / Property / General Liability /Aviation Insurance

Lieberman Financial & Consulting Services, LLC provides high quality Financial Planning services and Insurance Investment to advice to clients in all walks of life. Principal, Maurice Lieberman, CLU, ChFC, RHU, LUTCF, has over 40 years of experience specializing in Life Insurance, Annuities, and Health Coverage.

Mr. Lieberman also offers Financial Planning Workshops and conduct large and small group seminars. He provides individual and family financial counseling sessions to active duty members of the United States Military (all branches.)

Mr. Lieberman holds three professional designations from the American College, Chartered Life Underwriter, Chartered Financial Consultant, and Registered Health Underwriter. He is a Life Insurance Training Council Fellow, and a member of the American College of Financial Services Professionals, Forensic Expert Witness Association, and the American College of Forensic Examiners International.

Background Experience - Mr. Lieberman started as an insurance agent for Metropolitan Life and then advanced in his career to manage brokers. He successfully built agencies for Aetna, and Principal Financial Group. He was later promoted to Regional Director for New England Financial, and CSAA Life. Over the years he mentored hundreds of insurance agents, brokers, financial planners and agency managers to build their own successful careers and agencies. He was also a member of the Million Dollar Round Table and utilized his selling and management experience to train insurance agents, brokers and financial planners in advanced areas of estate, business insurance, and financial planning.

View Maurice Lieberman's Expert Witness Profile.

Key Coleman, CPA, CFA, CPCU, ARe is Executive Director and Founder of Litigation Economic & Forensic Consulting Group LLC. While his firm is located in Greater Philadelphia, his practice is nationwide. Mr. Coleman focuses his consulting practice on damages analysis in the context of commercial disputes, contract audits and investigations. Mr. Coleman has a specialty in the Insurance and Reinsurance Industry, having worked in or around the industry for over 30 years. Prior to starting his own firm, he spent the bulk of his career in Chicago where he was a partner at a Big Four accounting firm and subsequently held high level positions at other nationally recognized accounting and consulting firms. Prior to his consulting career, he spent more than eight years in the insurance and reinsurance industry. His major investigative work includes having spent 4 years on the then-largest insurance investigation in history.  He is one of the few experts nationwide who holds both the CPA and the CPCU designations; he has significant depth in reinsurance, as well, enabling him to gain the 'big picture' when dealing with insurance and reinsurance issues.  He has performed inspections of MGAs, TPAs, ceding companies, and insureds. An abbreviated list of his investigative and insurance specialties include:

Accounting, Forenisic Accounting and Investigations Analysis of accounting records Forensic accounting Investigative analysis Contract audits Consulting Services in Insurance and Reinsurance MGA/MGU audits or inspections Underwriting audits

Claims analysis Ceding company audits Premium audit analysis Insolvency and run-off analysis Workers’ Compensation Professional Employment Organizations (PEOs) Damages Analysis in Inurance and Reinsurance

View Key Coleman's Expert Witness Profile.

Florida Office:
Andrew Avalon, PE, PSP
Chairman & CEO
8633 Willow Kane Court
Orlando, FL 32835
aavalon@long-intl.com
T: (407) 445-0825     F: (407) 650-3399

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Long International provides expert engineering and construction claims analysis, expert testimony, project management consulting, and insurance claims analysis services. We focus on projects in the following industries: building and construction; gas, gasification, GTL, LNG, and NGL; industrial and manufacturing; mineral and mineral processing; offshore oil and gas; oil sands; pipelines and utilities; power; refineries, petrochemical, and chemical; transportation; and water, wastewater, dams, and marine.  We analyze claims, not limited to, disputed change orders, schedule delay, acceleration, time extensions, liquidated damages, loss of productivity, defective specifications, and deficient project management performance.

Richard J. Long, P.E., P.Eng., Founder of Long International, has over 50 years of U.S. and international consulting experience involving construction contract disputes analysis and resolution, arbitration/litigation support and expert testimony, project management, engineering/construction management, cost and schedule control, and process engineering. As an internationally recognized expert in the analysis and resolution of complex construction disputes for over 35 years, Mr. Long has served as the lead expert on over 300 projects having claims ranging in size from US$100,000 to over US$2 billion. He has presented and published numerous articles on claims analysis, entitlement issues, CPM schedule and damages analyses, cumulative impact claims, and claims prevention.

Rod C. Carter, CCP, PSP is President of Long International and has over 20 years of experience in construction project controls, contract disputes and resolution, negotiations, mediation, arbitration support, and expert testimony on scheduling, loss of productivity, and quantum issues.  He has experience in entitlement, schedule, and damages analyses on over 30 construction disputes ranging in value from US$100,000 to US$7 billion, related to oil and gas, oil refinery, LNG, heavy civil, nuclear, environmental, chemical, power, industrial, commercial, and residential construction projects.  Mr. Carter is proficient in the use of Primavera P6 and P3 software, and he has extensive experience in assessing the impact to engineering and construction works of RFIs, change orders and other events.  Mr. Carter specializes in loss of productivity, cumulative impact, and quantum calculations, and had a lead role in assessing damages on more than a dozen major disputes.  In addition, Mr. Carter has developed cost and schedule risk analysis models using Monte Carlo simulations to address the uncertainty of estimates and claims.

Scott M. Francis, P.E., PSP is a Vice President of Long International and has over 20 years of experience in project management, contract disputes analysis and resolution, CPM schedule preparation, execution, and analysis, productivity analysis, contract administration, design engineering, construction management, and government contracting.  He provides schedule development and assurance services, cost estimating, and claims analysis services on projects for both owners and contractors.  Specific responsibilities include CPM development and reviews, CPM schedule delay and acceleration analyses, change order impact analysis, issue identification, correlation of impacts to schedule activities, and productivity evaluations.

Milliman’s Tampa Office provides a variety of Health Insurance, Health Care services, and Pharma consulting services to law firms, health plans, insurance companies, HMO’s, Blue Cross/Blue Shield plans, hospitals and other providers, employers and government agencies. Stuart Rachlin and other staff are experienced actuaries and related consultants.  

We provide support to our clients with all types of health related services including Medicare Advantage and Prescription Drug plans (MAPD), Part D plans (PDP), ACA plans, medical, dental, long-term care, Medicare supplement & critical illness.

We assist clients nationwide with forensic actuarial work, rate filings, regulatory compliance, reserve projections, valuations, employee benefit analysis and design, mergers and acquisitions, claim cost analysis, and fee schedule analysis.

These health care services are used in litigation relating to:

• Life care planning
• Contract development and fee schedule analysis
• Pricing & Underwriting
• Senior Services
• New benefit plan design

Britta M. Moss CPCU, SCLA, AIC-M, is a graduate of The Ohio State University and a 25+ year veteran of the Property & Casualty Insurance industry.  She has claims experience in a wide variety of personal and commercial lines claims as a Claim Representative, Examiner, Supervisor, Trainer and Manager.

Ms. Moss handles, supervises, manages and provides training for claims involving auto damage, personal & commercial property damage, bodily injury, personal injury, property damage liability, commercial general liability, uninsured / underinsured motorists, medical payments, personal injury protection, and allegations of bad faith and extra-contractual exposure.

Consulting Services Include:

Claim Consultation & Training: 

• In-House Claims Consultation and Training available on a wide range of topics and highly beneficial for any party touched by the claim process, including adjusters, agents, CSRs, underwriters, sales reps, and legal counsel.
• Good faith claim handling, supervision and management, improvement of documentation skills & procedures, understanding & managing work environment pressures, maintaining credibility & mutual respect, managing corporate discovery demands, policy & procedure refinement.

Auditing 

• Flexibility to take on a wide range of audit projects, from complete claim portfolio reviews to focus audits. Objectively review factors that are often difficult to assess at ground level: handling/management consistency, reserve adequacy, process efficiency & effectiveness, training needs, reporting gaps, and bad faith, extra-contractual, and other volatile exposures.

Presentations

• Meetings, Seminars, or Panel Discussions on best practices and standards of care in claims investigation, evaluation, negotiation, and settlement, what they see on both sides of the aisle as experts, and bad faith litigation trends.

Britta Moss's Expert Witness Profile.