Medical Malpractice Insurance Expertise

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I have had extensive and substantive experience relating directly to the standard of care that comes to bear on malpractice insurers. As an insurance regulator, I have prosecuted (administratively) malpractice insurers for violations relating to standards of care. I have served as an Administrative Law Judge and entered findings of facts and conclusions of law in cases in which malpractice insurers were prosecuted for violations relating to standards of care.

As CEO of a major U.S. property casualty insurance entity, I have had substantial working relationships with the casualty insurance community. I know malpractice insurers and their duties.

Among my other positions and experiences, the following were particularly helpful in connection with this assignment and should be read together with my attached Curriculum Vitae:

A. Formal Education.

1. Bachelors Degree in Mathematics. I hold a bachelors degree in secondary mathematics education from the University of Northern Iowa;

2. Masters Degree in Psychology. I hold a masters degree in educational psychology from the University of Hawaii; and

3. Juris Doctor’s Degree. I hold a J.D. degree from the University of Illinois.

B. Licensure and Certification.

4. Certified Reinsurance Arbitrator. I am certified by ARIAS as one of about 250 U.S. certified reinsurance arbitrators;

5. Admitted to Practice Law. I am licensed and admitted to practice law upon examination in the states of Iowa, Illinois (inactive) and Florida; and

6. Admitted to Practice before the U.S. Supreme Court. I am also admitted to practice before the U.S. Supreme Court.

C. Insurance Expert. 

7. Expert Witness. I have served as an expert witness in several cases throughout the U.S. and have been qualified at trial as an expert witness in more than 20 states.

8. Insurance Consultant to the U.S. Attorney. By way of example of my various assignments, I am currently retained by the U.S. Attorney, the Middle District of Florida, as an insurance consultant in a complex civil insurance matter.

9. Insurance Consultant to the U.S. Department of Justice. Similarly, I have also been retained by the U.S. Department of Justice as an insurance consultant in a complex insurance case.

10. Expert Witness: United States Air Force. Similarly, I have been retained as an expert in a major property casualty matter by the United States Air Force.

11. Expert Witness: on Behalf of Various Departments of Insurance. I have also been retained as an expert witness by the: (i) Florida Department of Insurance and recently testified on their behalf in Florida state court, and (ii) the Arizona Department of Insurance and testified on their behalf. Likewise, I have been accepted as and testified as an expert insurance witness before the Nevada, Oklahoma, South Dakota and Texas Departments of Insurance.

D. Industry Background: Reinsurance Arbitrator. 

12. Reinsurance Arbitrator: Medical Malpractice Cases. November 2003 to Present. My background includes extensive exposure to the various reinsurance mechanisms and relationships. Along these same lines and as indicated above, I am a certified ARIAS-US reinsurance arbitrator (see immediately below) and have sat as an arbitrator in cases between medical malpractice insurers and their reinsurers. The relevance of this experience to this case is that reinsurers have substantial influence on the underwriting standards of medical malpractice insurers. As of November 2003, I was certified by AIDA Reinsurance and Insurance Arbitration Society, United States (“ARIAS-US”) as an arbitrator for reinsurance and insurance matters. Today, there are about 200+ individuals so certified by ARIAS in the United States. ARIAS-US certifies knowledgeable and reputable professionals for service as panel members in reinsurance and insurance arbitration matters. The organization’s criteria for certification are as follows:

  • 10 years of significant specialization in the insurance/reinsurance industry
  • Arbitration experience – must have completed appropriate credited ARIAS seminars;
  • A member in good standing of ARIAS-US;
  • Appropriate endorsement from existing members.

E. Industry Background in General

13. CEO of a Major US Insurance Organization, Regulated Throughout the US; President and Chief Executive Office of the National Council on Compensation Insurance (NCCI; Boca Raton, Florida), 1990 – 1998. NCCI is one of the larger and more pervasive U.S. insurance organizations. During my tenure as President and CEO, NCCI had (and continues to have) responsibility to accurately price and file pricing for some $12 - $15 billion of workers compensation insurance in 39 states throughout the U.S. NCCI prepared proposed premium filings for regulators to approve by extracting key data from its 600 member insurance companies and then used that data to project necessary premium changes. NCCI accomplished this mission through some 1,000 employees of which approximately 600 were professionals, and had an annual revenues of $140 million.

Insurance Program. As CEO, I had daily exposure and responsibilities to the U.S. workers compensation program as administered by the various states, which constitutes one of the largest property casualty insurance programs in the world with some 100 million worker lives insured (in addition, of course, other important coverages are provided through workers compensation, most notably life insurance, wage replacement and medical coverage).

Underwriting and Claim Settlement Practices. In addition and relevant to this case, NCCI had a vested interest in member insurer underwriting and claim practices in that the industry’s reputation for fair underwriting and claim settlement practices ultimately impacted regulatory attitudes toward NCCI’s premium approval process.

Industry Standards of Practice. While President and CEO of NCCI, I visited and physically toured and reviewed in excess of 400 insurance companies and gained direct exposure to the procedures and processes and standard industry practices of the U.S. insurance community and its underwriting and claim settlement practices. I have had extensive exposure to insurer practices and procedures.

Licensed to do Business Throughout the U.S.: Familiar with the U.S. Insurance Regulatory Scheme. While CEO of NCCI, it was (and remains) licensed to do business in throughout the U.S. In that capacity, my company, NCCI, was subject to licensure by the various state departments of insurance (DOIs”) and was subject as well to the regulatory scrutiny of the these DOIs as well as being subject to all applicable provisions of the these state’s various Insurance Code. NCCI was also subject to state and federal jurisdiction as to each such state. As such, I am familiar with the regulatory and statutory scheme that is brought to bear on insurance in the various states.

14. General Counsel and Director of Government Relations to the American Academy of Actuaries (Washington D.C.), 1980 – 1983. I served as General Counsel and Director of Government Relations for the American Academy of Actuaries, including advising on admissions, discipline, federal antitrust and general corporate law. I represented the 10,000 member professional organization before Congress (e.g., Senate Committees on Banking, Commerce, Finance and Labor, and House committees on Education, Labor, Energy, and Ways and Means) and the various federal regulatory agencies.

Medical Malpractice Insurance Companies. The Academy is the professional organization of actuaries and includes qualified actuaries from all disciplines and all forms of insurers. Academy members included affiliation with virtually every medical malpractice insurance company in America. The Academy’s Board of Directors was likewise made up of leading insurance company executives from such companies.

15. Risk Metrics Corporation. I co-founded this Florida based information company in 1998. Risk Metrics (including Datalister, Inc.) gathers and sells public data relating to workers compensation to a wide range of insurance oriented customers, including insurance agents. I sold my interest in this corporation many years ago.

16. Attorney in Private Practice. As an attorney in private practice, I represented a number of agent and insurer interests and became familiar with applicable regulatory and industry standards of practice. Those interests included the position of Iowa Counsel to the National Association of Independent Insurers.

Medical Malpractice Insurance Issues. Those interests also included intimate involvement with medical malpractice insurance, as counsel to the:Professional Insurance Agents of Iowa (whose members sold among other coverages, medical malpractice insurance) and Iowa Association of Life Underwriters (life, annuity and health insurance agents). Specific duties as counsel at both the Professional Insurance Agents of Iowa (whose members sold medical malpractice insurance) and the Iowa Association of Life Underwriters (life, annuity and health insurance agents) included in-depth familiarity with medical malpractice claim settlement practices.

F. Regulatory

17. Commissioner of Insurance, Iowa 1986 – 1990. As Insurance Commissioner appointed by Governor Terry Branstad in July 1986, I was responsible for the regulatory oversight of all insurance companies, agents and brokers authorized to conduct business in the state of Iowa. My agency was responsible for solvency oversight, insurance company examinations, financial and accounting matters of insurance companies, consumer protection, agent and broker licensing, and oversight of medical malpractice insurance company practices, including claim settlement practices. In particular, that oversight included the responsibility of overseeing practices of medical malpractice insurer claim settlement practices. In addition, I oversaw the state regulation of the securities industry with Iowa’s Superintendent of Securities reporting directly to me.

Regulatory Oversight: Medical Malpractice Insurer Practices. In addition, as Insurance Commissioner, my responsibilities included oversight over the education, licensing, discipline and general supervision of all medical malpractice insurance companies in the state. I am very familiar with the responsibilities and applicable obligations that come to bear upon medical malpractice insurance companies.

Regulatory Oversight: Medical Malpractice Insurance Underwriting. As Insurance Commissioner, I also had day-to-day responsibility to assure that all claim settlement practices carried out by medical malpractice insurance companies doing business in the state met their duties, obligations and statutory and regulatory responsibilities as they settled cases.

Examination of Medical Malpractice Insurance Companies. As Insurance Commissioner, I directed and oversaw the examination of all insurance companies authorized to do business in the State of Iowa. Those examinations included focus on both financial matters (so called triennial examinations of insurers – of which well over 100 such examinations were conducted while I was Commissioner) and examinations of specific complaints about insurers (so called Market Conduct Examinations - well over 50 such exams were conducted while I was Commissioner).

Market Conduct Examinations of Medical Malpractice Insurer Claim Settlement Practices. Market Conduct Examinations focused on marketplace issues, specifically examining medical malpractice insurance companies as to compliance with their claim settlement practices. Concurrent with such exams, I personally reviewed and approved the final Examination Reports before they were issued. In addition, in many of these instances, I visited the subject medical malpractice insurer before the Examination Report was issue, including walking the floors of such insurance companies – reviewing their effected operations first hand.

Prosecution of Medical Malpractice Insurance Companies. As Insurance Commissioner, I employed a full time team of lawyers who fielded consumer complaints relating to all areas of medical malpractice insurance company operations. Indeed, many of these complaints, as well as results of Market Conduct Examinations, resulted in formal action under the state’s Administrative Procedures Act. From time to time, I served as the Hearing Officer as to such matters.

Major Insurance State. Iowa has about 1,000 authorized property and casualty insurance companies and over 500 life insurance companies and an unusually large number of domestic insurance companies and as such, insurance regulation in that state is a serious job.

Familiarity with U.S. Insurance Regulation. As Insurance Commissioner in Iowa with interaction with all DOIs regulators, as a member of the NAIC with frequent interaction with the DOIs and as CEO of NCCI, where we were licensed to conduct business in most all of the states, I am familiar with the regulatory scheme in place in the states.

18. National Association of Insurance Commissioners (NAIC), 1986 – 1990. Concurrent with my service as Iowa Insurance Commissioner, I served as a member of the NAIC. The NAIC is an organization of the Insurance Commissioners of all 50 states and meets quarterly in locations throughout the U.S. to consider and evaluate national insurance issues. Further, the organization is professionally staffed with more than one hundred personnel. The organization is based in Kansas City, Missouri. The NAIC considers all major insurance issues and then promulgates model insurance laws and regulations, which are then routinely (but optionally) adopted at the individual state level.

NAIC Chairmanships – Chairman of the Midwest Zone. I was elected by my fellow Insurance Commissioners from the Midwest Zone (composed of the Midwest states, constituting about one quarter of all of the states) to provide leadership and representation of the Midwest before the balance of the states. This position included a position on the Executive Committee of the NAIC as well as major responsibilities relating to the assignment of states (and their related examiners) to specific examinations, both triennial and Market Conduct.

NAIC Leadership: Member of the Executive Committee. I also served as an elected member of the Executive Committee of the NAIC, the body that served as the steering committee of the organization, providing leadership between full membership meetings and providing recommendations to the full membership as to complex or politically charged issues within the organization.

NAIC Chairmanships – Chair of the Life Insurance Committee: Underwriting Issues. As a member of the NAIC, I served as both Vice Chairman and Chairman of the NAIC Life Insurance Committee. The charge of this Committee was oversight over all issues relating to life insurance products (including illustrations) as well as life insurers, including practices such as underwriting.

NAIC Chairmanships: Chair of the Universal Life Insurance Task Force. In addition to chairing the Life Insurance Committee, I also chaired the Universal Life Insurance Task Force.

NAIC Chairmanships: Chair of the Life Insurance Product Development Task Force. I also chaired the Life Insurance Product Development Task Force. While chairman of this task force, I led the development of model disclosure statements for universal and indeterminate premium life products designed to assist consumers in their comparison of different types of interest sensitive life insurance products.

Other NAIC Chairmanships: I also served in a number of NAIC capacities including Chairman of the Financial Services and Insurance Regulation Task Force.

In addition, my service on the following NAIC Committees was also helpful in this regard:

  • Member, the Blanks Committee
  • Member, Guarantee Fund Committee
  • Member, Rehabilitator and Liquidators Committee
  • Member, Casualty Actuarial Committee
  • Member, Commercial Lines Committee
  • Member, Valuation of Securities Committee,
  • Member, International Insurance Relations Committee
  • Member, Accounting Practices and Procedures Committee and
  • Member, State and Federal Legislative Committee.

Ongoing Regulatory Involvement. In the years since leaving the regulatory ranks, I have continued to be closely involved with the NAIC and the regulatory community. As President and CEO of NCCI, I was in regular attendance at meetings of the NAIC and continue to attend these meetings and to be actively engaged with the regulatory process. Included in this attendance were my observations at the NAIC of the regulation of the medical malpractice industry.

19. First Deputy Commissioner of Insurance, Iowa 1976 – 1978. As First Deputy Insurance Commissioner, I was responsible for the regulatory oversight of all insurance companies, agents and brokers authorized to conduct business in the state of Iowa. I was responsible for solvency oversight, insurance company examinations, financial and accounting matters of insurance companies, consumer protection, agent and broker licensing, and oversight of medical malpractice insurance company practices, including claim settlement practices. In particular, that oversight included the responsibility of overseeing practices of medical malpractice insurer claim settlement practices.

Regulatory Oversight: Medical Malpractice Insurer Practices. In addition, as First Deputy Insurance Commissioner, my responsibilities included oversight over the education, licensing, discipline and general supervision of all medical malpractice insurance companies in the state. I am very familiar with the responsibilities and applicable obligations that come to bear upon medical malpractice insurance companies.

Regulatory Oversight: Medical Malpractice Insurance Underwriting. As First Deputy Insurance Commissioner, I also had day-to-day responsibility to assure that all claim settlement practices carried out by medical malpractice insurance companies doing business in the state met their duties, obligations and statutory and regulatory responsibilities as they settled cases.

Examination of Medical Malpractice Insurance Companies. As First Deputy Insurance Commissioner, I directed and oversaw the examination of all insurance companies authorized to do business in the State of Iowa, including medical malpractice insurers. Those examinations included focus on both financial matters (so called triennial examinations of insurers – of which well over 50 such examinations were conducted while I was First Deputy Insurance Commissioner) and examinations of specific complaints about insurers (so called Market Conduct Examinations - well over 50 such exams were conducted while I was First Deputy Insurance Commissioner; see the discussion that follows).

Market Conduct Examinations of Medical Malpractice Insurer Claim Settlement Practices. Market Conduct Examinations focused on marketplace issues, specifically examining medical malpractice insurance companies as to compliance with their claim settlement practices. Concurrent with such exams, along with the Commissioner, I personally reviewed the final Examination Reports before they were issued. In addition, in many of these instances, I visited the subject medical malpractice insurer before the Examination Report was issue, reviewing their effected operations first hand.

Prosecution of Medical Malpractice Insurance Companies. As First Deputy Insurance Commissioner, I oversaw a full time team of lawyers who fielded consumer complaints relating to all areas of medical malpractice insurance company operations. Indeed, many of these complaints, as well as results of Market Conduct Examinations, resulted in formal action under the state’s Administrative Procedures Act. From time to time, I served as the Hearing Officer as to such matters.

20. Iowa Assistant Attorney General Assigned to the Insurance Department, 1975-1976; serving as the Department’s General Counsel. As Assistant Attorney General, I had departmental prosecutorial responsibilities for violations of the Insurance Code under the state’s APA act including those committed by medical malpractice insurance companies. The Attorney General responsibility also included issuing Attorney General Opinions as to the construction of insurance laws and regulations.

21. Legal Counsel to House of Representatives. As legal counsel to the Iowa House of Representative (1975 session), I provided counsel on all relevant caucus issues and provided the following support:

  • Researched pending legislation,
  • Prepared memorandums in support of proposed legislation,
  • Provided legal advice, and
  • Participated in bill drafting, including that relating to medical malpractice insurance.

22. Lecturer at the Bar Review School, authoring and delivering the Insurance Course to students studying for the Iowa Bar Exam (from about 1985- 1991). I was invited to provide the insurance content review material and lecture for the insurance section of the bar review course in Iowa. Included in this lecture was extensive law applicable to the interpretation and construction of laws and regulations applicable to medical malpractice insurance companies, including their underwriting practices. I authored this material and provided this lecture to students studying to pass the bar for about six years, until accepting the position of President and CEO of NCCI in Florida.

23. Chief of Staff in the U.S. Congress. I served as Chief of Staff in the U.S. Congress in Washington D.C. to an Iowa Congressman for about a year. Among others, I participated in legislative drafting of insurance and reinsurance legislation.

Contact Bill Hager at 561-306-5072 or via email to discuss your case.

bill

William D. Hager

Insurance and Reinsurance
Expert and Arbitrator

561-306-5072


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