Disability Insurance Policies

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SUMMARY OF MOST RELEVANT EXPERTISE.1

AS TO BOTH SHORT TERM AND LONG TERM

DISABILITY EXPERTISE FOR BOTH ERISA AND NON-ERISA PLANS

Expertise: A Brief Summary. In connection my short term and long term disability insurance expert opinions, I draw upon my expertise (i) as summarized immediately below, (ii) as set forth in my Curriculum Vitae at https://expertinsurancewitness.com/wp-content/uploads/2018/04/William-D-Hager-Appendix-A-September-13-2013.pdf as provided on the home page of my website at https://expertinsurancewitness.com/ and (iii) my website itself, which includes overall expertise and expertise as it comes to bear on short term and long term disability insurance2 and includes a full description of my disability expertise at https://expertinsurancewitness.com/disability-insurance-expert/

Disability matters often call for expertise as to custom and practice in the insurance industry as to: (i) the obligations and responsibilities of a disability insurer in connection with its claim obligations as measured in custom and practice and as measured against applicable statutory and regulatory considerations and (ii) the insured’s obligations in such circumstances. Set out below is specific expertise as to these matters.3

Applicable Short Term and Long-Term Disability Expertise: Regulatory. My expertise as to these matters can be found as follows: I am a former:

  • Commissioner of Insurance (Iowa); as appointed by the Governor of Iowa;

  • First Deputy Commissioner of Insurance; as appointed by the Commissioner of Insurance;

  • Assistant Attorney General assigned on a full-time basis to the Department of Insurance (Iowa) as appointed by the Attorney General of the State.4

  • Administrative Law Judge, f/k/a Hearing Officer; as appointed by the Commissioner of Insurance;

In those capacities, on a daily basis, I had full regulatory oversight and responsibility for: (i) the obligations and responsibilities of a disability insurer in connection with its claim obligations as measured in custom and practice and as measured against applicable statutory and regulatory considerations and (ii) the insured’s obligations in such circumstances.5

Applicable Short Term and Long-Term Disability Insurance Expertise: National Insurance Regulatory. My expertise as to these matters can be found as follows: I am a former:

  • Member of the National Association of Insurance Commissioners (NAIC);

  • Member of its Executive Committee with oversight over all underlying committees including those dealing with disability insurance, including the work of the “B” Committee relating to health and disability insurance, including long term disability insurance;

In those capacities, on a regular basis, I had full NACI regulatory oversight and responsibility for (i) the obligations and responsibilities of a disability insurer in connection with its claim obligations as measured in custom and practice and as measured against applicable statutory and regulatory considerations and (ii) the insured’s obligations in such circumstances.

Applicable Short Term and Long-Term Disability Insurance Expertise: Current Legislative Experience. In addition to my state and national insurance regulatory background, I have served or am serving in the following legislative capacities, each of which included daily knowledge of and interaction with disability insurance and insurance companies that sold such policies as it related to (i) the obligations and responsibilities of a disability insurer in connection with its claim obligations as measured in custom and practice and as measured against applicable statutory and regulatory considerations and (ii) the insured’s obligations in such circumstances.

  • Elected Member of the Florida House of Representatives (currently)6 where I serve or have served as a Member and Vice Chairman of the Insurance Committee (among other committees) as well as its upstream parent committee, the Commerce Committee, which collectively have legislative oversight over all insurance operations in the state (as administered by the Florida Office of Insurance Regulation) including those relating to long term disability insurance policies;

  • In addition, I have sat on and served as Vice Chairman of the Civil Justice Subcommittee of the Florida House, which has responsibilities as to Florida laws that establish (among other things) liability, which is of course one of the foundations of the relationship between disability insurance policies and liability,

Applicable Long-Term Disability Insurance Expertise: Prior Legislative Experience. In addition to my state and national insurance regulatory background and my current legislative background, I have served or am serving in the following additional legislative capacities, each of which included knowledge of and interaction with disability insurance and insurance companies that sold such policies as it related to (i) the obligations and responsibilities of a disability insurer in connection with its claim obligations as measured in custom and practice and as measured against applicable statutory and regulatory considerations and (ii) the insured’s obligations in such circumstances.

  • Legal Counsel to the Iowa House of Representatives;

  • Chief of Staff at the U.S. House of Representatives,

  • Elected Member of the Boca Raton City Council; Deputy Mayor of the City of Boca Raton, where I served as the Council’s lead on insurance issues;

Applicable Short Term and Long-Term Disability Insurance Expertise: Industry. In addition to my regulatory background and my current and prior legislative background as to disability policies and insurance companies that sell them, I have served or am serving in the following capacities, each of which included daily knowledge of and interaction with disability insurance in the following ways: (i) the obligations and responsibilities of a disability insurer in connection with its claim obligations as measured in custom and practice and as measured against applicable statutory and regulatory considerations and (ii) the insured’s obligations in such circumstances.

  • President and Chief Executive Officer of the National Council on Compensation Insurance (NCCI), a major U.S. workers compensation insurance company doing business throughout the United States, which employs about 1,000 personnel. One of the important workers compensation coverages is short term and long-term disability benefits.

  • While CEO, my position entailed responsibility for the formulation and pricing some $100 billion of property casualty insurance premium, an important component of which was short term and long-term disability coverage (insurance). My CEO position also included responsibility for all insurer relationships;

Applicable Short Term and Long-Term Disability Insurance Expertise: Actuarial. In addition to my state and national regulatory background and my legislative background and my industry background as to disability policies and insurance companies that sell them, I have served or am serving in the following actuarial capacities, which included daily knowledge of and interaction with disability insurance in the following ways: (i) the obligations and responsibilities of a disability insurer in connection with its claim obligations as measured in custom and practice and as measured against applicable statutory and regulatory considerations and (ii) the insured’s obligations in such circumstances.

  • American Academy of Actuaries, Washington D.C., where I served as general counsel and chief lobbyist. The American Academy of Actuaries is the actuarial professional association serving all areas of the profession; Actuaries price (set the premium) for the coverages at issue in this case.

  • Actuarial Standards Board. I served as counsel to this organization’s forerunner, the Interim Actuarial Standards Board (ASB). ASB promulgates professional standards that come to bear on the actuary’s professional work product. ASB is the actuarial equivalent of FASB on the accounting side of commerce. Among the standards are those relating to rate making (premium determination) as to short- and long-term disability.

  • NCCI. While President and CEO of this workers compensation and rate making organization, I had responsibility for, among others, the actuarial operations of NCCI, which totaled about 150 actuarial personnel (out of a total employment basis of 1,000 people), both professionals and supporting staff. While CEO of NCCI, working with the actuarial division along with the balance of the organization, I had responsibility to formulate policy language and assure actuarial accurate pricing on some $100 billion of workers compensation premium;

  • Commissioner of Insurance; First Deputy Commissioner of Insurance. While in these two capacities, I had responsibility to approve and/or disapprove most all short- and long-term disability policy form filings and rates, applying statutory criteria to determine whether those policy form filings conform with the statutory requirements.

Applicable Short- and Long-Term Disability Insurance Expertise: Industry: Reinsurance Arbitrator. In addition to my state and national regulatory background and my current and prior legislative background and my industry background and my actuarial background as to the matters at issue here, I have dealt with disability policies and their insurers as to (i) the obligations and responsibilities of a disability insurer in connection with its claim obligations as measured in custom and practice and as measured against applicable statutory and regulatory considerations and (ii) the insured’s obligations in such circumstances.

  • Nationally certified Insurance Arbitrator (ARIAS-US), where I sit as an arbitrator on disputes between (among others) disability insurers and other insurers (e.g., coordination of benefits issues) and enter decisions as to disability insurance policy issues,

  • Nationally certified Reinsurance Arbitrator (ARIAS-US), where I sit as an arbitrator on disputes between (among others) disability insurers and their reinsurers and enter decisions as to disability insurance policy issues,

Applicable Short Term and Long-Term Disability Insurance Expertise: Current Legal. In addition to my state and national regulatory background and my current and prior legislative background and my industry background and my actuarial background and my reinsurance arbitration background, I have served or am serving in the following legal capacities, each of which included daily knowledge of disability insurance policies in the following ways: (i) the obligations and responsibilities of a disability insurer in connection with its claim obligations as measured in custom and practice and as measured against applicable statutory and regulatory considerations and (ii) the insured’s obligations in such circumstances.

  • Hager Law Firm, Boca Raton, Florida, where I currently practice law, with a practice limited to insurance and reinsurance matters.

Applicable Short Term and Long-Term Disability Insurance Expertise: Prior Legal. In addition to my state and national regulatory background and my current and prior legislative background and my industry background and my actuarial background and my reinsurance arbitration background and my current legal practice, I have served or am serving in the following legal capacities, each of which included daily knowledge of disability insurance in the following ways: (i) the obligations and responsibilities of a disability insurer in connection with its claim obligations as measured in custom and practice and as measured against applicable statutory and regulatory considerations and (ii) the insured’s obligations in such circumstances.

  • As stated elsewhere in this report, I am an attorney admitted to practice in Florida, Illinois7 and Iowa (all upon examination) with an insurance practice;

  • Legal Counsel to the Iowa House of Representatives;

  • Practicing attorney in Des Moines at the law firm of Hager & Schachterle;

  • Iowa Counsel to the Property Casualty Insurance Association of America (PCIAA).

  • Legal Counsel to the Professional Insurance Agents of Iowa (property casualty agents);

  • Legal Counsel to the Iowa Association of Life Underwriters (whose member agents sold short- and long-term disability insurance).

  • General Counsel and Chief Lobbyist to the American Academy of Actuaries, whose members are often involved in disability insurance policies and their insurers, particularly from a relationship standpoint;

Applicable Short- and Long-Term Disability Insurance Expertise: Formal Undergraduate Education as a Basis for Disability Insurance Policy Expertise. In addition to my regulatory, legislative, industry, actuarial, reinsurance and legal background, my undergraduate educational background has also well-equipped me to provide disability insurance policy/claim expertise as follows:

  • Bachelor’s degree: Mathematics8 – University of Northern Iowa;

Applicable Short- and Long-Term Disability Insurance Expertise: Formal Graduate Education as a Basis for Disability Insurance Policy Expertise. In addition to my regulatory, legislative, industry, actuarial, reinsurance and legal background and my undergraduate education – my graduate educational background has also well-equipped me to provide disability insurance policy/claim expertise as follows:

  • Master’s degree: Educational Psychology, University of Hawaii, Honolulu; and

  • Juris Doctorate degree (law degree) from the University of Illinois;

Applicable Short- and Long-Term Disability Insurance Policy Expertise: Licenses as a Basis for Expertise. In addition to my regulatory, legislative, industry, actuarial, arbitration, legal and educational background, my licenses provide disability insurance policy expertise as follows:

  • Admitted to Practice before the U.S. Supreme Court;

  • Bar Admissions for the states of Iowa, Illinois9 and Florida, all by separate examination;

Applicable Short- and Long-Term Disability Insurance Policy Expertise: Certifications as a Basis for Expertise. In addition to my regulatory, legislative, industry, actuarial, arbitration, legal and educational background and my licenses – my certifications provide disability insurance policy expertise as follows:

  • Certified U.S. Reinsurance Arbitrator; and

  • Certified U.S. Insurance Arbitrator.

Overall Expertise. In the aggregate, these experiences have given me a significant grounding to provide expert short term and long-term disability insurance policy/claim testimony inclusive of the insurer and insured’s/claimant’s obligations in the claim process. Further detail as to my disability insurance expertise can be reviewed in general as follows, with each of the referenced materials to be read in conjunction with my curriculum vitae attached:

END OF THIS DOCUMENT

1 In summary fashion, I set out here my qualifications as to this matter. These qualifications should be read together with: (i) my Curriculum Vitae as set forth at Appendix A, inclusive of all of its references, of this report.

2 When I use the term “disability Insurance” or its equivalent in this document, I include as well both short term and long-term disability insurance as the context may require.

3 My opinions would be based on custom and practice in the industry that come to bear on this matter.

4 Functioning as the Department’s general counsel.

5 Because the long-term disability insurance business is conducted across state lines and more specifically, nationally, the rules and regulations (by whatever name) are substantially similar state over state. My point is that my experience is substantially similar to parallel experience in the balance of the states for that matter. This experience is bolstered by my 45 years of direct insurance experience, including that of being a CEO of a major insurance company doing business throughout the U.S. and my eight years of experience as an elected Member of the Florida House of Representatives where I currently serve or have served as Member and Vice Chairman of the Insurance Committee or its upstream parent committee, the Commerce Committee, with statutory and legislative oversight over the long term disability insurance business, which, as stated, is regulated in Florida much as it is in Kentucky. As of 12/31/2108, I will no longer be with the Florida House of Representatives, as I am term limited out, having served the full 8 years of 2-year terms.

6 I am currently serving my 8th year in the Florida House of Representatives.

7 This license has been placed in inactive status by me at my own volition and is eligible for reactivation at my request at any time. This is so because I am in good standing with the Illinois Bar.

8 Specifically, a B.A. in secondary mathematics education.

9 As stated elsewhere, this license is currently in inactive status and is eligible for reactivation at any time upon my request in that I am a member of that Bar in good standing.