1A. Expertise as to Insurance Applications and Policies from a Regulatory Perspective. From an educational standpoint, I hold a B.A. in mathematics, an M.Ed. in educational psychology, and a J.D. from the University of Illinois and am a member upon examination of the bars of Florida bar along with the bars of Iowa and Illinois (inactive), both also by examination.
I have had extensive and substantive experience relating directly to both life health and property casualty insurance applications (and their related) policies. As a regulator for eight years in three positions ((i) Assistant Attorney General assigned to the Department of Insurance (Iowa), (ii) First Deputy Commissioner of Insurance and (iii) Commissioner of Insurance), along with my staff, I approved (or disapproved) every word of every phrase of every sentence of every page of every property casualty and life health application and policy used by each of the 1,000 property casualty insurance company doing business in the state and each of the 500 life health insurance companies doing business in the state. Included in these numbers were the lead insurers doing business throughout most of the U.S. As a result, I am familiar with the wording of these applications and proficient in construing the meaning of words and phrases within such applications.
These regulatory positions also included the responsibility to approve (and disapprove, as necessary) (i) policy forms related to the applications and (ii) in most instances, the proposed premiums to be used in connection with the particular application and policy form.
While Commissioner, I also served as a member of the Executive Committee of the National Association of Insurance Commissioners (“NAIC”), the nationwide organization of all state insurance commissioners, including Florida’s Commissioner. That organization has responsibilities for establishing model insurance administrative regulations and model statutes for consideration by all of the states.
One of the reasons insurance can be conducted smoothly on a national basis in the U.S. is the comparability of state-by-state insurance laws, many of which originated from NAIC model laws. While with the NAIC, I served on, among other committees, the (i) Commercial Lines Committee, with nationwide jurisdiction over applications and policies and (ii) on the Casualty Actuarial Committee and (iii) finally, I served as chair of the three lead NAIC life insurance committees including the (a) Life Insurance Committee: The charge of this Committee was oversight of all issues relating to life insurance products as well as life insurers, including insurer practices such as applications and policy issuance; (b) Chair of the Universal Life Insurance Task Force: The charge of this Committee was oversight of universal life and similar products including their applications; and (c) Chair of the Life Insurance Product Development Task Force, including their applications. 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 life insurance products. In all of these instances at the NAIC, I had significant responsibility for property casualty and life health policy applications.
Watch insurance expert Bill Hager discuss issues with applications for life, health and property casualty insurance.
1B. Expertise as to Insurance Applications and Policies from an Insurance Industry Executive and from a Company CEO Perspective. Along these same lines, I served as general counsel and chief lobbyist to the American Academy of Actuaries, Washington, D.C. The Academy is the national professional association for actuaries. These professionals assist in policy application language for the simple reason that the application form is the first phase of underwriting, determining the amount of risk an insurer chooses to accept and therefore the related rate or premium levels necessary to support the risk. (In addition to application language, because policy language dictates premium levels, actuaries are also active in determining policy language).
Further, from 1990 to 1998, I served as President and Chief Executive Officer for the National Council on Compensation Insurance (“NCCI”), New York City and Boca Raton, Florida, a nationwide property casualty industry-owned organization with about 1,500 employees with annual revenues of about $150 million that did (and does) business in about 40 states including Florida, which is also the domiciliary state of NCCI. This means while I served as president and CEO, NCCI was subject to the full authority of the Florida Office of Insurance Regulation (“FL OIR”) and subject as well to the Florida Insurance Code as well as the jurisdiction of all Florida courts, state and federal.
Among my responsibilities at NCCI was (together with my staff) to formulate all workers compensation insurance applications (and related policy forms) as used in our states of operation (about 40 such states). This work included drafting all applications and policy language (tailored to the specific state’s Insurance Code) as well as drafting all endorsements and all other policy forms. In addition, my responsibility included gaining state insurance department approval of all such applications and policy forms as a condition precedent to their use as submitted by some 600-property casualty insurance companies.
I am also one of about 200 certified reinsurance arbitrators (by ARIAS-US) and have sat as an arbitrator on property casualty issues in disputes about policy language between reinsurers and their insurers when application language has been in dispute. I know insurance applications and policies and applications and policy forms.
Insurance Applications Expert Witness
Contact Bill Hager at 561-306-5072 or via email to discuss your case.