Results For Articles or Consultants

Operational Audits

Michelle Villarreal

Michelle Villarreal began her claims career over 30 years ago, with Cigna Companies while attending St. Mary’s University in San Antonio. She is the President and CEO of Occupational Accident Risk, Inc, a Third Party Administrator specializing in Texas work injury programs. They have been in the Third Party Administration industry since 2006, offering services…

Richard Faber

Richard Faber is a highly experienced insurance professional who possesses a wide array of skills and a distinctive combination of experience, ranging from marketing, and consulting to managing/underwriting a staggering array of  risks. His background and extensive experience work together to make Richard a much sought after authority in his field. Richard began his career…

Thomas Quaka

Claim Auditing

The claims audit is the anathema of day-to-day claim operations. Nothing is more disruptive. Yet, if properly defined, nothing is more informative and helpful in improving a claim management program. This article will examine the need for a regular auditing program and provide a recipe for a three-dimensional approach to the process in order to maximize the accuracy of the audit results.

The need to conduct regular claims audits has already been widely discussed. With the magnitude of self-insured claims programs (including self-funded programs) and the millions of dollars spent on claim administration fees, what better way to verify whether the money spent has been justified or wasted? In essence, an audit of closed and open claims should accomplish several things.

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James J Moore

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies…

Michael Gay

An interpreter of “insurance-ese” assisting others in understanding insurance policies, procedures, and practices of the industry. Expert Witness/Litigation Consultant in P&C coverages and Agent/Broker “Best Practices”. Four decades of insurance program development in the specialty P&C insurance space. Skilled in the identification, analysis, evaluation, and treatment of complex risk and loss exposures. Insurance Educator for…

Akos Swierkiewicz

Akos Swierkiewicz has over 50 years of experience in property and casualty insurance and reinsurance underwriting, management, company startup, marketing and product research and development. He founded IRCOS, LLC in 2000 to provide property and casualty insurance and reinsurance consulting and outsourcing services, including company startup and runoff, arbitration, mediation and expert witness services, feasibility…

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David Mandt

Dave has been retained in over 150 cases as a consulting or testifying expert on insurance claim handling standards and practices in both state and federal courts in a variety of jurisdictions, both at deposition and trial. He has been qualified to testify in Washington and Oregon state courts and the United States District Courts…

Areas of Expertise