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Third Party Administration

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…

Jane Marie Downey

Jane Marie Downey, ARM, M. Ed Principal Risk Consultant, Clarity Concepts, Inc.   Jane Downey is an internationally known Risk Management consultant and Insurance industry expert. Jane has a background in both Insurance brokerage and Risk Management. Her specialty industries include manufacturing, financial institutions, and technology risks.  She has made many Risk Management reports to…

Stephen Miller, CPCU, AIC

Steve is a 30+ year veteran of property and casualty insurance claims.  He holds the CPCU and AIC designations and is Past President (2006) of the National Society of Professional Insurance Investigators (NSPII). Over the course of his carrier career, Steve worked as a direct claim handler, manager, litigation examiner, senior claim specialist and director…

J. Eric Peterson, Jr.

I have been in the insurance industry for over 30 years, working as a Licensed Commercial Property and Casualty Insurance Broker, Licensed Property and Casualty Insurance Adjuster, Litigation Manager for wholly owned, Captive Insurance companies as well as handling Property and Casualty Insurance claims for two of the country’s top Third Party Administrative Companies. I…

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Chantal M. Roberts

I am dedicated to providing trustworthy, valuable assistance in order to give my clients a clear understanding of claims standards and practices. As an expert witness, I strive to turn this complex topic into an easy to understand concept. Known for my honest and direct approach, I work hard to meet each of your individual…

Damian J. Arguello

Damian is an insurance coverage attorney, expert witness, and former adjunct law professor whose legal practice focuses on representing and counseling commercial policyholders, business and trial attorneys, and insurance agents and brokers regarding insurance issues. In his consulting and expert witness practice, Damian also draws from his pre-law school experience as a claims adjuster for…

Technical Aspects Of Professional Liability Claims

“To the uninformed, “a claim is a claim is a claim.” To some extent this is true. Any type of liability claim requires proof that the insured owed a duty to another person or entity, that the insured breached this duty, and that the breach was the proximate cause of quantitatively measurable damages suffered by the person or entity to whom the duty was owed. Thereafter, it becomes a matter of determining whether or not there are any defenses such as comparative or contributory negligence on the part of the claimant. Finally, there is the question of coverage—the issue of whether or not the policy will respond to the claim. ….

There are significant differences between managing professional liability claims, compared to those arising out of more standardized coverages. …”

“Ten Claim-Handling Lessons from `The Game of Thrones'”

Kevin extracts insights from HBO’s popular series and sees implications for how claim professionals approach the challenges in their work.

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