Professional Negligence Expert in Worker's Compensation Claims

Case Description:

A professional negligence expert in worker’s compensation claims administration was needed for a breach of contract suit regarding third party administration of claims. The plaintiff, a California employer, retained the defendant to administer its worker's compensation program. After approximately one year, the plaintiff terminated the contract, alleging the defendant was out of compliance with California worker's compensation board rules as well as with the defendant’s own standards and procedures. The plaintiff filed suit in Federal Court, alleging damages resulting from mishandled claims.

IMS ExpertServices™ was asked to locate a professional negligence expert with knowledge of the California worker's compensation appeals board, or WCAB, regulations. The expert was needed to review claims and opine as to whether the disputed claims resulted from professional negligence on the part of the claims administrator.

Experts Presented:

  • Claims Administration

    This expert in professional negligence law has over thirty years of experience in the worker's compensation field, including claims management, operations, and third party administrator, or TPA negotiations. He is certified to administer self-insured worker's compensation claims in the state of California. He has managed a TPA conversion and conducted management audits of claims. He is well qualified to speak to issues of professional negligence in worker's compensation claims administration. This expert has prior litigation support experience.IMS Reference #4985285

  • Professional Negligence

    This professional negligence expert has a Worker's Compensation Certificate from the Insurance Education Association and has undertaken post graduate studies in the worker's compensation field. She has served as head of Quality Assurance and Training teams at a claims management software company that has decades of experience developing claims management software for the California market. This experience has provided her with broad knowledge of California worker’s comp law and provides a solid background for establishing or refuting professional negligence.IMS Reference #4984826

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