Vident Partners provides vetted claims handling expert witnesses for cases involving adjuster practices, investigation adequacy, reserve setting disputes, and compliance with fair claims settlement statutes and regulations. Request a referral today.
Find a Claims Handling Expert →Overview
Claims handling experts evaluate whether insurance adjusters and claims departments followed industry-standard practices in investigating, evaluating, and resolving claims. They assess the adequacy of investigations, the reasonableness of reserve decisions, compliance with unfair claims settlement practices statutes, and whether claims were processed in a timely manner. The NAIC Model Unfair Claims Settlement Practices Act (Model 900) identifies fourteen categories of prohibited conduct -- including failing to adopt and implement reasonable standards for the prompt investigation of claims, and failing to affirm or deny coverage within a reasonable time after proof of loss is submitted 1. The NAIC Model Laws index confirms that all 50 states have enacted statutes derived from or similar to Model 900, making it the national baseline for claims handling standards in litigation 2. These experts provide essential context when policyholders or claimants allege that insurers failed to handle claims in accordance with applicable standards 3.
The NAIC Model 900 Act identifies failing to adopt reasonable standards for prompt investigation of claims as an unfair claims settlement practice when committed with such frequency as to indicate a general business practice.
Case Types
Claims investigation adequacy and thoroughness
Reserve setting and claims evaluation practices
Compliance with state unfair claims settlement practices acts
Timeliness of claims processing and payment
Adjuster training and supervision adequacy
Qualifications
Related Specialties
FAQ
A claims handling expert should have extensive senior-level claims management experience, hold industry designations such as AIC or CPCU, and demonstrate thorough knowledge of claims handling standards and applicable regulations. Practical claims management experience is valued more highly than academic credentials alone.
Claims handling experts are needed in bad faith litigation, cases involving alleged claims investigation deficiencies, disputes over reserve setting practices, regulatory enforcement actions against insurers, and any case where the reasonableness and adequacy of insurance claims handling is at issue.
In general, insurance expert fees are determined by the expert themselves, based on a variety of criteria. Among those criteria are professional experience, forensic experience, industry certifications, regulatory knowledge, and publications. Vident does have some influence over expert fees by comparing experts within a specialty, but ultimately it is a personal decision by the expert.
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Vident Partners connects attorneys with qualified claims handling expert witnesses. Complimentary consultation, 24-hour turnaround, no obligation.
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