Expertise
Examples (but not an exhaustive listing) of Expertise of
William D. Hager
Actuarial Malpractice
Bill Hager is the author of "The Emerging Law of Actuarial Malpractice," a leading authority on actuarial malpractice
Issue: Most lawyers overlook liability embedded in the negligent provision of actuarial services, or overlook defenses to such allegations. Actuaries, like accountants and other professionals, have a professional obligation to their clients which in many cases is evidenced by professional liability coverage. Almost every insurance company insolvency raises at least the issue of actuarial malpractice. That cause of action and its potential recovery is among the many assets to be targeted for collection by the liquidator.
In addition, many financial transactions today contain professional actuarial work product. To the extent that that work has been negligently provided, a cause of action against the consulting actuary can arise.
Particular Expert Skills.
- Intimate knowledge of the organization and structure of the actuarial profession, gained through 25 years of experience and direct supervision of a staff of 150 actuaries
- Ability to optimize an actuarial malpractice case (for or against) through cross-examination assistance and expert testimony as to actuarial standards for work product and ethics
- Former General Counsel to the American Academy of Actuaries
- Intricate knowledge of the interaction of actuarial science and insurance
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Agent Liability Issues
To review Bill Hager's expertise as to Agent Liability Issues, click here: Agent Liability Issues.
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Airport Liability Insurance
Mr. Hager has extensive and substantive experience relating directly to airport liability insurance policies, which are sold by property casualty insurance companies and by licensed property casualty insurance agents.
To review Bill Hager's expertise as to Airport Liability Insurance, click here: Airport Liability Insurance.
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Annuity, Annuity Insurers and Annuity Producer Expertise
To review Bill Hager's expertise as to Annuity, Annuity Insurers and Annuity Producer Expertise, click here: Annuity, Annuity Insurers and Annuity Producer Expertise.
To review Bill Hager's expertise as to Annuities Application Expertise, click here: Annuities Application Expertise.
To review Bill Hager's expertise as to Annuities Securities Issues Expertise, click here: Annuities Securities Issues Expertise.
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Antitrust
Overall, as to Insurer Federal Antitrust Actions. Mr. Hager served as General Counsel and Director of Government Relations to the American Academy of Actuaries. This organization brings pricing competitors together (for professional purposes). As a result, constant antitrust sensitivity to all Academy activities was required. Mr. Hager led this effort. Similarly as CEO of NCCI, Mr. Hager had ultimate responsibility to assure ongoing antitrust compliance for that organization. NCCI lawfully established proposed rates on behalf of insurer/competitors ($16 billion of proposed rates annually). As such, antitrust compliance was a major responsibility for Mr. Hager.
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Applications
To review Bill Hager's expertise as to Applications: Life Health and Property Casualty, click here: Applications: Life Health and Property Casualty.
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Auto Policies, Commercial and Personal and Agents
To review Bill Hager's expertise as to Auto, Commercial Auto and Related Agent Expertise, click here: Auto Policies, Commercial and Personal and Agents.
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Bad Faith / Unfair Claims Practices Act
To review Bill Hager's expertise as to Bad Faith / Unfair Practices Act, click here: Bad Faith / Unfair Practices Act.
Issue. Insurance bad faith allegations can arise today in both first party and third party claim settings. The allegations can arise in all forms of life, health, and property casualty policies and similarly can arise as to individual insureds and as to large commercial insureds. Allegations can arise as to: (i) claim payments being wrongfully denied; (ii) unreasonably delayed claim payments; (iii) wrongfully underpaid claim payments; (iv) failure by the insurer to adequately investigate the claim; and (v) unreasonable interpretation and application of policy language by the insurer.
Expertise. Mr. Hager has wide ranging bad faith expertise as to life, health and property casualty matters. As a regulator in a major insurance state for eight years, Mr. Hager had statutory responsibility to regulate against bad faith for all lines of insurance and to identify and as appropriate, pre-empt or prosecute bad faith within the regulatory administrative action context.
On the industry side, as a CEO of a major insurance industry organization (NCCI), he had responsibility to assure that his organization adhered to all applicable provisions of bad faith. As an insurance lawyer in private practice, he guided insurance clients away from the pitfalls of bad faith. As an expert witness, he has testified in numerous bad faith cases. Because of his expertise and ability to articulate applicable standards of practice/ standards of care/ custom and practice, Mr. Hager is an effective bad faith expert witness.
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Commercial General Liability and Related Agent Expertise
To review Bill Hager's expertise as to Commercial General Liability and Related Agent Expertise, click here: Commercial General Liability and Related Agent Expertise.
To review Bill Hager's expertise as to Commercial General Liability Application Expertise, click here: Commercial General Liability Application Expertise.
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Coverage Opinions and Policy Interpretation
Issue. Particular policy language frequently is at the center of insurance-based litigation. Commercial General Liability policies lead the list of interpretation cases. CGL policies are followed closely by all forms of liability policies (whether free-standing such as professional liability policies or as coverage embedded in broader policies such as auto). Coverage issues also arise as to auto policies (including liability and uninsured and underinsured coverage), homeowners policies, disability policies, health policies, life policies, annuity (including variable annuities) policies and reinsurance contracts. In addition, issues arise in connection with the application form relating to these policies as completed by the agent or the insured. Mr. Hager has provided extensive testimony in cases with policy language interpretation issues, including their related applications.
Specific Expert Skills as to Language Interpretation
- Tracking specific policy language to: (a) case law; (b) statutory provisions; (c) drafting intent; (d) insurance industry literature; and (e) academic/textbook commentary.
- As Insurance Commissioner, Mr. Hager annually oversaw the approval of some 50,000 insurance policy forms, including every word of every form. This approval process included word-by-word and sentence-by-sentence and paragraph-by-paragraph examination of the following types of policies (including their accompanying application forms): GCL, all forms of professional liability policies including errors and omission and director and officer policies, automobile policies, homeowners policies, disability policies, health and long term care polices, life insurance policies, annuities and certain reinsurance policies. Further, his department had responsibility to regulate insurer construction of policy language as to insureds.
- As CEO of NCCI, Mr. Hager had responsibility to annually file numerous standard industry-wide workers compensation policy forms and provisions nationwide, including responsibility for every word of every such form.
- As General Council and Director of Government Relations to the American Academy of Actuaries, Mr. Hager worked daily with the actuarial profession. Ultimately most coverage language is approved by company actuaries in that pricing must be made commensurate with the related coverage.
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Crop Insurance
To review Bill Hager's expertise as to Crop Insurance, click here: Crop Insurance.
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Damages - Most areas including Punitives
Overall as to Damages. Given Mr. Hager's extensive and broad-based experience in most aspects of insurance transactions, he is highly capable of providing articulate damage testimony including reports and punitives.
Specific Expert Skills as to Calculating Damages (Including Punitive Damages)
- Mr. Hager has previously provided expert testimony and reports on damages in insurance cases
- Experience includes opinions on punitives
- Bachelors degree in mathematics (B.A., Secondary Mathematics Education)
- Former General Counsel, American Academy of Actuaries
- Lawyer
- Extensive exposure to insurer practices at the highest levels as to what is fair and unfair, reasonable, and unreasonable
- Able to apply damage formulas to complex cases
- Conversant with the foundation for punitives and determining their applicability
- Extensive exposure to insurance federal antitrust matters, including liability and damages in connection with insurer RICO/collusion matters
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Demutualizations
Overall. As an attorney in private practice, Mr. Hager provided full representation (including case presentation at the demutualization hearing) for insureds challenging the fairness of a specific demutualization. As Insurance Commissioner, Mr. Hager administered Iowa's demutualization law and dealt with several demutualization issues before adoption of the Model Act.
Specific Expert Skills as to Demutualizations.
- Full knowledge of relevant statutes
- Optimization of demutualization case results (for or against) through strategic and tactical guidance
- Cutting edge knowledge of successfully using the media component of demutualizations
- Ability to provide expert testimony as to most phases of a demutualization proposal
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Disability Expertise
To review Bill Hager's expertise as to Disability Expertise, click here: Disability Expertise.
To review Bill Hager's expertise as to Disability Application Expertise, click here: Disability Application Expertise.
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Health Insurance
To review Bill Hager's expertise as to Health Insurance, click here: Health Insurance.
To review Bill Hager's expertise as to Health Insurance Application Expertise, click here: Health Insurance Application Expertise.
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HMOs / PPOs / POSs
To review Bill Hager's expertise as to HMOs / PPOs / POSs, click here: HMOs / PPOs / POSs.
To review Bill Hager's expertise as to HMOs / PPOs / POSs Application Expertise, click here: HMOs / PPOs / POSs Application Expertise.
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Homeowners Policies and Related Agent Expertise
To review Bill Hager's expertise as to Homeowners Policy, click here: Homeowners Policy.
To review Bill Hager's expertise as to Homeowners Application Expertise, click here: Homeowners Application Expertise.
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Insolvency / Liquidations / Solvency / Form A
To review Bill Hager's expertise as to Insolvency / Liquidations / Solvency / Form A, click here: Insolvency / Liquidations / Solvency / Form A.
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Insurance Agency Valuations
To review Bill Hager's expertise as to Insurance Agencies and Agents, Brokers and Surplus Liens Agents, click here: Insurance Agencies and Agents, Brokers and Surplus Lines Agents.
Issue: Increasingly the value of a specific insurance agency can be pivotal in litigation, whether as a result of: (i) divorce; (ii) a dispute between owners; (iii) a buy sell agreement that has gone wrong; (iv) estate based litigation; or (v) other transactions. In such event, it is important to get the value of the insurance agency right so that a fair result is available to all of the parties.
Overall: As a lawyer with an undergraduate mathematics degree and significant direct regulatory and industry financial experience, Mr. Hager has in-depth knowledge and hands-on expertise in valuing insurance agencies. As First Deputy Insurance Commissioner and later as Insurance Commissioner, he had responsibility to assure that insurance company-owned insurance agencies were correctly valued on the insurer's balance sheet. As required, this valuation was confirmed with a hands-on field review of the agency, its operations and its financials.
As to financial acumen, Mr. Hager has spent most of his career around the financial underpinnings of the insurance and agency industry. As a lawyer in private practice, Mr. Hager has served as counsel to both the statewide life agent's association (then, the Association of Life Underwriters) and the statewide property casualty agent's association (Professional Insurance Agents). As an Administrative Law Judge (the title at the time was Hearing Officer) while serving as a regulator, Mr. Hager has heard scores of cases relating to insurance agents and insurance agencies and their value. As CEO of a major insurance industry organization (NCCI), Mr. Hager had daily responsibility for liaison with the national professional insurance agents associations. As a result of this and the other work set out in this website, Mr. Hager has knowledge of the macro and micro elements of insurance agency valuations and the ability to credibly articulate them.
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Life Insurance
To review Bill Hager's expertise as to Life Insurance, click here: Life Insurance.
To review Bill Hager's expertise as to Life Insurance Application Expertise, click here: Life Insurance Application Expertise.
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Lloyd's of London / Equitas
To review Bill Hager's expertise as to coverage provided by Lloyd's of London and Equitas, click here: Lloyd's of London / Equitas.
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Long Term Care Policies and Their Insurers
To review Bill Hager's expertise as to Long Term Care Policies and Their Insurers, click here: Long Term Care Policies and Their Insurers.
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Liquidations
To review Bill Hager's expertise as to Liquidations, click here: Liquidations.
Overall. As Insurance Commissioner, Mr. Hager oversaw six different insurance company liquidations and served on several committees of the NAIC dealing with liquidation matters. He has intimate knowledge of most aspects of the liquidation process.
Specific Expert Skills as to Liquidation Matters
- Interpretation of reinsurance contracts and clauses in accordance with applicable NAIC guidelines.
- Accounting matter evaluation (SAP vs. GAAP) working with seasoned regulatory CPAs.
- Damage determination.
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Medical Malpractice Insurance Issues
To review Bill Hager's expertise as to Medical Malpractice Insurance Issues, click here: Medical Malpractice Insurance Issues.
To review Bill Hager's expertise as to Medical Malpractice Application Expertise, click here: Medical Malpractice Application Expertise.
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Medicare Supplemental Policies and Insurers
To review Bill Hager's expertise as to Medicare Supplemental Policies and Insurers, click here: Medicare Supplemental Policies and Insurers.
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Mold
Overall. Though mold has probably been around since the beginning of time, it received prominence in part following the Ballard case in Texas. Since that decision, mold has become one of the hot insurance topics for both insureds and insurers. Mold claims can arise from faulty construction, storm damage, fire, ice, frozen water pipes, leaking plumbing and burst water heaters, to name just a few. Though mold is generally excluded today in most first party property coverage forms (both personal and commercial) there may be coverage (in a first party situation) if a covered cause of damage is connected to the mold. In third party circumstances, mold claims parallel other third party claims in that: (i) coverage; (ii) damages; and (iii) legal liability must all be assessed.
Expertise Mr. Hager has testified both in deposition and trial as to insurer’s duty of care in connection with mold claims. His expertise is grounded in: (i) policy language (having approved and disapproved thousands of policy forms as a regulator); (ii) regulatory oversight over the claim handling processes of hundreds of property casualty insurance companies and thousands of claim files, all to assure compliance (or non-compliance) with applicable law, policy provisions and the Unfair Claims Practices Act; and (iii) industry experience as CEO of a large property casualty insurance organization.
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Premium Finance Companies and Agreements
To review Bill Hager's expertise as to Premium Finance Companies and Agreements, click here: Premium Finance Companies and Agreements.
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Rate Filings
- Challenging or Supporting Proposed Rate Changes, partnering as needed with an FCAS or FSA.
- Federal Antitrust matters / RICO / Collusion by Insurers in Rate Matters Industry Practices and in general.
Overall. As the former CEO of NCCI, Mr. Hager is uniquely positioned to provide pivotal testimony in ratemaking cases in the additional areas of property casualty rates other than workers comp. As necessary, he teams up with casualty/life actuaries who themselves in the past created and advocated rate increases on behalf of the industry. Together, they present a formidable combination to either support or resist proposed rate increases. In addition, these skills can be applied to optimally position the case or its resistance in chief. While CEO of NCCI, Mr. Hager annually filed for rate changes affecting $16 billion of workers compensation premium.
This same background provides Mr. Hager with a strong platform to provide expert testimony on insurer collusion (on either side of this issue) as to rate activity.
Unique Skills/ Attributes
- Leadership positions with NCCI, American Academy of Actuaries and the Iowa Insurance Department
- Served as Hearing Officer on many Proposed Rate Increases
- Full knowledge of the U.S. insurance regulatory community, including filing strategies and tactics
- Can team with highly qualified actuaries
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Reinsurance
To review Bill Hager's expertise as to Reinsurance, click here: Reinsurance.
Overall. As a regulator charged with liquidating several insolvent insurers, recovering reinsurance assets was perhaps the most important task of a successful wind-down. Every kind of reinsurance issue and defense arises under these circumstances. As an experienced regulator, Mr. Hager has managed many complicated reinsurance issues. In addition, his other professional experiences required intricate knowledge of most reinsurance mechanisms. Mr. Hager is a certified U.S. reinsurance and insurance arbitrator (www.arias-us.org). See also Mr. Hager's arbitration website at www.insurance-metrics.com.
Particular Expert Skills. Mr. Hager has provided successful expert testimony as to the appropriate interpretation of reinsurance contracts and provided related expert reports. Mr. Hager routinely sits as a reinsurance arbitrator in complex reinsurance matters.
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Securities Issues and Insurance
To review Bill Hager's expertise as to Securities Issues and Insurance, click here: Securities Issues and Insurance.
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Standards of Practice / Custom and Practice - Industry
Issue: The reasonableness and adherence to standards of practice of particular actions or inactions taken by an insurance company periodically becomes an issue in litigation. Examples include a delay or refusal to pay claims, the timing of policy issuance, etc.
Overall. Mr. Hager has pervasive and extensive experience as to the appropriateness of insurance company actions as measured against standards of practice/custom and practice, having intensely participated on both sides of insurance company decision-making for over 25 years.
Specific Expert Testimony as to What Constitutes Standard Industry Practices.
- Articulation of applicable standard of practice/
custom and practice;
- Determination of whether specific insurance company action complied with standards of practice; and
- Concluding that the particular insurance company action taken did (or did not) comply with applicable standards of practice.
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Standards of Practice / Custom and Practice - Regulatory
Issue: The reasonableness of particular actions or inactions taken by an insurance department (DOI) periodically becomes an issue in litigation. The situation arises most often as an insurance company defense. For example, when regulators fail to uncover fraud during a company examination the examined insurer alleges they should be fully or partially absolved from liability. Additionally, reinsurers and others often allege failure by a DOI to act quickly enough in face of an impending insolvency - thus driving up the total amount of the ultimate insolvency losses.
Overall. Mr. Hager has pervasive and extensive experience as to the appropriateness of regulatory actions, having participated extensively on both sides of regulator decisions in almost all of the various states for over 25 years.
Specific Expert Testimony as to What Constitutes Standard Regulatory Practices.
- Articulation of applicable regulatory standards of practice;
- Determination of whether specific regulatory action actually undertaken complied with how mainstream state insurance departments handled or would have handled the particular issue; and
- Concluding that the particular regulatory action taken did (or did not) comply with standard regulatory practices.
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Statutory and Regulatory Construction
Issue. In the course of insurance litigation, the interpretation of specific insurance statutory and regulatory provisions invariably comes into play and a clear understanding of the law is a condition precedent to effective expert witness testimony. A few examples (and there are thousands of others) include:
- Whether a particular insurer’s policy complies with the statutory and regulatory requirements for such policies;
- How to interpret and apply in a specific case, the rate filing materials of a specific insurer;
- Whether a state DOI’s regulations as promulgated fall within their related statutory authority;
- The relationship of a state’s Unfair Claims Practices Act to standards of care as applicable to a particular insurer and a particular set of facts;
- Whether a violation of a state’s Unfair Claims Practices Act creates a cause of action in the first party or third party insured;
- Whether a life insurer’s application form complies with regulatory requirements;
- Whether an insured materially misrepresented information on a life, annuity or property casualty application form, given the subject state’s definition of materially misrepresented; and
- Whether a variable annuity complies with both state and federal (securities) law.
Expertise. As Commissioner of Insurance, Mr. Hager has applied state statutory and regulatory provisions in approving and disapproving tens of thousands of all types of life, health, and property casualty applications and forms. As a regulator for eight years, he also applied the law and related regulations (including Model NAIC Acts) to a wide range of transactions including mergers, reinsurance arrangements, insurer reserving and accounting practices, annual statement filings, agents and agent licensing activities, compliance and non-compliance with the Unfair Claims Practices Act and the Unfair Trade Practices Act, and market conduct actions.
As an insurance lawyer, Mr. Hager has written four insurance law review articles and understands the interplay between statutes, regulations, case law, NAIC model acts, NASD and SEC requirements (to insurance products with security features), application of the various treatises including Couch on Insurance 3rd and the application of the myriad of other supporting materials, all available to interpret and apply the law to a specific factual situation.
As General Counsel to the American Academy of Actuaries and later as President and Chief Executive Officer of the National Council on Compensation Insurance (NCCI), Mr. Hager had daily executive responsibilities to assure compliance of these organizations and all of their products to all applicable insurance law.
Conclusion. As an expert witness testifying in complex insurance matters, it is inevitable that a clear understanding of the application of the law to the subject transaction is a condition precedent to an effective expert opinion as to standards of care/ duty of care/ custom and practice. Mr. Hager brings this competence to every insurance expert witness assignment.
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Surplus Lines
To review Bill Hager's expertise as to Surplus Lines and Surplus Lines Agents, click here: Surplus Lines and Surplus Lines Agents.
Issues. Surplus lines issues arise in litigation in connection with:
- Whether the particular surplus lines carrier is authorized in the first instance to write insurance policies in the state in question;
- Whether their policy forms and rates adhere to the law and custom and practice;
- Whether their agents and brokers are duly licensed;
- Whether appropriate affidavits and taxes have been submitted to the regulators;
- Whether the insured received notice that there is no guaranty fund protection for surplus lines policies;
- Whether the insured received notice that there is generally no department oversight over forms and rates;
- Whether the policy actually issued by the surplus lines insurer met other state requirements (i.e., some states require that where the surplus lines binder references exclusions, it is assumed during the pendency of the binder, that standard exclusions are intended; other states have no such requirements); and
- Whether the agents and brokers exercised due care in placing the insured with a particular surplus lines carrier in the first instance.
Of course the operative question for all of these issues is the related consequences of compliance or non-compliance.
Expertise. As a regulator (Assistant Attorney General for the Department of Insurance, First Deputy Commissioner of Insurance and Commissioner of Insurance) for eight years in an insurance intensive state, Mr. Hager has dealt directly with each of the above issues. For example, he had oversight over: (i) authorizing surplus lines insurers to do business in the state in the first instance; (ii) licensing and regulating surplus lines agents and brokers; (iii) the statutory filing of related affidavits and surplus lines taxes; and (iv) bringing administrative charges against surplus lines insurers where there were allegations of wrongdoing. As a member of the Executive Committee of the NAIC, Mr. Hager has dealt directly with Model NAIC Surplus Lines provisions.
On the industry side, Mr. Hager has consistently dealt with surplus lines carriers and knows both the insurers and marketplace well. As an insurance attorney in private practice, Mr. Hager has provided advice and counsel to surplus lines carriers and their agents. As an expert witness, he has qualified as a surplus lines expert and testified in a number of surplus lines cases. To the point, Mr. Hager has substantial expertise to articulate custom and practice in the surplus lines industry.
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Third Party Administrators
To review Bill Hager's expertise as to Third Party Administrators, click here: Third Party Administrators.
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Umbrella Policies
To review Bill Hager's expertise as to Umbrella Insurance Policies, click here: Umbrella Policies.
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Underwriting - Life, Annuities & Health
To review Bill Hager's expertise as to Underwriting - Life, Annuities & Health (PPOs, POS, HMOs), click here: Underwriting - Life, Annuities & Health (PPOs, POS, HMOs).
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Underwriting - Property Casualty
To review Bill Hager's expertise as to Underwriting - Property Casualty, click here: Underwriting - Property Casualty.
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Vanishing Premiums
Issue: Life policies sold in the mid 1980s and later with illustrations projecting up to 12% to 14% returns (preempting the need for further premiums after a few years - the premium "vanished") encountered challenges as rates fell; sometimes resulting in allegations of agent/insurer misrepresentation. Damages alleged include (among others), the lost protection, the delta between what the insured believed they were sold and what they in fact received, as well as punitives as appropriate. A number of these cases still continue to surface.
Overall, Mr. Hager has in-depth, highly technical knowledge and hands-on background in these cases. His background enables him to testify as to: (i) damages; (ii) applicable law; and (iii) the illustrations themselves. As a former Commissioner of Insurance, Mr. Hager had full authority over life insurance agents and life insurance companies including their use of illustrations. As past chair of the National Association of Insurance Commissioner's (NAIC) lead committees on life insurance, Mr. Hager has had significant national exposure as to the issue. He is past chair of the NAIC: (i) Life Insurance Committee; (ii) Universal Life Insurance Task Force; and (iii) the Life Insurance Product Development Task Force.
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Warranties: Home and Auto
To review Bill Hager's expertise as to both home warranties and auto warranties (anti theft devices), click here:Home and Auto Warranties.
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Workers Compensation
To review Bill Hager's expertise as to Workers Compensation, click here: please note that the click through takes you to Mr. Hager (and Mr. Burrus') workers compensation consulting website (Comp Premium Wizards) which includes an extensive discussion of Mr. Hager's related expertise: Workers Compensation.
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