Insurance Expert’s Testimony on Legal Obligations Excluded
Posted on October 22, 2025 by Expert Witness Profiler
Plaintiff The Lucia Family Trust (“Plaintiff” or the “Trust”) and non-party Daniel Unrein had a homeowners insurance policy (the “Policy”) with Defendant American Family Mutual Insurance Company, S.I. (“Defendant” or “American Family”). The policy covered a property located in Denver, Colorado (the “Property”). A fire occurred at the property in September 2021, and Unrein submitted a claim under the policy. Unrein passed away in November 2021, leaving the Trust as the remaining insured listed in the policy.
The repairs to the Property required asbestos abatement.The first contractor selected to perform the abatement, CAT Environmental Services, LLC (“CAT”), failed to complete the job and violated several Colorado Department of Public Health and Environment regulations, among other issues. The Trust then hired other contractors to complete the abatement and perform additional reconstruction work on the Property. Although American Family made some payments, the Trust alleged that American Family has refused to pay for approximately $112,000 of covered abatement and reconstruction work, in violation of the Policy.
American Family filed a motion to exclude certain opinions of Plaintiff’s insurance industry standards expert, Brian Seigal, pursuant to Rule 702.
Insurance Expert Witness
Brian Seigal has been involved in the insurance industry throughout his career for several decades. He served as the lead supervisor and claim manager position in property and casualty claims, the senior adjuster and team manager status of property and casualty claims at Liberty Mutual Group, in which capacity he adjusted, audited, and led multi-disciplinary claim teams.
Seigal is engaged as a consultant in a wide variety of insurance related cases, which include evaluation of first and third-party property claims.
In 1998 he earned and obtained the Associate Insurance Claims (AIC) Designation from the Insurance Institute, which is a nationally recognized insurance claims designation.
Discussion by the Court
I. Motion to Exclude
A. Qualifications
American Family first attacked Seigal’s qualifications as an expert under Rule 702(a). American Family argued that Seigal “has not worked in the insurance industry since 2018″—focusing instead on consulting work—and that his industry experience “did not involve property damage claims.”
To the extent American Family contended that Seigal must have specific experience in “homeowners property damage claims involving asbestos abatement,” that is an “overly narrow” test of Seigal’s qualifications. Rather, Seigal’s report reflected a familiarity with the applicable industry and statutory standards for handling property claims in Colorado.
Seigal has “passed the licensing exams for a Colorado Property & Casualty and Life Producer.” And his curriculum vitae and report describe over 20 years of experience at various stages of the claim-shandling process, including “reviewing and auditing thousands of open and closed claim files from 50+ claims departments for the adherence to company standards and practices.” Seigal’s more recent pivot to consulting work does not undermine his extensive industry experience.
The Court accordingly found that Seigal’s opinions regarding American Family’s handling of Plaintiff’s claim are “within the reasonable confines of his subject area” and will assist the jury in evaluating American Family’s conduct.
B. Methodology
American Family next attacked Seigal’s methodology. American Family faults Seigal for failing to analyze American Family’s conduct based on the information it had at the time it handled Plaintiff’s claim.
Seigal’s methodology essentially involved reviewing the facts of the case and relevant documents and then analyzing them based on his knowledge and experience of insurance industry standards. Courts routinely find that such a methodology is reliable for an insurance industry expert.
In light of Seigal’s methodology, the Court respectfully disagreed with American Family that Seigal failed to evaluate American Family’s conduct based on the information available at the time. Seigal’s report spends more than 50 pages detailing the timeline of the claim and specifically references the statements and communications made to and by American Family’s employees during the claim adjustment process.
American Family next argued that Seigal failed to set forth a methodology to support his statement that “liability was reasonably clear.”
In full, the relevant statement in Seigal’s report is:
“Liability was reasonably clear in this matter and the claim was accepted by [American Family]. Nonetheless, [American Family] put [Plaintiff] into a situation where they had to file multiple reports for the abatement process and proof of loss. [American Family] understood the impact on the personal property claim under Coverage B. The process [American Family] used put the Coverage B claim in jeopardy for [Plaintiff]. This influenced the settlements under the insurance policy.”
The Court did not understand this statement to opine that “[l]iability was reasonably clear” for Plaintiff’s claimed reconstruction costs, or that American Family was obligated to automatically pay every dollar demanded by Plaintiff. This portion of Seigal’s opinion exclusively discussed abatement costs and personal property losses, not reconstruction.
C. Specific Opinions
American Family also challenged several specific opinions in Seigal’s report that it contended are ipse dixit, subjective beliefs, legal conclusions, or impermissible statements about litigation conduct.
1. Ipse Dixit
American Family contended that five of Seigal’s opinions are inadmissible ipse dixit. First, American Family challenged Seigal’s description of American Family’s investigation and denial of coverage for Unrein’s and his dog’s injuries as “a heavy-handed approach for an insured who AMF knew was unfamiliar with the insurance process.”
The Court respectfully disagreed that this statement is ipse dixit. Seigal reviews the applicable industry standards in earlier portions of his report, including Colorado’s good faith standard.
The Court likewise found that another challenged opinion is not ipse dixit for substantially the same reasons. This opinion involved Seigal’s criticism of American Family’s “negotiating tactic” of offering Unrein a “lowball” amount to cover his living expenses in order to “force a settlement at a compromised value to [American Family’s] benefit.”
The remaining three challenged opinions relate to Seigal’s references to how other insurers might handle similar claims. The opinions are (1) “In my opinion, [American Family] did not manage this claim in accordance with industry standards regularly embraced by carriers in cases like this one,” (2) “[American Family’s] claim handling fell short of how claims like [Plaintiff’s] are typically investigated,” and (3) “[American Family] offered [Plaintiff] substantially less than the amounts of insureds in these types of matters.”
The Court agreed with American Family that these opinions are unsupported to the extent they imply that Seigal has expertise in the specific type of claim at issue. Seigal’s report and curriculum vitae reflect that he does not specialize in or have particular experience with property damage claims. Nor does his report discuss any comparator cases involving claims “like” Plaintiff’s, let alone how such claims would be investigated, adjusted, and settled.
2. Subjective Beliefs or Opinions
American Family next challenged five more opinions as based only on Seigal’s subjective beliefs. Plaintiff conceded that three of these opinions are inadmissibly speculative. Those opinions involved Seigal’s statements that American Family “utilized a strategy designed to limit its claim costs,” was “more concerned with lowering [its] claim costs,” and possessed “preconceived thoughts and bias” during the claim-handling process. The Court agreed that, as stated in Seigal’s report, these opinions lack foundation and must be excluded as speculative.
The remaining two opinions asserted that American Family’s employees were “focused on reducing [American Family’s] exposure” and hired certain vendors “for this purpose in mind.” In Plaintiff’s view, = Seigal’s conclusion that American Family sought to reduce its exposure is grounded in factual observations. Plaintiff appeared to concede, however, that claiming American Family had a certain “purpose in mind” is improper speculation.
The Court agreed with American Family that, as presented in Seigal’s report, these statements improperly assigned a motive to American Family and its employees. Seigal did not adequately provide a factual basis for his opinions about the “purpose” of certain actions or what certain employees were “focused on.”
3. Legal Conclusions
American Family asked the Court to exclude several of Seigal’s statements that American Family believes are legal conclusions. In these statements, Seigal opined that American Family’s conduct was “unreasonable,” violated the “standards of good faith and fair dealing,” and “occurred intentionally or with reckless disregard.”
The Court will permit Seigal to testify about insurance industry standards and why he believes American Family deviated from those standards in this case. He may also “testify generally about his understanding of the law and how it impacts his understanding of the standards that govern the insurance industry.”
But Seigal may not testify about whether American Family acted unreasonably, in bad faith, or knowingly or recklessly. Nor may he opine about American Family’s legal obligations and whether it complied with them.
4. Opinions About Litigation Conduct
Finally, American Family sought to exclude opinions in Seigal’s report about American Family’s conduct during this litigation. For instance, Seigal stated that American Family’s “claim manual was provided on the eve of the Plaintiff’s expert report being due.” Seigal also opined that based on his review of the Parties’ discovery disclosures, “there appears to be redactions that were taken which are routinely disclosed in cases like this one.” American Family contended that Plaintiff has not shown sufficient facts to permit admission of these opinions under Rules 702 and 403.
However, Plaintiff only made the cursory argument that Seigal’s opinions about American Family’s litigation conduct are based on industry standards and grounded in factual obligations. This does not explain why American Family’s attorneys’ discovery practices are probative of American Family’s alleged bad faith in handling Plaintiff’s claim. Nor is it clear to the Court that Seigal’s discovery-related opinions are based on industry standards.
Held
The Court granted in part and denied in part American Family’s motion to exclude or limit the testimony of Brian Seigal pursuant to Rule 702.
Key Takeaway:
Seigal’s methodology boils down to explaining the applicable industry standards, reviewing the facts of the case, and analyzing whether American Family’s claim-handling practices complied with Seigal’s understanding of the industry standards. Consequently, courts routinely find that such a methodology is reliable for an insurance industry expert.
Courts also routinely preclude experts from opining about whether an insurer acted reasonably or unreasonably in the handling of an insured’s claim. As a result, Seigal may not testify about whether American Family acted unreasonably, in bad faith, or knowingly or recklessly. Nor may he opine about American Family’s legal obligations and whether it complied with them.
Case Details:
| Case Caption: | Lucia Family Trust V. American Family Mutual Insurance Company S.I. |
| Docket Number: | 1:23cv2156 |
| Court Name: | United States District Court, Colorado |
| Order Date: | September 25, 2025 |
