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Item 37 - Renewal with Third Party Administrator for Claims Admin. Service
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08/17/2021 Regular
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Item 37 - Renewal with Third Party Administrator for Claims Admin. Service
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Clerk of the Council
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37
Date
8/17/2021
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five of which involved adjusting liability claims for public entities. No adjuster or supervisor/account <br />manager shall service the City's account without prior approval by the City. <br />ii) The responsibilities ofAdministrator shall include, but not be limited to, the <br />following; <br />1) Establish and maintain an electronic file for each claim reported, to <br />include a diary review system by both the examiner and supervisor; statistical data for each claim should <br />be stored electronically and shall include all data required to comply with federal and state requirements <br />including Medicare secondary payer laws and regulations; <br />2) Provide comprehensive claim investigative services; <br />3) Periodically, determine potential liability and establish, review, and <br />update reserves for each reported accident and advise the City of any changes as they occur; <br />4) Notify Big Independent Cities Excess Pool (BICEP) Litigation <br />Manager of a claim as required by the BICEP Liability Program Memorandum of Coverage (MOC) and <br />coordinate with the City Risk Management Division, City Attorney's Office and BICEP Litigation <br />Manager in the defense, settlement, and payment of claims. Prepare and submit information to the <br />Litigation Manager, and upon request insurance carrier(s), on all claims that fall within the reporting <br />requirements set forth by the MOC or the insurance carrier(s); <br />5) Document sufficiency of reserve minimally at 90 -day intervals; <br />6) Provide the City with a recommendation to accept or deny a claim <br />within the statutory period in the California Government Tort Claims Act; <br />7) Provide immediate notification to the City of offers to settle; <br />8) Obtain settlement authority from City, BICEP (when required),and <br />the excess carrier where applicable; <br />9) Obtain releases and other necessary forms from all appropriate <br />parties upon settlement of a claim prior to issuing a settlement check; <br />10) Upon the City's request, assist with preparation for appearances in <br />small claims court, court hearings and City Council meetings at no additional charge to the City; <br />11) Prepare and, where needed, obtain approval for issuance of checks, <br />drafts, or other documents in the payment of claims with electronic copies sent to the City; <br />12) Promptly determine any potential to tender a claim to third parties <br />and the feasibility of subrogation, and take appropriate steps to subrogate, where such action is <br />appropriate; <br />13) Promptly close each claim as soon as possible, but no later than 30 <br />days after final check issuance; <br />Page 2 of 13 <br />25D-8
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