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2016-137
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2016-137
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Last modified
9/16/2016 11:37:49 AM
Creation date
9/16/2016 11:37:46 AM
Metadata
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Official Documents
Official Document Type
Agreement
Approved Date
09/13/2016
Control Number
2016-137
Agenda Item Number
8.V.
Entity Name
Johns Eastern Company Inc.
Subject
Third Party Administration Services
Self Funded Worker's Compensation and Liability
Project Number
UPC 3228
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12. Prepare and maintain files necessary for legal defense of claims and/or other litigation(such as <br /> actions for subrogation, contribution, or indemnity) or other proceedings. <br /> 13. Where appropriate or desirable,attend hearings,depositions,mediations,and other proceedings. <br /> The attorney or other party representing IRC shall provide a written report to IRC within ten <br /> working days after the hearing,deposition,mediation or other proceeding. The adjuster handling <br /> the claim file will provide an oral report to IRC within ten working days after the hearing, <br /> deposition, mediation or other proceeding. <br /> 14. Pay in a timely fashion all claims and expenses pertaining to IRC's claims. <br /> 15. At the request of IRC,provide a complete copy of all files involving litigation,potential or actual <br /> subrogation, to the Risk Manager or the designee thereof. <br /> 16. Aggressively pursue all possibilities of subrogation,excess insurance reimbursement,third party <br /> liens, contribution or indemnity on behalf of IRC. Services for Automobile Liability shall <br /> include the pursuit of subrogation on behalf of IRC for Automobile Physical Damage losses. <br /> 17. Periodically as appropriate,but at least every six months,review all open cases in and complete a <br /> strategic action plan in order to assist in the settlement of the cases. Such written review shall <br /> include a review and verification of outstanding reserves. A written summary of the review shall <br /> be documented in the open case file and shall be provided to IRC within ten working days after <br /> the end of the period for which the report is being made. <br /> 18. The supervising adjuster shall meet with IRC's Risk Manager,or the designee thereof,to consult <br /> with and refer all questionable or contested cases and those with an estimated value in excess of <br /> $10,000. <br /> LOSS STATISTICS SERVICES <br /> The TPA shall provide IRC with the ability to access comprehensive on-line, real-time claim <br /> information data, including reporting capabilities, at no additional cost to IRC. The TPA shall <br /> provide IRC with regular monthly reports, as agreed upon by the parties, in such a format as is <br /> acceptable to IRC. The on-line claim security shall permit on-line input of accident reports by IRC. <br /> The TPA agrees that IRC shall have on-line, real-time access to all claim files, including all <br /> adjuster notes, supervisory notes, diary items, payment records, medical bills and expense bills in <br /> an electronic manner with internet based access available to IRC. <br /> Page 21 <br />
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