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ATTACHMENT D
<br /> ALLOCATED CLAIMS EXPENSES
<br /> The TPA and IRC agree that the following are acceptable Allocated Claims Expenses. The TPA
<br /> Fee, as shown in Article 3 of this Agreement, does not include Allocated Claims Expenses.
<br /> Attorneys' and legal assistance' fees for claim and any lawsuits, before and at trial, on
<br /> appeal, or otherwise;
<br /> Court and other litigation settlement expenses, including, without limitation:
<br /> • Medical examination to determine extent of liability,
<br /> • Expert medical and other testimony,
<br /> • Laboratory, X-ray and other diagnostic tests,
<br /> • Autopsy, surgical reviews, and other pathology services,
<br /> • Physician related fees and expenses in reading,interpreting,or performing any of the
<br /> foregoing tests or services,
<br /> • Stenographer,process server,and other related trial preparation,trial,settlement,and
<br /> court costs,
<br /> • Witness fees and expenses before and at trial, deposition, settlement discussions, or
<br /> otherwise, and
<br /> • Fees and expenses for surveillance, private investigators, or otherwise;
<br /> Fees for any work done outside the office, including,but not limited to,field investigations
<br /> necessary to determine compensability, liability, Special Disability Trust Fund or
<br /> subrogation recoverability, claimant control, attendance at mediations, hearings and
<br /> depositions, attendance at management meetings, attendance at medical consultations or
<br /> hearings, appraisals, case management, recorded statements;
<br /> Fees for field investigation will be $105.00, $0.55 a mile and $1.00 per photograph, and
<br /> administrative expenses;
<br /> Handling of property claims during a catastrophe will be billed based upon the catastrophe
<br /> schedule in effect at the time of the catastrophe.
<br /> Fees for over-night or special mail services for various documents;
<br /> Field Case Management Services, Peer Review Services, Medical Care Audits or Hospital
<br /> Bill Audits;
<br /> Medicare Set-Aside (MSA) services to include: MSA cost projections, MSA submission,
<br /> liability MSA services,comprehensive drug utilization review,lien search,conditional lien
<br /> dispute and projection updates.
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