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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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