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2024-237
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Last modified
10/21/2024 11:45:59 AM
Creation date
10/21/2024 11:41:35 AM
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Template:
Official Documents
Official Document Type
Agreement
Approved Date
09/24/2024
Control Number
2024-237
Agenda Item Number
8.P.
Entity Name
Davies Claims North America, Inc.
Subject
Third Party Claims Administration Services Agreement for the Self-Funded Workers’
Compensation and Liability Program
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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 <br />actual 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 include <br />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 the <br />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 <br />consult with and refer all questionable or contested cases and those with an estimated value in <br />excess of $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 provide <br />IRC with regular monthly reports, as agreed upon by the parties, in such a format as is acceptable to <br />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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