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MB-3728 - USA (California) - General Liability Claims Administration Services - Deadline February 7,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3728

Government authority located in California; USA based organization looking for expert vendor for general liability claims administration services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide general liability claims administration services including potential liability and claims investigations, negotiation of claim settlements, assumption of the handling of existing open claims, review of all relevant law firm invoices, and reporting to the County’s excess general liability carrier.
- Claims Administration - Existing and New Files: -
1. Establish claims handling and investigation protocols for the County with the Risk Manager.
2. Conduct a thorough investigation of all new claims.
3. All actions required, such as denial, late, and insufficient letters will be overseen by the assigned adjuster.
4. Releases and waivers regarding small claims settlements will be obtained by the adjuster.
5. All claims in excess of $25,000 must be reported to the Risk Manager immediately and must include a summary of facts, legal issues, actions taken, and recommendations for further action.
6. The TPA shall provide technical and clerical expertise to adjust and report on claims.
7. Review all open files individually to determine claim status and develop plan of action regarding claim closure.
8. Apply accepted claims management practices and County protocols consistently.
9. Establish monetary reserves reasonably adequate for the expected value of the claim in coordination with Risk Management.
10.Handle claim to conclusion and obtain all appropriate releases and W2 forms. Authority for settlements must be obtained from the County prior to settlement resolutions with claimant.
11.Report losses to County’s excess insurance carrier as required in their reporting requirements.
- Litigation / Small Claims Court Hearings
1. Litigation management and defense are controlled and closely monitored by Risk Management and County Counsel.
2. The TPA shall refer all litigated claims to the Risk Manager and County Counsel unless otherwise directed by the County.
3. The TPA shall maintain an open case file and ensure loss runs accurately report claims that become litigated including legal fees, legal costs, settlements, and judgements.
4. The TPA shall assist in defending the County at all small claims court hearings (whether existing or new) including court appearances as necessary, and shall work in conjunction with the Risk Manager and/or defense counsel assigned to the case.
- Prompt Handling: - The TPA will promptly create a claim file within twenty-four (24) hours of receipt of the claim form or accident report from the County and make contact with claimant. Requested payments to the County for claim invoices must also be handled in a timely manner. The TPA will promptly initiate investigation of issues identified as material to potential litigation.
- Customer Service: - The TPA will represent the County and will be specially trained, experienced, expert, and competent to perform the special services required.
- Settlements: - The TPA shall make claims recommendations and obtain the County’s authorization on all settlements prior to taking action to settle. The TPA shall forward settlement proposals to the County in a form acceptable to the Risk Manager. All requests for settlement authority shall be clear and concise and include a written claim analysis, estimate of liability and examiner’s recommendations
- Claims Reporting: - The TPA will provide monthly statistical data/reports – content to be established between the TPA and the County. The TPA will provide other special reports required by the County including, but not limited to: loss trend reports including year-end loss reports, claim abstract reports, reports required by actuaries, check register reports, excess insurance carriers, etc.,
- Records Retention: - The TPA must at all times maintain complete and detailed claim files as well as a claims log with regard to work performed under the agreement. All claim files shall be maintained in accordance with statutory time requirements and the County of El Dorado’s Record Retention Policy.
- Funding General Liability Claims: - The County has established an imprest fund checking account to cover payments and reimbursements applicable to the self-insured General Liability program. The account will be established in the name of the TPA as agent of the County. Deposits shall be made by County to the account as required to ensure that funds are available for payment of claims for settlement and allocated loss expenses upon presentation of check or warrant.
- For more information describe in documents.
(2) All question must be submitted no later than January 17, 2020.

[C] Eligibility:

- Onshore (USA Only);

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Friday, 7 February, 2020

Question Answer Deadline : Friday, 17 January, 2020

Category : Medical Billing and Coding

Country : USA

State : California

Cost to Download This RFP Document : $ 5

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