MB-4012 - USA (California) - General Liability Claims Administration Services - Deadline April 17,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-4012

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:

Vendor needs to provide general liability claims administration services to tort claim management services including: potential liability and claims investigations, negotiation of claim settlements, assumption of the handling of existing open claims, rev1ew of all relevant law term invoices,
reporting to the City excess General Liability carrier.
A. General Liability Claims Management
1. Provide a dedicated claims team to manage claims assigned by the City and promptly notify the City of any team replacements. City shall have right to approve any replacements.
2. Promptly create a claim file upon receipt of the claim against City and ensure timely and responsive claim processing, including follow up with claimant(s) regarding claim issues. Send acknowledgment letter to each claimant(s) advising them of the adjuster's contact information and the expected response date. Make prompt contact (within one business day) with the claimant(s) or claimant's attorney.
3. Conduct investigation of claim, including contact with City personnel and any witnesses within the first five days after receiving a new claim, documented with recorded statements, if possible. Obtain all possible reports, photographs and diagrams of the scene, and use video when appropriate. Report all injury claims to the Index Bureau and have them re-indexed once or twice a year while the claim remains open. Property damage claims will be inspected promptly and the damages evaluated and assessed.
4. Assess and evaluate the nature and extent of each claim, and establish claim reserves for indemnity, medical, and legal expenses at their most probable outcome, based on what is known about the claim at the time. Review reserves regularly at each diary interval and adjust as warranted by developments in the case. Contractor will make evaluation and recommendation on sufficiency and timeliness of submitted claims to City. Promptly input data into the claims management system.
5. Upon completion of investigation, recommend acceptance/rejection of submitted claims to City. Take immediate action to promptly settle claims within the authority granted by the City, where there is clear liability on the part of City.
6. Ensure timely initial reporting, progress reports and claims documentation for all non-litigated claims by submitting information to City's excess carrier or pool in accordance with the pool's claims reporting policy.
7. On a quarterly basis, meet with representatives of the City to review the status of claims and develop action plans related to complex claims.
8. Submit requests for reimbursement on behalf of City to City's excess insurance carrier or pool.
9. Promptly identify subrogation, indemnity, and defense rights owed to City through contracts and
additional insured endorsement. Tender and demand indemnification from responsible persons,
agencies, and/or agents in an effort to recover losses suffered by City in connection with claims filed
against City.
B. General Liability Claims Litigation
1. Monitor litigation involving claims against the City through closure as information is made available from outside defense counsel or City staff. Input relevant data into the claims management system.
2. Provide adjusting services as requested by City or outside defense counsel.
3. Monitor all bills and expenses prior to payment and require that no unauthorized discovery take place. Ensure retention of experts is cleared with City.
4. Upon authority and approval by City, handle settlement negotiations, including attendance at all
settlement conferences and mediations. Settlement authority on litigated claims in excess of the
authority granted by City must be approved by the City.
C. General Liability Claims Financial Accounting
1. Maintain a trust fund for the purpose of paying expenses that may be due on the claims. The amount that will be maintained in the trust fund shall be determined by the parties and confirmed by written document.
2. A monthly check/voucher register of all transactions made for the period shall be provided by
Contractor to City.
3. City reserves the right to conduct a financial audit of the trust account to insure the integrity of the account.
D. General Liability Claims Data Products
1. Provide a computerized loss run and summary report each month including all newly reported, open, and newly closed claims for the period. This report will be provided within fifteen (15) days of month end. This report will provide the following by claim year: monthly listing of open claims by date of loss, department, location, and alpha by name showing expense categories, reserves and total incurred.
2. Provide loss run data and required reports for actuarial, auditing and reserve analysis purposes.
3. Provide ann

[C] Eligibility:

- Onshore (US Organization Only);

[D] Work Performance:

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

Expiry Date : Friday, 17 April, 2020

Category : Medical Billing and Coding

Country : USA

State : California

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