MB-6505 - USA (California) - General Liability Claims Administration Services - Deadline June 15,2022

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-6505

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

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide third party administrator (TPA) for liability claims investigation, claims administration and related services.
- Such services shall include, but not be limited to, tort claim management services, potential liability and claims investigations, negotiation of claim settlements, assumption of the handling of existing open claims, and reporting to the city’s excess general liability carrier.
- Provide a dedicated claims team to manage claims assigned by the city and promptly notify the city of any team replacements. City shall have the right to approve any replacements.
- Promptly create a claim file upon receipt of each claim against the city and ensure timely and responsive claim processing, including follow up with claimant(s) regarding claim issues.
- Conduct investigation of each claim, including contact with city personnel and any witnesses within the first five (5) days after receiving a new claim, documented with recorded statements, if possible.
- 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.
- Upon completion of investigation, recommend acceptance and rejection of submitted claims to city attorney’s office. Prepare for city attorney’s signature all claims acceptances, rejections, notices of insufficiency, and returns for untimeliness.
- Ensure timely initial reporting, progress reports, and claims documentation for all non-litigated claims.
- Promptly identify subrogation, indemnity, and defense rights owed to city through contracts and additional insured endorsements.
- Monitor litigation involving claims against city as information is made available from outside defense counsel, city attorney, or risk management staff.
- Prepare initial written assignment to outside defense counsel with complete file documentation and specific instructions and direction.
- Monitor all bills and expenses prior to payment and require that no unauthorized discovery take place. Ensure retention of experts is cleared with city.
- Handle settlement negotiations, including attendance at all settlement conferences and mediations.
- 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 in writing.
- 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 and include the following by claim year: monthly listing of open claims by date of loss, department, location, and name showing expense categories, reserves and total incurred.
- Provide loss run data and required reports for actuarial, auditing, and reserve analysis purposes.
- Provide annual fiscal year reports comparing city claim data over a ten-year period. Each report will provide trending information over time, including types of claims, causes of claims, city department responsible, how claim was resolved, total cost of claim, and outside legal defense fees and costs.
- Provide desired Microsoft windows-based software systems, available twenty-four (24) hours/day, seven (7) days/week, with the ability of providing email exchanges.
- Attend hearings, settlement conferences, conferences with defense counsel, small claims court proceedings, and meetings with city staff, as required.
- Be available to respond, potentially upon short notice, to major emergencies or catastrophes (e.g., earthquake, floods, fire, etc.) involving potential claims.
- Provide monthly claims diary of all open files and enter review notes in claims management system.
- Provide input and final approval of the TPA’s personnel assigned to city’s account.
- Respond to TPA’s requests for information and authority in a timely manner.
- Provide final approval on the resolution of all city claims, including but not limited to, settlement amounts.
(2) All questions must be submitted no later than June 8, 2022.
(3) Contract term will be three years.

[C] Eligibility:

- Onshore (USA Organization Only);

[D] Work Performance:

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

Expiry Date : Wednesday, 15 June, 2022

Question Answer Deadline : Wednesday, 8 June, 2022

Category : Medical Billing and Coding

Country : USA

State : California

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