Third Party Liability Claims Services

The vendor is required to provide that third party liability claims services to own library, police department, fire department, airport, landfill, solid waste service, and water utility.
- Claims administration:
• Administering the city's self-insurance retention program and shall act as the city's representative in connection with the investigation, adjustment, processing, supervision and resolution of general liability, motor vehicle liability, property damage and potential money damage claims asserted by third parties against city, or against parties for alleged to be legally responsible, are premised upon allegations of willful, intentional, negligent or careless acts and/or omissions;
• Perform liability claims adjusting services;
• Inform city staff of any changes to current laws that could have an impact on the city's liability claims program;
• Advise city staff of any claim trends that may have an impact on the city's claim program; provide data and analytics regarding the city's program to the risk manager and/or claims specialist on a monthly basis; provide ad hoc reports as requested by the city;
• Meetings and file reviews and provide updates on the city's open liability cases;
• Provide statistical reports on a monthly basis that depict the claims opened or closed per month, payments that have been issued and current reserves on all open claims; and other reports as needed;
• Any inquiries the city's excess carrier may have in regards to any particular claim as well as providing the excess carrier with any reports requested
• Identify all subrogation claims and initiate a written report to the city on potential success of subrogation; identify all costs including attorney fees involved in specific subrogation eligible files.
• Provide recommendations based upon cost-benefit analysis of potential subrogation files.
- Claims handling:
• Set up a claim file within 24 hours of receipt of the claim;
• an acknowledgment letter on all new files opened;
• Assign an initial case reserve;
• The claim to verify the claim complies with the reporting requirements as set forth in the state government code;
• Prior approval of the city on a per claim basis, promptly issue the appropriate letters and notices to the claimant advising of any deficiencies; claim rejections; claim denials; or any other pertinent correspondence as required under the state government code;
• If claim is to be accepted, gather damages documentation and with prior written approval on a per-claim basis from the city, negotiate a reasonable settlement for final presentation to the city for approval or ratification
• Claims administrator shall prepare a settlement request and forward that request to the human resources manager or risk management analyst for approval;
• All settlements are subject to city approval and the claims administrator has no settlement authority;
• Obtain settlement agreements and releases upon settlement of claims or potential claims not in litigation;
• City's excess carrier as appropriate and directed; and in compliance with excess insurance policy requirements; provide ongoing reporting for all excess cases as may be requested or required by the excess insurance carrier;
• Obtain reimbursement from excess carrier should expenditures exceed self-insured retention; monitor and manage all excess reporting and reimbursement from the excess carrier; all reimbursements shall be reconciled by the third-party administrator (TPA) and any and identified for specific discussion and reporting to the city; all reimbursements paid in full and received by the third-party administrator must be immediately provided to the city for deposit into the city's bank account.
• Provide monthly reports on reimbursement or excess carrier recoveries; and monitor excess carrier for reimbursement every 30 days;
- Investigative services:
• Receipt and examination of all reports of accidents, incidents, or claims that are or may be the subject of claims.
• Investigation on behalf of the city's attorney’s office and risk management include contact with the claimant or attorney for additional claim details, regarding the claim from the city and field work, if appropriate, include photographs, measurements of defects etc.; for all field work, prior approval of the city on a per-claim basis is required.
• Investigate accidents, incidents, or claims where the examination warrants such investigation to include on-site investigation, photographs, interviewing of witnesses, determination of losses and other such investigative services necessary to determine any city losses, but not to include extraordinary investigative services outside the expertise of the contractor.
• Investigation is complete, determine whether to recommend the city accept or reject the claim
• If rejection is appropriate, promptly issue rejection notice to claimant or claimant’s attorney or representative, which will include an explanation of claim was rejected; and may include any and all other notices required under government
• Maintain service on a 24-hour, 7 days per week basis, to receive telephone reports of any incident or accident which may be the subject of a liability claim and provide immediate investigative services to the extent necessary to provide a complete investigation.
• Undertake items of investigation requiring special handling for city at the direction of the city attorney or authorized representative.
- Adjustment services:
• Maintain a claim file on each potential or actual claim reported
• Process any such claim or potential claim for settlement in accordance with instructions and policies of city for settlement of such claims.
• Notify city's primary and excess carriers of all claims exceed or may exceed city's self-insurance retention.
• Act as liaison between the excess/insurance carriers and the city on matters affecting the adjustment of such claims.
• Maintain records on any such claim and notify city when city is entitled to reimbursements for loss in excess of retention. 6. litigation management at direction of city attorney
- Administrative services:
• Assist in training at the request of the city.
• Assist city in preparing accident kits for city vehicles.
• Assign a principal account adjuster satisfactory to city to provide liaison between city and contractor.
• Provide tabulated monthly statistical reports and status reports of all reported claims.
• The status of each reported open claim, the outstanding reserves for each claim and details of all claim payments during the month.
• The city attorney and human resources manager within five days of the close of each calendar month. 5. Periodically review and adjust reserves on all open claims.
• Assist city attorney in selection of special counsel, if requested.
• Investigate and handle through conclusion telephone adjusted claims.
• Prepare an internal revenue service form number 1099 for service providers as required by the internal revenue code.
• Provide loss information for the city’s annual excess liability application.
- Legal support services:
• The city attorney that litigation has been filed on an open claim, provide special counsel with all information and files concerning the claim.
• Cooperate with and assist any attorney assigned to litigation of open claims and provide such investigative services as directed during pre-trial and trial stages.
• Oversee the efforts of defense counsel through a sound litigation management plan; responsible for obtaining a copy of defense counsel’s proposed defense budget; and setting reserve appropriately for each specific case/file/claim
• Assist in answering any interrogations or requests for admissions filed by third parties
• The city attorney, attend mandatory settlement conferences on behalf of city.
• The human resources manager or designee, appear on behalf of city in small claim actions filed against or on behalf of the city on open claims handled by contractor.
• Regularly and reasonably discuss and review investigation issues, discovery, and case strategy with special counsel.
• Review case evaluations, correspondence and status reports forwarded to contractor by special counsel.
• Cooperate with special counsel as a team with an open communication approach on each case to obtain the most economical and best result for the city.
- Budget:
• Fiscal year 2024/25 is approximately $127.5 million.
- Contract Period/Term: 3 years
- Questions/Inquires Deadline: February 18, 2025