Third Party Claims Administrator Services

The Vendor is required to provide third party claims administration for the commission.
- Ensure key local personnel conduct service calls as needed at each participating department or entity for the purpose of establishing lines of communications and reporting procedures.
- Provide a reporting procedure for accidents occurring after normal business hours, during holidays, or on weekends.
- Provide complete handling of all loss adjustments, investigations, and settlements within the approval authority of reported claims.
- The receipt of a notice of the commencement of a lawsuit by a third party.
- Provide complete accounting for the claims administration program which at all times is subject to review by the Commission.
- Set claim reserves and provide a continuous review and updating to reflect changes.
- Assist in the collection of claims against others for damage to the participating members' property and make recommendations regarding salvage matters.
- Comply with and apply all cost containment and managed care programs adopted by the commission.
- Supply monthly financial reports detailing, summarizing, and reconciling imprest transfers, claim payments, and other financial transactions (voids, recommissions, recoveries, etc.) in the manner specified by the commission.
- The claims management system must provide for a historical claims database accessible by valuation date and current claim information.
- The service provider agrees to set up dedicated units to adjust workers' compensation and liability claims. In addition, the service provider will make every attempt to have all files remain with the initial assigned adjuster for the life of the claim file.
- The service provider agrees to provide a field investigator to take written and/or recorded statements from the claimant, employer and witnesses.

- Contract Period/Term: 1 year