Third-Party Claims Admin Services

The Vendor is required to provide third-party claims admin services for the investigation, negotiation, and payment of claims, including but not limited to general liability, professional liability, public officials and employee’s liability, automobile liability, employment practices liability, workers' compensation, and other claims asserted against the parish.
- Claims administration
• A general statement about the company, stating the length of time it has been in business as a claims administrator and has been adjusting general liability, professional liability, employment practices liability, public officials and employee's liability.
• Automobile liability, workers' compensation, property, and other claims.
• Include the location of the company's principal office.
• Including any professional designations, membership, in local and national professional organizations held by the individuals, and the number of staff members.
• The identities of supervisors and adjusters to provide claims administration, a complete resume for each, and the resume should include the number of years of experience in each assigned area, and a description of whatever training is provided.
- Administrative philosophy as it relates to:
• Payment or nonpayment of claims;
• Method of managing the reporting of claims;
• Injured employee's work status;
• Workers' compensation appeals bond and rehabilitation unit appearances;
• Fraud referrals;
• Notification of payment or nonpayment decisions to claimant;
• Providing loss information;
• Approach to subrogation;
• Settlements;
• Reserving;
• Late payment policy;
• Assignment, utilization and monitoring of vendors, e.g. surveillance, rehabilitation counselors, case management etc.
- Claims administrative system procedures:
• Promptness of accident investigation including: procedures utilized by your firm to complete accident investigations and turnaround time from receipt of claim to investigation.
• TPA to provide various reports.
• The development and preparation of these reports should be included in the final cost of service.
• TPA will be responsible for the verification of the legitimacy of payments made to service providers and for the disbursal of the benefits through check issuance process.