Third Party Administration of Claims Services

The Vendor is required to provide third party administration of claims services including, but not necessarily limited to the following:
• Have key local personnel conduct service calls as needed by the city for the purpose of establishing lines of communications and reporting procedures.
• Provide claim reporting by telephonic and electronic means.
• Provide complete handling of all loss adjustments, investigations, and settlements within the approval set by the city.
• Claims not received through the city solicitor or city risk manager shall be immediately referred to the city risk manager for review and handling.
• Claim acknowledgement to be returned to the city risk manager via electronic mail.
• Liability claims adjusters shall carry a maximum claim count of 225; property adjusters shall carry a maximum claim count of 300; workers’ compensation lost time adjusters shall carry a maximum of 150 claims; workers’ compensation medical-only adjusters shall carry a maximum of 200 claims.
• Loss adjustment shall include (but not be limited to) all state-mandated electronic reporting, 48 hour three point contact, liability/compensability investigations, reserving based on exposure, inquiries on all losses, Medicare secondary payor reporting, identify, preserve and pursue subrogation opportunities, make settlement recommendations and immediate notification to risk manager of any claim with exposure to excess coverage.