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Agmt15 York Risk Services Group, Inc.
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Agmt15 York Risk Services Group, Inc.
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Last modified
12/17/2020 9:03:47 AM
Creation date
6/10/2015 9:24:45 AM
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Template:
Agreement
Contractor Name
York Risk Services Group, Inc.
PROJECT NAME
Claims Administration Services- Workers' compensation program
RMP File Number
304
Date
7/1/2015
MO Ref
15-049
Amendment
Yes
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IV. DUTIES OF YORK <br /> A. YORK shall maintain sufficient staff with the necessary experience and <br /> management oversight. Adjusters assigned to Claims shall have a case load that allows <br /> proper attention to the work. <br /> B. To the extent required by law, YORK shall utilize only licensed <br /> adjusters and licensed private investigators, where applicable and such adjusters and <br /> investigators shall in the rendering of their services conform to the provisions of all <br /> applicable laws, rules, orders or written interpretations issued by the applicable <br /> regulatory authorities. <br /> C. YORK shall investigate, evaluate, negotiate, settle, or deny Claims <br /> within the authority granted to YORK from time to time by PRINCIPAL. YORK may <br /> settle Claims in excess of its authority limits only with prior written approval. PRINCfPAL <br /> shall in writing, promptly grant or deny upon YORK's request for authority. <br /> D. YORK shall notify PRINCIPAL'S insurer of all claims which may affect <br /> the insurer's coverage in excess of PRINCIPAL'S Self-Insured Retention layer in <br /> accordance with the instructions of PRINCIPAL'S insurer as provided to YORK pursuant <br /> to Section V. (A) of this Agreement. <br /> E. Upon termination of this Agreement, all hard copy and electronic files <br /> shall be transferred to PRINCIPAL. <br /> F. YORK acknowledges that all of the Claims files in its possession are <br /> the property of PRINCIPAL and agrees to promptly provide access to or deliver any <br /> such file to PRINCIPAL, at PRINCIPAL'S expense, at any time upon PRINCIPAL'S <br /> request. In exchange for PRINCIPAL'S absolute right to obtain the Claims files, <br /> PRINCIPAL agrees that it shall not have the right to set off any sums claimed due from <br /> YORK against fees due to YORK under this Agreement. <br /> G. YORK expressly agrees to hold all funds and assets of PRINCIPAL <br /> that come into its control or possession during the term of this Agreement as a fiduciary <br /> of PRINCIPAL. <br /> H. YORK shall make available, through YORK'S proprietary claims <br /> system, claim-related data with "web-enabled" access. PRINCIPAL will have "view only" <br /> access to the system. PRINCIPAL will bear its own hardware, software, connection and <br /> similar costs for accessing YORK'S electronic claims management system. <br /> I. During the TERM of this Agreement and at all times that there are open <br /> Claims being handled by YORK, YORK shall fully cooperate with PRINCIPAL. <br /> ATTY/AGR/2015.068/YORK TPA REDWOOD CITY <br /> REV:04-20-15 MLG <br /> Page4of17 <br />
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