Agmt04 Claims Management BCJPIA - Laserfiche WebLink

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claim. Such report shall include the examiner's plan of action for the future handling of the claim. The examiner will provide on-site file reviews quarterly if requested by the member city. Other periodic on-site file reviews will be scheduled based upon the needs of the member city. 5. Employee Contact: In all non-litigated, lost time cases, where the employee has not returned to work, telephone or personal contact will be established with the injured employee within two (2) working days of receipt of notice of claim. Such contact will continue as often as necessary, but at least monthly until the employee returns to work. Such contact with the employee shall be documented in the computer notepad. Return phone calls to employees will be accomplished within one (1) working day. All correspondence from employees will be responded to within five (5) days of receipt. 6. Reserves: Reserves shall be established based upon the ultimate probable cost of each claim. All reserve categories shall be reviewed on a regular basis but at least every ninety (90) days. Such review shall be indicated in the computer notepad. The examiner shall utilize a reserve worksheet which has been approved by the Local Agency Workers' Compensation Excess Joint Powers Authority (LA WCX) pursuant to that JP A's Resolution Establishing a Claims Management Policy. Any changes to reserves shall include an explanation for the change. A claims assistant shall have authority to establish reserves not to exceed $3,000. An examiner shall have authority to establish reserves not to exceed $50,000. A senior examiner shall have authority to establish reserves not to exceed $75,000. The supervisor shall have authority to establish reserves not to exceed $150,000. A director, vice president, or president of the TP A shall review and approve all reserves in excess of $150,000. 7. Medical Administration: The TP A shall select a panel of general practitioners, specialists, hospitals, and emergency treatment facilities to which injured employees should be referred, as approved by the City, and the TP A shall regularly review and update the panel. The physician's office will be contacted within five (5) days of notice of all indemnity claims. Such contact will continue as needed during the continuation of temporary disability to assure that treatment is related to a compensable injury or illness. The TP A shall maintain contact with treating physicians to ensure employees receive proper medical treatment and are returned to full or modified employment at the earliest possible date. City of Redwood City - Performance Standards Page 2 of8 July 1, 2004 -- ,., .-