Agmt04 Claims Management BCJPIA - Laserfiche WebLink

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27. Status Reports: Special claim status reports requested by member cities outside the regular 90-day status reports shall be provided by the TP A to the respective city within ten (10) business days. Verbal status reports requested by member cities shall be provided by the TP A to the respective city within two (2) business days. Special computer generated loss data reports requested by member cities shall be provided within twenty (20) business days. 28. Claims Reporting: The TP A shall maintain all loss information as required by the Workers' Compensation Insurance Rating Bureau. The TP A shall assist in the preparation of all reports that are now, or will be required by the State of California or other government agencies with respect to self-insurance programs. The TP A will also assist in the preparation of all reports or databases required by the California Institute for Public Risk Analysis (CIPRA) or other statistical database organizations as requested by the City. 29. Record Retention: All claim files shall be maintained in accordance with statutory time requirements and the City's Record Retention Policy. 30. Claim Supervision: The TP A shall provide supervisory staff that will regularly review the work product of the claims examiners. The supervisor shall review at least ten percent (10%) of each examiner's caseload each month to ensure each examiner is following the performance standards outlined in this document. In addition, the supervisor shall conduct a regular quarterly review of all open indemnity claims with reserves in excess of$100,000 and all problem or complex claims. 31. Availability of Personnel: The TP A shall ensure at least one (1) or more of the examiners assigned to the City are on-site and available to the City and its member cities every business day throughout the term of the approved contract between the City and the TPA. 32. Examiner Training: The TP A shall annually certify to the City that each claims examiner handling the City's claims is in compliance with all legal and regulatory licensing and continuing educational requirements as presently or in the future shall be promulgated and required by the State of California. Where required by law or regulation, copies of all such certifications shall be provided at least annually by the TP A to the City. 33. Member Services: The TP A shall provide special on-site training services when requested by the City to ensure that the people who process workers' compensation claims are effectively carrying out the procedures required for a successful program. The TP A shall require one of the dedicated unit examiners to meet with city personnel, at the city's location, at least once annually to review program procedures regarding workers' compensation reporting requirements and other program matters that require the timely participation of the city's personnel. City of Redwood City - Performance Standards Page 7 of8 July 1, 2004 --.,. ..