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<br /> V. CLAIMS ADMINISTRATION <br /> CMI shall provide the following workers' compensation claims management for the Client: <br /> A. Review on behalf of Client all reports of injury as defined by Labor Code Section 3208 and <br /> 3208.1, and make contact with injured employee within 24 hours notice of lost time injury is <br /> received. <br /> B. On each reported injury, determine those benefits, if any, that should be paid or rendered under <br /> the California Workers' Compensation Laws. Client is responsible for completion of <br /> Employer's Report of Injury within five (5) days from the date of knowledge. Client will be <br /> responsible for any penalties or assessments if claim is not reported in five (5) days from date <br /> of knowledge. <br /> C. Establish and maintain an orderly claims file on each reported claim. Each file shall be <br /> available to Client for inspection, with or without prior notice to adjusting firm. <br /> D. Maintain an estimate of the total cost of all reasonably foreseeable benefits and related <br /> expenses on each case. Each cost shall be recorded separately in the following categories: <br /> I. Medical <br /> 2. Indemnity <br /> 3. Allocated <br /> 4. Rehabilitation <br /> E. Pay on behalf of Client from Client funds, those sums that should reasonably be paid under the <br /> California Workers' Compensation Laws for each reported claim. Any settlement in excess of <br /> the mutually agreed limit set forth in Client's Performance Standards, must be first approved by <br /> the Client. <br /> F. Refer to attorneys selected by the Client, cases where an employee of the Client files an <br /> Application with the California Workers' Compensation Appeals Board. It is understood that <br /> even when an Application has been filed, a substantial effort will be made by CMI to settle the <br /> claim file without assigning it to legal counsel. <br /> G. Select medical doctors, psychiatrists, psychologists, medical managers, etc., schedule medical <br /> appointments, and other services, as is reasonably necessary in the management of workers' <br /> compensation cases. <br /> H. Proceed against responsible persons, agencies and/or their agent in subrogation actions in order <br /> to recover losses suffered by Client. <br /> I. The following fees will be billed to the file under the "allocated loss expenses" which are <br /> defined to include all fees for attorneys, witnesses, court reporters, photocopies, process <br /> servers, independent investigators, claims index bureau filing fees, any court or Workers' <br /> Compensation Appeals Board costs or filing fees, fees for depositions, surveillance, or the <br /> necessary engagement of personnel, independent of CMI in the handling of any claim subject to <br /> the proposed Agreement. <br /> Redwood City 2004-2005\word\cmi\contractsllk Page 2 of6 09/08/04 <br /> ......_.._>''" <br />