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Agmt04 Claims Management Inc
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Agmt04 Claims Management Inc
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Last modified
7/5/2005 2:28:52 PM
Creation date
10/5/2004 8:41:20 AM
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Template:
Agreement
Contractor Name
Claims Management Inc CMI
PROJECT NAME
Workers' Compensation Claims Admin Svcs.
RMP File Number
304
Date
9/30/2004
MO Ref
03-135 04-184
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<br /> J. Provide a monthly check register of all financial transactions. <br /> K. Provide a computerized loss analysis and summary each month covering activity of claims <br /> reported to CMI to include cumulative loss information to date. <br /> L. CMI's employees shall perform field investigations on individual claims upon the mutual <br /> agreement of both parties. All costs and fees for these services will be paid at the standard <br /> billing rate plus 50 cents per mile. These fees shall be paid under allocated expenses after <br /> approval by Client. <br /> M. Horizon Managed Care, LLC, an affiliated entity, is our on-site copy service. Allowable <br /> photocopy charges are billed to the file under allocated loss expense. <br /> N. CMI will fully cooperate with all audit requests by Client or other associated agencies. <br /> O. Affiliated Entities. Separate entities, Horizon Managed Care, LLC ("HMC") and Single Source <br /> Medical, LLC ("Single Source Medical") are owned by shareholders and executives of CMI. <br /> HMC provides a medical cost management program. HMC shall be paid by Client for bill <br /> review and other services rendered by staff for the managed care program. Costs for outside <br /> services for managed care shall also be paid by Client. <br /> Single Source Medical provides durable medical equipment (DME) and other supplies to the <br /> injured workers of Client at competitively low rates. Client shall have access to the best pricing <br /> offered by Single Source Medical, and will automatically be eligible to receive available <br /> discount rates. <br /> In the event that Client elects not to participate in the goods and services offered by either of <br /> CMl's affiliated entities, but rather to contract through unrelated vendors, please contact CMI's <br /> executive staff to make these arrangements. <br /> VI. PENALTIES AND CITATIONS <br /> CMI shall indemnify and save harmless Client from and against all losses and all claims, demands, <br /> payments, suits, actions, recoveries, and judgments of every nature and description brought or <br /> recovered against it, by reason of any act or omission of CMI, its agents or employees, in the <br /> execution of the service or in consequences of any negligence or carelessness the same and shall <br /> provide an Errors and Omissions policy in the amount of $1,000,000 dollars to assure that Client <br /> will be protected for any errors and omissions resulting from the work of CMI. <br /> The parties acknowledge that the California Workers' Compensation Reform Act of 1989 requires <br /> first payment of Temporary Disability Indemnity within 14 days of the Client's knowledge of the <br /> injury and generally imposes an automatic penalty of 10% of the amount delayed for late indemnity <br /> payments which shall be payable directly to the injured employee without application. <br /> Furthermore, the parties agree that unless CMI is provided with notice of the claim within 5 days of <br /> the Client's knowledge of the injury, the above-referenced automatic penalty of 10% shall be and <br /> remain the sole responsibility of the Client. CMI will agree, however, to make a good faith effort <br /> with due diligence to issue the first Temporary Disability Indemnity payment within the 14-day <br /> Redwood City 2004-2005lwordlcmilcontracts\lk Page 3 of6 09/08/04 <br />
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