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Agmt05 Claims Management Inc
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Agmt05 Claims Management Inc
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Last modified
4/24/2007 9:04:37 AM
Creation date
7/22/2005 8:55:38 AM
Metadata
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Template:
Agreement
Contractor Name
Claims Management Inc
PROJECT NAME
third party administrator
RMP File Number
304
Date
7/20/2005
MO Ref
05-105
Box
6360
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<br />L. CMl's employees shall perform field investigations on individual claims upon the mutual agreement of both <br />parties. All costs and fees for these services will be paid at the standard billing rate plus 50 cents per mile. <br />These fees shall be paid under allocated expwses after approval by Client. <br /> <br />M. Horizon Managed Care, LLC, an affiliated entity, is our on-site copy service. Allowable photocopy charges <br />are billed to the file under allocated loss expense. <br /> <br />N. CMI will fully cooperate with all audit requests by Client or other associated agencies. <br /> <br />O. Affiliated Entities. Separate entities, Horizon Managed Care, LLC ("HMC") and Single Source Medical, <br />LLC ("Single Source Medical") are owned by shareholders and executives of CMI. <br /> <br />HMC provides a medical cost management program. HMC shall be paid by Client for bill review and other <br />services rendered by staff for the managed care program. Costs for outside services for managed care <br />shall also be paid by Client. <br /> <br />Single Source Medical provides durable medical equipment (DME) and other supplies to the injured <br />workers of Client at competitively low rates. Client shall have access to the best pricing offered by Single <br />Source Medical, and will automatically be eligible to receive available discount rates. <br /> <br />In the event that Client elects not to participate in the goods and services offered by either of CMl's <br />affiliated entities, but rather to contract through unrelated vendors, please contact CMl's executive staff to <br />make these arrangements. <br /> <br />VI. <br /> <br />PENALTIES AND CITATIONS <br /> <br />CMI shall indemnify and save harmless Client from and against all losses and all claims, demands, payments, <br />suits, actions, recoveries, and judgments of every nature and description brought or recovered against it, by <br />reason of any act or omission of CMI, its agents or employees, in the execution of the service or in <br />consequences of any negligence or carelessness the same and shall provide an Errors and Omissions policy <br />in the amount of $1,000,000 dollars to assure that Client will be protected for any errors and omissions <br />resulting from the work of CMI. <br /> <br />The parties acknowledge that the California Workers' Compensation Reform Act of 1989 requires first payment <br />of Temporary Disability Indemnity within 14 days of the Client's knowledge of the injury and generally imposes <br />an automatic penalty of 10% of the amount delayed for late indemnity payments which shall be payable <br />directly to the injured employee without application. Furthermore, the parties agree that unless CMI is provided <br />with notice of the claim within 5 days of the Client's knowledge of the injury, the above-referenced automatic <br />penalty of 10% shall be and remain the sole responsibility of the Client. CMI will 'agree, however, to make a <br />good faith effort with due diligence to issue the first Temporary Disability Indemnity payment within the 14-day <br />requirement, even in the event that notice of claim is not received by CMI within 5 days of the Client's <br />knowledge of the injury. <br /> <br />CMI will not be responsible for penalties assessed that are the responsibility of the Client, including: <br /> <br />A. Failure by the Client to provide an Employee Claim Form within twenty-four (24) hours upon request of the <br />injured worker or hislher agent. Failure of employer to complete DWC-1 as required by the Labor Code, <br />even when DWC-1 is submitted to employer by an attomey. <br /> <br />Redwood City 2004-2005\word\cmi\contracts\lk <br /> <br />Page 3 of 6 <br /> <br />OS/24/05 <br /> <br />r- <br />
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