AgdaPkt 2009-06-15 clsd and spc - Laserfiche WebLink

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6.10 Page 8 o. Make all disability payments and send all notices in a timely manner, abiding by all applicable provisions of the California Labor Code and California Workers' Compensation Laws, Rules and Regulations. p. Make payments of bills within thirty (30) days of receipt, and assure timely review and payment of all medical bills in accordance with statutory deadlines and requirements. q. Acknowledge to Employer all claims reported to Administrator within three (3) working days of receipt of the notice of claim and to notify Employer and injured workers within five (5) working days of the notice of claim to Employer, whether the claim has been accepted, delayed for further investigation, or denied. r. Convert all Medical Only Claims to Indemnity Claims status when the paid amount reaches two-thousand-five-hundred ($2,500) dollars orwhen the claim remains open in excess of one (1) year. s. Recognize and where appropriate investigate all subrogation and/or contribution possibilities, preserving evidence and utilizing appropriate investigators and experts, as needed, after first obtaining Employers permission to engage such investigators/experts. As respects subrogation and contribution cases, any compromise settlements or lien reductions will be discussed with the Employer. 1. SCHIP Reporting - Administrator has contracted with Gould & Lamb, LLP as our preferred provider for Medicare Set Aside Allocations. Gould & Lamb, LLP is also our preferred partner in all SCHIP reporting efforts. Unless specifically approved in advance by Employer, Administrator will exclusively utilize the services of Gould & Lamb, LLP to satisfy and comply with all SCHIP reporting requirements. 4.03 Administrator agrees to monitor relevancy of medical treatment by the following: a. Maintain continual contact with medical practitioners in order to monitor claimant treatment process and a timely return to work. Administrator shall make a good faith effort to establish contact with attending phYSician within twenty-four (24) hours of receipt of injury report and shall make contact with attending physician's office within forty-eight (48) hours of receipt of injury report and shall document such contact in the claim file. b. Review and discuss Vocational Rehabilitation Program(s) with Employer prior to its initiation for an individual claimant. c. Monitor individual vocational rehabilitation programs to determine appropriateness and progress. 4.04. Administrator agrees to the following record keeping and reporting requirements: a. Provide Employer with monthly reports consisting of: (1 ) Check Registers including all claim disbursements made on behalf of Employer. City of RedwOod City - Claim Service Agreement - 2009 through 2010 5