Agmt 09 Athens Administrators - Laserfiche WebLink

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,. ", ." 1 :~., ATHENS I,/:i:a _ n .____ __ ,_ ,_.____ ",:g,' ADMINtSTFIATor~s 6.04. Copies of FUes Administrator may, at its discretion keep a copy of Employer's files if it deems it necessary to comply with or defend itself in relation to any obligation or rights that it has under 1his Agreement, applicable laws or regulations. VII. FlN'ES. PENALTIES AND STANDARDS 7.01. All services as described in this Agreement shall be performed in accordance with all applicable laws, rules and regulations of any and all govermne~ authorities and applicable standards, and specifically performed in accordance with au applicable Workers' Compensation Laws of the State ofCalifomia. 7.02. Administrator and Employer acknowledge the obligations and penalties contained in the California Workers' Compensation Reform Act of 1989 that may be imposed on both employers and claim administrators and agree to the following: . a. Penalties for errors or omissions caused by Employer's failure to act or timely report claims or issues to Administrator that create a delay in payment of benefits, incorrectpayment ofbenefits, or administrative flne(s) or penalty(s) shall be the responsibility ofEmployer. Penalties for errors or omissions caused by Administrator's performance of services under this contract that create a delay in payment of benefits, incorrect payment of benefits, or administrative fine(s) or penalty(s) shall be the responsibility of Administrator. b. Administrator shall provide Employer with a quarterly accounting of penalties paid by Administrator on behalf of Employer including a description and detailed listing of each penaltypay.oumt and the specific claim file 10 which the penalty payment was charged. Penalties, which are computed by Administrator, shall be paid out of Employer's benefit account and Administrator shall then reimburse Employer quarterly for those penalties, which are the responsibility of Administrator under the terms and conditions of this Agreement, with pro-rated interest at the prevailing prime interest rate. c. Without limiting the provisions set forth in the above two paragraphs it is agreed that upon receipt by Administrator ofanotice of claim. from Employer, upon which ind~ benefits sball be paid or notice given promptly to the employee in order to avoid late payment or notice of benefit penalties, Administrator shall have ten working ~ys (excludipg weekends and holidays) from. the date of receipt of the claim from Employer, to investigate and pay the temporary disability or send the required wage continuation notice, and that failure on the part of Administrator to do so within this time frame shall be the financial responsibility of Administrator for any fine imposed for late notice or payment ofbenefits. Any' fines or penalties for late payment or notice of benefits on claims, which are received :from Employer by Administrator on or, afterthe ninth day following the date Employer knew or should have known about the c1aim(s) shaI1 be the responsibility of Employer. d. Administrator will be responsible for any fines or penalties associated with questionable or controverted claims which Administrator denies without first consulting and obtaining approval by Employer for denial of the claim(s} Administrator will not be responsible for any fines or penalties levied by the Division of Workers' Compensation or any other judicial or quasi-judicial organization for improper denial of a c1aim(s) it over the written objections of Administrator, Administrator has denied said claim(s) at the express written direction of Employer. e. Any controversy between the parties 10 this Agreement involving the construction or application of the terms, provisions, or conditions of this Agreement relating to the payment of penalties or fines shall be submitted to arbitration upon the written request of one party, after service of that request upon the other party. f. Arbitration and controversies relating to the payment of penalties or fines under this Agreement shall comply with and be governed by the provisions of the CalifomiaArbitrationAct, as set forth at sections City of Redwood city - Claim Servica i\sreement - 2009 through 2010 7