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HomeMy WebLinkAboutReso. 1990-419 - Approving the service agreement for workers' compensation • • RESOLUTION NO. 90 -y(47 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF REDDING APPROVING THE SERVICE AGREEMENT FOR WORKERS' COMPENSATION CLAIMS ADMINISTRATION SERVICES , BETWEEN THE CITY OF REDDING AND FLEMING & ASSOCIATES , AND AUTHORIZING THE RISK MANAGER TO SIGN ALL NECESSARY DOCUMENTATION. BE IT RESOLVED by the City Council of the City of Redding as follows : 1 . That the City Council of the City of Redding hereby approves the Service Agreement dated August 16 , 1990 , for workers ' compensation claims administration services for the period September 1 , 1990 , through August 31 , 1991 , entered into between the City of Redding and Fleming & Associates, a true copy of which is attached hereto. 2 . That the Risk Manager of the City of Redding is hereby authorized and directed to sign said Agreement and all necessary documentation on behalf of the City of Redding in connection therewith, and the City Clerk is hereby authorized and directed to attest the signature of the Risk Manager and to impress the official seal of the City of Redding on the aforesaid documents, when appropriate. I HEREBY CERTIFY that the foregoing Resolution was intro- duced and read at a regular meeting of the City Council of the City of Redding on the 21st day of August , 1990 , and was duly adopted at said meeting by the following vote: AYES: COUNCIL MEMBERS: Arness, Dahl , Fulton & Buffum NOES: COUNCIL MEMBERS : None ABSENT: COUNCIL MEMBERS : Moss ABSTAIN: COUNCIL MEMBERS : None - /J% sly', ,4114// c—/". NANCY. BUFFUM, May// City -of Redding ATTEST: ETHEL A. NICHOLS , City Clerk RA DALL A. HAYS, City Attorney M 4 SERVICE AGREEMENT THIS AGREEMENT, entered into this sixteenth day of August, 1990 by and between City of Redding , hereinafter called the "City" and Fleming & Associates, hereinafter called "Contractor" , for certain services as outlined in connection with the duties and responsibilities of administering a program of workers' compensation self-insurance. WITNESSETH NOW, THEREFORE, in consideration of the promises, covenants and agreements set forth herein, the parties hereby promise, covenant and agree as follows: I . OBLIGATIONS OF CONTRACTOR A. GENERAL Contractor shall: 1 . Supervise and administer the Self-Insurance Workers' Compensation Program for the City, and, 2 . Represent the City in all matters related to the investigation, adjustment, processing, supervision and resolution of Workers' Compensation claims asserted by employees against the City; and, 3 . Provide to the City during the term of this Agreement all the services more particularly set forth hereinafter. B. EXAMINING SERVICES 1. Contractor shall provide complete administration services including, but not limited to: a. Review and process all claims for Workers' Compensation benefits in accordance with the requirements of the Department of Industrial Relations for reporting and notification. b. Determine the compensability of claimed injuries and illnesses in accordance with the 111 411 California's Workers' Compensation laws. c. Determine eligibility and authorize payments of medical benefits and authorize examinations to determine the nature and extent of disability when appropriate. d. Determine the eligibility for and authorize payment of temporary arY disability compensation ation in coordination with medical advice and rehabilitation efforts. e. Determine the degree of permanent disability, if any, of injured workers utilizing, as necessary and desirable, advisory ratings of the Permanent Disability Rating Bureau. f. Authorize the payment of permanent disability compensation and death benefits in accordance with advisory ratings, orders of the Workers' Compensation Appeals Board, Compromise and Release settlements, and Litigation Avoidance Programs. g. When appropriate refer litigated cases to attorneys utilizing an agreed listing of legal firms, assist in the preparation of litigated cases, negotiations of Compromise and Release settlements and subrogation actions. h. Maintain current estimates of costs of all anticipated benefits and related expenses on each case. i. Investigate or arrange for investigation of, as necessary and appropriate, questionable cases and the status of disabled employees in order to adjust all cases and to assist in the trial or settlement of litigated cases. Authorization for outside investigation is subject to approval by City. j . When medically appropriate , develop • • rehabilitation programs for injured employees for approval by the City, the employee, and other agencies to provide rehabilitation, retraining, or reassignment for employees with physical or performance limitation resulting from industrial injuries. k. Provide monthly reports to the City which will set forth requested accounting and , statistical data to allow the City to interpret and evaluate the self-insurance program. Reports shall be delivered within 20 days of the close of each calendar month. 1 . Notification of the City's excess insurers of all claims which exceed the City ' s self-insurance retention limit. Maintain liaison between the insurance carriers and the City on matters affecting the adjustment of such claims. 2 . Non-staff expenses such as legal costs and fees, investigations and rehabilitation vendor fees, the cost of employing experts for professional advice, opinion or testimony, and similar costs normally considered as Allocated Loss Expenses are not included in our fee in the compensation to Contractor as hereinafter set forth. Such expenses are chargeable as part of the claims cost, as is the custom under insured plans when computing losses for experience rating , retrospective rating, or dividend computation, and are paid by the City. C. LEGAL SUPPORT SERVICES Contractor shall provide at least the following legal support services on each claim wherein the claimant has commenced litigation. r 1. Upon notification by the City or other sources that an attorney has proceeded to litigate on an open claim, Contractor shall attempt to settle the claim directly with the employee's attorney without litigation . If litigation becomes imminent, an attorney specializing in the defense of Workers' Compensation claims shall be retained to represent the City. Upon request of the City, Contractor shall provide all information and files concerning said attorney. • D. PERIOD OF AGREEMENT This Agreement shall become effective as of September 1, 1990, and shall continue in effect until , August 31, 1991 and may be annually renewable on September 1 of each year thereafter. If the Contractor believes that a fee increase is necessary, the City shall be notified at least 30 days prior to any proposed fee increase. II . OBLIGATIONS OF THE City A. CONSIDERATION. 1. The City hereby agrees to pay to Contractor and Contractor hereby agrees to accept in full satis- faction for its services provided for hereunder, compensation in the following amounts: a. Contractor shall be compensated in the amount of $35, 775 per year based upon the most recent years claims count. One billing shall be issued reflecting a charge of $35, 775 representing fees for contractor's claims supervision and other necessary administrative duties and shall be paid in total within 30 days of approval of this contract. b. Contractor shall reimburse City on a monthly prorata basis for services not performed as a i 411 result of cancellation of this Agreement by the City. B. TIME OF PAYMENT 1. Upon execution of this Agreement by both parties, the City shall remit to Contractor the sum of $35, 775. Payment shall be transmitted to Fleming & Associates, 1150 Foothill Blvd. , Suite E, La Canada, CA. 91011. C. The City shall provide Contractor with copies of all relevant documents upon request and without charge and shall make available any City employee for interviews by Contractor at reasonable times concerning any investigations of a claim or incident pursuant to this Agreement. III . OTHER CONTRACTUAL PROVISIONS A. CANCELLATION OF AGREEMENT. The Agreement may be terminated by City, or Contractor, with or without cause, upon giving the other written notice of at least 60 days prior to date of termination. In case of termination by City, a prorata adjustment will be made on any sum paid under 1 the applicable Section of this Agreement. B. DISPOSITION OF FILES ON TERMINATION OF AGREEMENT 1. All files on each claim shall be the property of the City. 2 . In the event of expiration of the Agreement, and non-renewal thereof, Contractor shall bill City, subject to the rate quoted hereinabove, for work completed on each claim, and also promptly forward all completed and pending claim files to the City. 3 . In the event of cancellation of this Agreement by the City, Contractor shall return all files to the 'j . • • City unless the City requests Contractor to continue to process such files pursuant to contractors current time-and-expense rates at the time such services are rendered. C. HOLD HARMLESS 1. The City agrees to defend any legal action commenced against Contractor caused directly or indirectly by the wrongful or negligent acts of the City's officers, employees, agents or others engaged by the City, and indemnify Contractor against any liability, loss, cost of damage including attorney's fees resulting therefrom. 2 . Contractor agrees to defend any legal action commenced against the City caused directly or indirectly by the wrongful or negligent acts of the Contractor, employees, agents or others engaged by Contractor and to indemnify the City against any liability, loss, costs or damage ( including attorney's fees resulting therefrom. D. PENALTIES AND FINES PURSUANT TO THE 1990 WORKERS' COMPENSATION REFORM ACT 1. Penalties and fines resulting from the Contractor's negligence will be paid by the Contractor. 2 . Penalties and fines resulting from the Citys' negligence, late filings or incurred as a result of action or inaction directed by the City will be paid by the City. �I' • • 11 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be signed by their duly authorized officers, or representatives, as of the day and year first written above. DATED: : - / ‘= 1990 -Fleming & ssoci.tes Jeff S . Seabrook - DATED: 1990 City of Redding A • fr ATTEST: