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HomeMy WebLinkAboutCC Resolution 9794 (Claims Administration Services)RESOLUTION NO. 9 7 9 4 A RESOLUTION AUTHORIZING THE SIGNING OF AN AMENDMENT TO THE AGREEMENT WITH RENAISSANCE RISK MANAGEMENT FOR WORKERS' COMPENSATION CLAIMS ADMINISTRATION SERVICES (3/1/97 - 2/28/99) THE CITY COUNCIL OF THE CITY OF SAN RAFAEL RESOLVES as follows: The MAYOR and CITY CLERK are authorized to execute, on behalf of the City of San Rafael, an Amendment to the Agreement with Renaissance Risk Management, as the City's Workers' Compensation Administrator, extending the term of the Agreement from March 1, 1997 to February 28, 1999. I, JEANNE M. LEONCINI, Clerk of the City of San Rafael, hereby certify that the foregoing resolution was duly and regularly introduced and adopted at a regular meeting of the City Council of said City on Tuesday, the 18th day of February, 1997, by the following vote, to wit: AYES: COUNCILMEMBERS: Heller, Miller, Phillips & Mayor Boro NOES: COUNCILMEMBERS: None ABSENT: COUNCILMEMBERS: Cohen JE �NEM.EONC I, City Clerk AMENDMENT TO AGREEMENT WITH RENAISSANCE RISK MANAGEMENT FOR WORKERS' COMPENSATION CLAIMS ADMINISTRATION SERVICES The parties to the Agreement dated January 3, 1995 hereby amend the Agreement as follows: Section 2. Duration The term of this Agreement shall commence on the first day of March, 1997, and shall terminate on February 28, 1999. All other terms and conditions of the Agreement dated January 3, 1995 shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Amendment to Agreement as of the 18th day of February, 1997. RENAISSANCE RISK MANAGEMENT THOMAS V. MILLER, CEO 1�', Z T RM:GHIA�TI, City Attorney CITY OF SAN RAFAEL Z AL ENJ.O, Mayor ATTEST: ATNNE M. LEO C�ty Clerk COPY PROFESSIONAL SERVICE AGREEMENT THIS AGREEMENT, made and entered into this 3rd day of January, 1995, by and between the CITY OF SAN RAFAEL, a public agency, operating under the laws of the State of California, hereinafter referred to as "CITY", and RENAISSANCE RISK MANAGEMENT, hereinafter referred to as "CONTRACTOR", WITNESSETH: In consideration of the mutual promises as hereinafter contained, the parties hereto agree as follows: SCOPE OF WORK During the term of this Agreement, as set forth below, CONTRACTOR shall perform those services outlined in "Contractor's Statement of Services" (hereafter "services") attached hereto as Attachment A and by this reference incorporated herein. CONTRACTOR shall perform said services in a manner compatible and consistent with the standards of CONTRACTOR'S profession, and shall use reasonable care and due diligence in performing its obligations under this Agreement. 2. DURATION The term of this Agreement shall commence on the first day of March, 1995, and shall terminate on February 28, 1997. 3. RELATIONSHIP CONTRACTOR (including CONTRACTOR'S agents, officers and employees) is not an agent or employee of CITY, but is an independent contractor solely responsible for CONTRACTOR'S acts, and this Agreement shall not be construed as an agreement for employment. 4. CONTRACT PRICE, BILLING AND PAYMENT a) CITY agrees to pay CONTRACTOR the sum of seventy thousand dollars ($70,000) per year, said sum to be paid as follows: in quarterly installments of $17,500, due and deliverable to contractor on the dates specified, the first installment due on March 1, 1995, and thereafter on the first business day of every June, September, December and March, during the term of this Agreement, unless this payment schedule is altered by written mutual COPY agreement of the parties hereto. b) Paragraph (a) notwithstanding, CITY agrees to consider an increased fee during the second year of this Agreement provided that: 1) such increase in fee be specifically justified by CONTRACTOR; and 2) such increase not exceed 5 % of the fee for the initial year of the Agreement. 5. NON-DISCRIMINATION & COMPLIANCE WITH ALL LAWS CONTRACTOR, and any sub -contractor, shall not discriminate against any individual based on race, color, religion, nationality, sex, age or disability. CONTRACTOR shall comply with all applicable local, state, and federal laws and regulations. 6. NOTICES Any notice required to be provided pursuant to this Agreement shall be provided to CITY as follows: Suzanne Golt, Assistant City Manager City of San Rafael POB 151560 San Rafael, CA 94915-1560 and shall be provided to CONTRACTOR as follows: Thomas V. Miller, CEO/Claims Administrator Renaissance Risk Management POB 5819 Nuvdtu, CA 94548-5819. 7. ENTIRE AGREEMENT The terms and conditions of this Agreement, all exhibits attached and any documents expressly incorporated by reference represent the entire Agreement between the parties with respect to the subject matter of this Agreement. This Agreement shall supersede any and all prior agreements, oral or written, regarding the subject matter between CITY and CONTRACTOR. No other agreement, statement or promise relating to the subject matter of this Agreement shall be valid or binding except by a written amendment to this Agreement. If any conflicts arise between the terms and conditions of this Agreement and the terms and conditions of the attached exhibits or any documents expressly incorporated, the 2 terns and conditions of this Agreement shall control. 8. INSURANCE CONTRACTOR shall provide CITY with a certificate of insurance, duly executed by the insurance company or companies authorized to transact business in the State of California, and said certificate shall certify that the CONTRACTOR has in full force and effect errors and omissions coverage in the amount of $1,000,000 per occurrence as well as automobile and general liability insurance in the amount of $1,000,000 combined single limit, and statutory workers' compensation insurance coverage. The CITY shall be all additional named insured on CONTRACTOR'S automobile and general liability insurance. CONTRACTOR shall provide CITY an endorsement specifically evidencing CITY as additionally named insured. 9. INDEMNIFICATION CONTRACTOR shall indemnify, hold harmless and defend CITY, its officers, officials and employees from any and all loss, liability, cost and damages (whether in contract, tort or strict liability, including but not limited to personal injury, death at any time and property damage) incurred by CITY, CONTRACTOR, or any other person, and from any and all claims, demands and actions in law or equity (including attorney's fees and litigation expenses), arising or alleged to have arisen directly or indirectly out of the services provided under this contract. CONTRACTOR'S obligations under the preceding sentence shall apply regardless of whether CITY or any of its officers, officials, employees or agents are actively or passively negligent, but shall not apply to any loss, liability cost or damages caused solely by active negligence or willful misconduct of CITY. CONTRACTOR shall not be liable for any action taken at the express direction of CITY which is a violation of any state or federal law or regulation. 10. RECORDS OWNERSHIP All claim files, loss reports, payroll information and other documents and materials shall be the property of the CITY. Said documents are subject to audit by an independent agent or contractor of CITY's choice and at CITY's expense. Adequate notice of such an audit shall be thirty (30) days. All information and reports described in this section shall be delivered to CITY upon termination of this Agreement. Additionally, all documentation generated by contractor in performance of this Agreement shall be made available for review and copying by the CITY upon reasonable notice. CONTRACTOR agrees not to release any report, any portion thereof, or any result of any investigation it may undertake on behalf of CITY to any outside person or agency without the express written consent of CITY, except as provided in this Agreement. 3 11. TERMINATION Either party hereto shall have the right to terminate this Agreement at any time upon giving the other party hereto sixty (60) days' written notice prior to the effective date of such termination, unless a shorter period is mutually agreed. Upon termination of Agreement, CONTRACTOR shall be entitled to only that pro rata fee based upon work actually accomplished as of the effective date of the termination. Any monies paid to the CONTRACTOR in excess of the pro rata fee shall be refunded to CITY. 12. RENEWAL After the initial contract period (3/1/95 to 2/28/97), this Agreement may be renewed from year to year by mutual written consent. Any proposed revisions to or renewal of this Agreement must be in writing. Renewal Agreement must be submitted no later than sixty (60) days prior to the expiration of this Agreement. IN WITNESS WHEREOF, the parties hereto have entered into this Agreement the day and year first above written. RENAISSANCE RISK MANAGEMENT BY_ �--, THOMAS V. Vim.. MILLER, CEO 4 CITY OF SAN RAFAEL BY ZBW-T J. Mayor ATTEST: J NNE M. LEO CINI, City Clerk ATTACHMENT A CONTRACTOR'S STATEMENT OF SERVICES On behalf of CITY, CONTRACTOR agrees to perform the following services in connection with CITY's Workers' Compensation Program: I. Claims Administration A. Determine liability of claimed injuries and illnesses in accordance with California Workers' Compensation Laws. B. Review and process all claims in accordance with rules and regulations established by the Division of Industrial Relations, Department of Self -Insurance Plans. C. Establish files containing medical and factual information on each reported claim together with complete accounting records and maintain same in accordance with statutory time requirements. D. Compute and pay temporary disability benefits to injured employees based on earnings information and authorized disability payments. E. Determine nature and extent of permanent disability and arrange for informal disability rating whenever possible to avoid Office of Benefit Determination and Workers' Compensation Appeals Board litigation. F. Explain to and assist employee in completing necessary forms for permanent disability rating. G. Review, compute and pay all informal ratings, findings and awards, life pensions or compromise and release settlements. H. Maintain and establish reserve estimates for each reported claim. I. Arrange for and supervise all necessary investigation to determine eligibility for compensation benefits and/or liability of negligent third parties. J. Handle excess reinsurance claims on CITY's behalf, complying with all conditions of reinsurance contract. Submit billings and collect paid losses in excess of self-insurance retention. K. Arrange and supervise rehabilitation services where indicated. L. Maintain all payroll and loss information as required by Workers' Compensation Attachment A - Page 1 Rating Bureau. M. It being acknowledged that CITY shall at all times provide funds for adequate payment of reported claims or losses and of allocated loss expenses, (for purposes of this contract, allocated loss expense shall mean all costs, charges or expenses of third parties incurred by CONTRACTOR, its agents or its employees which are properly chargeable to a reported claim or loss, and approved in advance by CITY when required, including, without limitation, court costs, fees and expenses of attorneys, investigators, experts and witnesses, and fees for obtaining diagrams, reports, documents and photographs), arrange for and set up system for payment of benefits and allocated expenses in accordance with CITY needs. N. Assist in the preparation of all reports which are now, or will be required by State of California or other government agencies, including Cal -OSHA reports, regarding self- insured and self-funded programs. O. Assist CITY in maintaining adequate balance in workers' compensation checking account by producing weekly, or at other agreed-upon interval, check register, as a basis for funding of the account. P. Prepare quarterly claims summary reports of claims designated by the City and participate in quarterly reviews of said claims with the City. II. Medical Administration A. Select, with CITY approval, a panel of general practitioners, specialists, hospitals and emergency treatment facilities to which injured employees should be referred. Review and update panel on a regular basis. B. Authorize, review and monitor all medical treatment required on injury or illness claims. Audit and pay all medical expenses. C. Maintain close contact with treating physicians to ensure employees receive proper medical treatment and are returned to full employment at earliest date. D. Arrange for medical -legal opinions in disputed cases, conferring with medical examiners, CITY, and legal counsel where indicated. E. Consult frequently with CITY in those cases where injury residual might involve restriction and/or retirement potential. III. Lep-al Administration A. Refer litigated cases to attorneys recommended by CONTRACTOR and approved by Attachment A - Page 2 CITY for purposes of defending CITY interests before the Office of Benefit Determination and the Workers' Compensation Appeals Board and the courts. B. Work closely with counsel in preparing defense of litigated cases. C. Obtain CITY authorization on all settlements or stipulations. D. Work closely with applicant's attorney and legal counsel in informal dispositions of litigated cases. E. Attend, where indicated, Workers' Compensation Appeals Board hearings and conferences before Bureau Consultants of the Rehabilitation Bureau. F. Discharge on behalf of CITY, all legal obligations to its injured employees imposed by Office of Benefit Determination, Workers' Compensation Appeals Board and higher courts. G. Protect and preserve CITY interest in all potential subrogation cases. IV. EmDlovee Services A. Develop with CITY, materials which will provide information and guidance to employees regarding Workers' Compensation and the Self -Insurance Program. B. Meet and confer with CITY to review and update them on Workers' Compensation benefits and self-insurance. C. Meet -with and assist injured employees in resolving problems that arise from injury or illness claims. V. Statistical A. Produce reports from on-line database describing status of claim payments and reserves on an individual claim basis and in the aggregate, and assist in development of loss analysis reports as needed by CITY for ad hoc projects or news releases. B. Assist in preparation of all reports required by the State of California or other governmental agencies relating to workers' compensation claims. VI. File Storage A. CONTRACTOR shall maintain claim files with an open status on site at CONTRACTOR'S adjusting location. Attachment A - Page 3 V B. CONTRACTOR will maintain closed files at CONTRACTOR'S location unless otherwise directed by CITY. VII. Miscellaneous A. CONTRACTOR agrees that Ms. Sue Stone shall be the dedicated claims examiner assigned to handle CITY claims. In the event that there is a change in the claims examiner assigned to the CITY account, CITY shall have the right to approve such staff change prior to implementation. B. CONTRACTOR shall obtain prior CITY approval of all assignments for legal, rehabilitative or investigative services. Attachment A - Page 4