HomeMy Public PortalAboutORD13723 BILL NO, 2004-14 Substitute
SPONSORED BY COUNCILMAN WEBER
ORDINANCE NO. / J, V)
AN ORDINANCE OF THE CITY OF JEFFERSON, MISSOURI, AUTHORIZING THE
MAYOR AND CITY CLERK TO EXECUTE AN AGREEMENT WITH CCMI FOR CLAIMS
MANAGEMENT SERVICES.
WHEREAS, CCMI is engaged in the business of the administration, investigation and
payment of claims arising from self-insured workers'compensation and casualty programs;
and
WHEREAS, in conjunction with City's property and casualty insurance program through
St. Paul, a plan and claim administration agreement is required with CCMI
BE IT ENACTED BY THE COUNCIL OF THE CITY OF JEFFERSON, MISSOURI, AS
FOLLOWS:
Section 1 . The Mayor and City Clerk are hereby authorized to execute an
agreement with CCMI.
Section 2. The agreement shall be substantially the same in form and content
as that agreement attached hereto Exhibit A.
Section 3. This Ordinance shall be in full force and effect from and after the
date of its passage and approval.
Passed: Approve
Officer G� Mayor
ATT 7siding
APPROVE? AS TO)FORM:
City Clerk City dounselor
A
CLAIMS ADMINISTRATION AGREEMENT
THIS AGREEMENT is made as of June 8, 2004, between Corporate Claims Management, Inc., a corporation
organized and existing under the laws of the State of Missouri (hereinafter "Administrator") and the City of
Jefferson, Missouri, a municipal corporation organized and existing under the laws of the State of Missouri
(hereinafter"Client").
WITNESSETH:
WHEREAS, Administrator is engaged in the business of the administration, investigation and payment of
Claims arising from workers' compensation Programs for its Clients; and
WHEREAS, Client has entered into a self-insurance Program which requires the services of an independent
contractor to administer its workers'corn pensation Claims arising during the term of such agreement; and
WHEREAS, Client desires to retain Administrator for the provision of its services for Client's Claims for its
self-insured workers' compensation Program to the extent as set forth in the following articles of this
Agreement;
NOW THEREFORE, in consideration of the mutual promises and covenants hereinafter contained, and other
good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties
® hereto, intending to be legally bound, hereby agree as follows:
1. Definitions
As used in this Agreement, the following terms shall have the following meanings:
(a) "Agreement" shall mean this Agreement, as originally executed and amended or supplemented
from time to time.
(b) "Allocated Loss Adjustment Expense" shall mean such of the following items of expense incurred or
authorized by Administrator on behalf of Client as may be reasonable and necessary in connection
with Administrator's rcndition of services in accordance with this Agreement:
i. Medical examinations of Claimants, including the reasonable and necessary transportation
expenses of Claimants.
ii. Reports from attending or examining physicians.
iii. Attorneys' fees and disbursements.
iv. Court reporter services and transcripts.
V. Stenographic services and transcripts.
Avi. Witness attendance fees.
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vii. Court costs.
viii. Appeal bonds.
ix. Printing costs related to trials and appeals.
X. Testimony, opinions, appraisals, reports, surveys, and analyses of professionals and
experts.
xi. Trial and hearing attendance fees.
xii. Reports to or from government agencies or branches.
xiii. Credit bureau reports.
xiv. Private investigators.
xv. Photographs.
xvi. Medical or vocational rehabilitation.
xvii. Medical cost containment services including but not limited to hospital bill audit, provider
bill audit, and medical case management incurred with the consent of Client.
xvUL Extraordinary Claim investigation rind/or travel expense incurred with the consent of
Client.
xix. Fees for services provided by any investigation or adjusting firm other than Administrator
related to the investigation and defense of a particular Claim.
xx. Any similar service related to the investigation and defense of a particular Claim, or the
protection of and collection of the subrogation rights of the Client, for which Client shall
have given prior approval.
xxi. Costs, fees and expenses associated with submission of Claim data to the Central Index
System.
xxii. Costs, fees and expenses associated with the required submission of Claim data to state
regulatory agencies via electronic data interface (EDI).
xxiii. Costs, fees and expenses incurred by Administrator for services above and beyond those
covered by this agreement with prior approval from Client.
(c) "Claim" shall mean any occurrence from which injury, damage, or expenses are sustained or
asserted or from which liability under the Missouri Workers Compensation Law is alleged.
(d) "Claimant" shall mean any person alleging or having a right to file a Claim against the Client for
® damages as a result. of Client's duty or breach of duty under any various Workers' Compensation or
Civil laws.
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(e) "Client Program" or the "Program" shall mean the Client's self-insured workers' compensation plan
which qualifies in all respects to such Programs as defined in the Missouri Workers' Compensation
Law, as such law is herein defined.
(f) "Claims Payment Account" (or 'Loss Fund') shall mean a bank account to be established by
Administrator to which Client will contribute the amounts agreed and from which Administrator
may draw funds to pay Claims and Allocated Loss Adjustment Expenses required in the
administration of Client's Program covered by this Agreement..
(g) "Party" shall mean Client or Administrator as the context requires, and the term "Parties" shall
mean both Client and Administrator.
(h) "Loss Run" shalt mean a computer generated listing of Claims that have been posted to
Administrator's Claims Administration Information System.
(i) "Loss Payment Accounting Record" means a computer generated listing of accounting activity in
the Claims Payment Account as described below, during the preceding month that has posted to
the Administrator's Claims Administration Information System.
(j) "Administrator's Authority Limit" shall mean the amount of Claim settlement authority provided by
the Client to Administrator for each Claimant, set forth in writing from time to time, which
Administrator may utilize in its sole judgment to settle Claims as described. Administrator's
Authority Limit does not :efer to, nor is it intended to restrict Administrator's ability to issue
periodic and regular payment of statutorily required amounts owed to Claimants on clearly
compensable Claims as agreed to by the Parties.
(k) "Missuuri Workers' Compensation Law" shall mean such Law as defined in Chapter 287, revised
Statutes of Missouri, as amended, and as such Law may be amended from lime to time during the
term of this Agreement, including any renewal or extension of such term.
2. Term
Administrator agrees to provide all services set forth herein to Client in connection with its Workers'
Compensation Claims exposures Occurring during the period commencing .July 1, 2004 and ending June 30,
2006, unless earlier terminated pursuant to Section 3 hereof. With the Consent of both parties, the
contract may be renewed for three (3) additional one (1) year periods at an increase of 3%each year.
3. Termination
Unless explicitly renewed by the Parties in writing, this Agreement shall terminate on June 30, 2006. With
the consent of both parties, the contract may be renewed for three (3) additional one (1) year periods at
an increase of 3% each year. This Agreement may be terminated at any time with or without cause by
either Party giving the other Party written notice of termination sixty (60) nays prior to the effective date
of such termination.
If this Agreement is terminated by Client before June 30, 2006, Client may require Administrator to
conclude the handling of all Claims occurring during the term of this Agreement whether reported before
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or after the term of this Agreement, subject, however, to the terms, conditions and limitations of this
Agreement. Such termination shall not. result in a reduction in fees paid to Administrator prior to the
effective date of termination.
4. Compensation
Administrator shall provide all claims administration services for an annual fee of $18,000.00 for the initial
term of this agreement. With the consent of both parties, the contract may be renewed for three (3)
additional one (1) year periods at an increase of 3% each year.
5. Services To Be Performed
Administrator shall adjust, supervise, and administer fully the Client's Program in a manner so that such
Program is at all times in full compliance with all current and future applicable laws, rules and regulations
governing such Workers' Compensation Programs; and, in fulfilling the foregoing obligations, Administrator
will act as the independent contractor and/or representative of Client in all matters related to the
administration of the Program.
In addition to the foregoing obligations, Administrator hereby agrees to perform fully all of the following
duties:
(a) To review all Claim and/or loss reports with Claim and/or dates incurred during the term
of this Agreement for all losses involving the hereinabove stated exposures to the Client.
(b) To establish a file with respect to each Claim.
(c) To investigate, to the extent deemed necessary in the mutual judgement of the Parties,
all reported Claims as defined in Section 1 above.
(d) To provide each Claim file with a written chronology of all actions taken with respect to
the underlying Claim.
(e) To furnish all Claim forms necessary for proper Claims administration.
(f) To investigate, adjust, settle or resist all such losses and/or Claims as defined in Section 1
above within the per Claim discretionary settlement authority limit of the Administrator
as agreed upon by Administrator and Client.
(g) To investigate, adjust, settle or- resist all such losses and/or Claims as defined in Section 1
in excess of the discretionary settlement authority limit of the Administrator with specific
prior approval of the Client..
(h) To assist in all litigation or other proceedings involving any Claim as directed by Client.
(i) To retain all Claim files for a period of two (2) years after the applicable statute of
limitations has expired. After this period, files will be returned to the Client or destroyed
as Client requests.
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(j) To recommend adequate reserves and provide to Client a continuous review of such
reserves and any required changes t.o such reserves.
(k) To monitor all treatment Programs recommended to a Claimant by any care provider.
(t) To furnish to Client and/or its designees on a monthly basis, a Loss Run and Loss Payment
Accounting Record Report. Administrator also shall furnish to Client and/or its designees
on an as requested basis ad-hoc reports as may be available within its Claims
administration system,
(m) To establish a designated bank account for the benefit of the Client and its insurer (the
'Loss fund'), to be funded by the Client., to be used solely for the purpose of the payment
by Administrator of Claims and allocated loss adjustment expenses incurred by Client as
defined in this Agreement, associated with Claims for which the Administrator is providing
services hereunder, and for the deposit of recovery amounts, including, without
limitation, subrogation and adjustment reimbursement:, from Claim and/or allocated toss
adjustment expense amounts previously paid from such Loss Fund account ('Recoveries').
Such funds shall not be co-mingled with any other funds including, but not limited to,
funds from other of Administrator's Clients and Administrator's general operating funds.
All banking arrangements established by Administrator shall comply with state laws and
regulations.
(n) Provided that Client has first presented Administrator with sufficient funds in the 'Loss
Fund' to cover such payment amounts, to issue all payments required to be made in the
administration of Client's Program and provide to Client a monthly record of all such
payments.
(o) To prepare and file all reports required by any current or future applicable law, rule or
regulation.
(p) Discretionary settlement authority, as referred to in Section (F) Ft (G) above is $ 0 .00
per Claimant. Notwithstanding the foregoing, this discretionary settlement authority level
will in no way prohibit Administrator from paying statutory benefits on clearly
cornpensable cases as determined by the Parties.
b. Covenants and Agreements of Client
Client covenants and agrees as follows:
(a) Client appoints Administrator as its Claims management company, as its agent and
authorized Administrator to exercise in Client's behalf, Administrator's sole judgement
and discretion to pay, settle, or resist all Claims within Administrator's discretionary
settlement authority as stated in Section (5.0) above. Client reserves the right to advise
Administrator to riot pay any particular Claim or to pay a lessor amount even within
Administrator's discretionary settlement authority.
(b) To pay to Administrator the fees prescribed in Section 4. If Client fails to pay
Administrator the fees prescribed in Section 4 and/or in accordance with the time frames
set forth therein, Administrator may terminate this Agreement immediately,
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notwithstanding the sixty (60) clays prior written notice set forth in Section 3. In the event
Of Such immediate Agreement termination, the options upon termination as set forth in
Section 3, shall not be available to Client, but instead Administrator shall immediately
cease work on all pending Claims, and return Lo Client all Claims and/or losses pending on
the date of such termination for the Client to handle Lo a conclusion, and such handling
shall not result in any expense or redaction of fees to Administrator.
(c) To pay all Allocates! Loss Adjustment Expense, as defined herein, in addition to the fees
to be paid to Administrator as prescHhed in Section 4 hereof.
(d) To indemnify, protect, save, defend and hold Administrator and Administrator's directors,
officers, attorneys, employees, shareholders, agents and other representatives wholly
harmless from and against any and all loss, cost, damage or expense (including attorney's
fees and costs incurred by Administrator in connection therewith) arising out of the
administration or handling of any Claims by reason of any negligent, grossly negligent, or
Willful act or omission of Client or of Client's directors, officers, shareholders, attorneys,
employees, agents or other representatives, taken or ornitte-.d to be taken pursuant to this
Agreement, including, without limitation, any such loss, costs, damage or expense
incurred by reason of the following;
i. Any act or omission of Administrator or any of Administrator's directors, officers,
attorneys, employees, agents or other representatives taken or omitted to be taken at
the direction of Client or any of Client.',, directors, officers, shareholders, agents, or
other representatives;
® fl. Administrators being named in litigation as the insurer of record or other capacity based
upon its present or past retationshih with Client;
iii. The failure of Administrator or Administrator's directors, officers, attorneys,
shareholders, errrp(oyees, agents or other representatives to settle a Claire that could
have been settled wit.hin Adininistrator's Authority Limit. (so tong as such failure
Lo-settle does not result from a negligent, grossly negligent, or willful act, error or
omission by Administrator or by any of Administrator's directors, officers, shareholders,
attorneys, employees, agents or other representative); or
iv. The failure of Administrator or Administrator's directors, officers, shareholders,
attorneys, employees, agents or other representative} to pay any Claim or Allocated Loss
Adjustment Expense on a timely basis due to the failure of Client or Client's directors,
officers, Shareholders, attorneys, employees, agents or other representatives to comply
with Section 6, subparagraphs (e) and (f) hereunder.
In the event Administrator or any of its directors, officers, shareholders, attorneys, employees, agents or
other representatives, is named as a defendant in, or is otherwise obligated to defend, any such action
asserting any Claim indemnified hereunder, Client will assume, at Client's expense, the defense of such
actions on behalf of Administrator and its directors, officers, shareholders, attorneys, employees, agents
or other representatives, as the case may be. Client shall have the sole discretion to select the attorneys
who wilt defend any such action, provided, however, that Client shall exercise such discretion reasonably.
Notwithstanding the foregoing, nothing herein shall waive any rights of any Party hereto to contributory
negligence Claims or defenses with respect. t.o any indemnity provided herein. This indemnity shall survive
termination of this Agreement.
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(e) To provide, in an amount. consistent with the requirements of (Nance of Insurer),
Administrator with sufficient funds in its 'Loss Fund' to enable Administrator at all times
to pay Claims and Allocated Loss Adjustment Expanses in accordance with the terms and
conditions contained herein.
(f) To authorize and hereby does authorize Administrator to issue payments as may be
necessary to enable Administrator to pay Claims. Administrator may also issue payments
as may be necessary to enable Administrator to pay all Allocated Loss Adjustment
Expenses. Client agrees that Administrator shall slave no duty to issue payments on
Client's behalf unless Client has previously deposited sufficient funds in Administrator's
'Loss Fllnd' to honor such payments.
Sectiort7. Covenants and Agreements of AdtninistiMor
Administrator covenants and agrees as follows:
(a) To Client's right. to ISSLI[Ile the control and handling of any Claim at any time, and
Administrator agrees to deliver promptly any Claire file to Client which it. may request,
but without any offset or deduction of the fees or charges paid or payable by Client to
Administrator under Section 4 above. The Parties agree that al. all times prior to and after-
the cancellation of this Agreement, all Claim files are owned by and are the property of
Client. Claim files are subject to review by Client and its employees and authorized
agents during Administrator's regular business hours, with reasonable pr for notice.
(b) To exercise reasonable efforts to manage the Services provided hereunder in such a way
and in such manner as to insure that every adjuster, Claims investigator, and/or employee
used by the Administrator or subcontracted to by the Administrator will adjust and/or
investigate every alleged Claim or matter covered by this Agreement in accordance with
this Agreement and any Clairn handting instructions as implemented from time to time.
(c) To provide to Client, upon written request, certificate of insurance evidencing adequate
General Liability Insurance, AutonlUl.�ile Liability Insurance, Workers' Compensation
Insurance, Fidelity Covetage (frond) and Errors and Omissions Insurance (Professional
Liability Coverage).
(d) To provide all necessary personnel to perform the services agreed upon herein.
(e) To indemnify, protect, save, defend and hold Client and Client's directors, officers,
shareholders, attorneys, employees, agents and other representatives wholly harmless
from any and all loss, cost, damage or expense arising out of the administration or .
handling of any Claims by reason of any negligent., grossly negligent or act or omission of
Administrator or of Administrator's directors, officers, shareholders, xtorneys,
employees, agents or other representatives, taken or omitted to be taken pursuant to this
Agreement; provided, however, taut. Administrator shall have no obligation to indemnify
anyone pursuant hereto with respect to the following:
i. Any act or omission of Administrator or any of Administrator's directors, officers,
• shareholders, attorneys, employees, agents or other representatives taken or omitted to
be taken at the direction of Client or any of Client's directors, officers, shareholders,
attorneys, employees, agents or other representatives,
ii. Administrator being named in litigation as the insurer of record,
iii. The failure of Administrator or Administrator's directors, officers, shareholders,
attorneys, employees, agents or other representatives to settle a Claim that could have
been settled within Administrator's Authority Limit (so long as such failure to settle does
not result. from a grossly negligent or' willful act, error or omission by Administrator or by
any of Administrator's directors, officers, shareholders, attorneys, employees, agents or
other representatives), or, the failure of Administrator or- Administrator's directors,
officers, shareholders, attorneys, employees, agents or other representatives to pay any
Claim or Allocated Loss Adjustment Expense on a timely basis due to the failure of Client.,
Client's directors, officers, shareholders, attorneys, employees, agents or other-
representatives to comply with Section G, subparagraphs (e) and (f) of this Agreement.
In the event Client or any of its directors, officers, shareholders, attorneys, employees, agents or
other representatives, is named as a defendant in, or is otherwise obligated to defend, any such action
asserting any Ciainl indemnified hereunder, Administrator will assume, at Administrator's expense, the
defense of such actions on behalf of Client and its directors, officers, shareholders, attorneys, employees,
agents or other representatives, as the case may be. Administrator has sole discretion to select the
attorneys who will defend any such action, provided, however, that Administrator shall exercise such
discretion reasonably. Notwilhslanding the foregoing, nothing herein shall waive any rights of any Party
hereto to contributory negligence Clain-is or defenses with respect to any indemnity provided herein.
8. Miscellaneous:
(a) This Agreement shall be governed and constructed in accordance with the laws of the
Stale of Missouri.
(b) If any provision of this Agreement shall be held to he invalid or unenforceable for any
reason, such invalidity or tinenforceability shall not affect any other provisions of this
Agreement..
(e) No waiver or, modification of this Agi*eenient or of any covenant, condition or limitation
Contained shall be valid unlrs, in writing Mid duly exec rrted by the Parties.
(d) The failure of either Party to insist, in any one or rube instances, upon performance of
the terms or conditions of this Agreement shall not be construed as a waiver or a
reliruluishment of any ric;ht granted hereunder or of the future performance of any such
term, covenant, or condition.
(e) This Agreement is personal to the Parties and may riot he assi+;nerd by either- Party in
whole or it) part without prior written consent of the other Party.
(f) Any notice to be given hereunder shalt be deemed sulficient if in writing and delivered
either personally or by certified mail, return receipt requested, to the following:
If to Administrator: Michael D. Greco:, President
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Corporate Claims Management, Inc.
7132 Spirit 40 Park
Chesterfield, Missouri 63005
If to Client: Nathan Nickolaus, City Counselor
City of Jefferson
320 E. McCarty
.Jefferson City, Missouri 65101
(g) The headings of this Agreement are intended solely for convenience of reference and shalt
have no effect on the construction or interpretation of this Agreement.
(h) In the event of any litigation between the Parties, the prevailing Party shall be entitled to
recover from the non-prevailing Party any attorney's fees and expenses incurred.
(i) This Agreement shall be binding upon -ind inure to the benefit of each Party hereto and
their respective permitted Successors and permitted assigns.
IN WITNESS WHEREOF, the Parties by their authorized agents have caused this Agreement to be executed
as of the date first written above.
On BP,hatf�of CITY OF JEFy'LRSON On Behalf of CORPORATE CLAIMS MANAGEMENT
J0 n Landwehr, Mayor ^ `Michael D. Greco, President
Attest:_,.
Phyllis PAell, City Clerk
Approved a . form: '
Nathan NickolauS, City Caunselor
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nn
CLAIMS ADMINISTRATION AGRI?I: MFNI'
THIS AGREEMEN'r is made as of November I, 2004, between C'o►porate Claims Management,
Inc., a corporation organized and existing under the laws of the State of Missouri (hereinafter
"Administrator") and The City of.lcftcrson City, Missouri (hcreinaflcr "Client").
WITNESSE?Tl-l:
WHEREAS, Administrator is engaged in the business of the administration, investigation and
payment of claims arising from self-insured workers' compensation and casualty programs tier its
clients; and
WHEREAS, Client requires the services of'an independent contractor to administer its self'-insured
property/casualty program up to its self'-insured retention; and
® WHEREAS, Client desires to retain Administrator filr the provision of its services for Client's
claims for its sell=insured property/casualty program to the extent as set firth in the following
articles of this Agreement;
NOW THEREFORE, in consideration of'the mutual promises and covenants hereinafter contained,
and other good and valuable consideration, the receipt and sufficiency of which is hereby
acknowledged, the parties hereto, intending to he legally bound, hereby agree as follows:
1. Definitions
As used in this Agreement, the following terms shall have file lollowing meanings:
(a) "Agreement" shall mean this Agreement, as originally executed and amended or
supplemented from time to time.
(b) "Allocated Loss Adjustnlcllt L"xpense" shall mean such of' the following items of expense
incurred or authorized by Administrator on behalf of Client as may be reasonable and
necessary in connection with Administrator's rendition of services In accordance with this
Agreement:
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® i. Medical examinations of claimants, including the reasonable and necessary
transportation expenses of claimants.
ii. Reports from attending or examining physicians.
iii. Attorneys' Ices and disbursements.
iv. Court reporter services and transcripts.
V. Stenographic services and transcripts.
vi. Witness attendance fees.
Vii. Court costs.
iii. Appeal bands.
ix. Printing costs related to trials and appeals.
X. Testimony, opinions, appraisals, reports, surveys, and analyses of professionals and
experts.
A Automobile and Property appraisals.
xii. Trial and hearing attendance fees.
xiii. Reports from government agencies or branches.
xiv. Credit bureau reports.
xv. Private investigators.
xvi. Photographs.
xvii. Medical or vocational rehabilitation.
xviii. Medical cost containn►cnt scrviccs including but not limited to hospital bill audit,
provider bill audit, and medical case managcmcnt incurred with the consent of
Client.
xix. Extraordinary claim investigation and/or travel expense incurred with the consent of
Client.
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xx, Bees tilt- services provided by ally investigation or adjusting firm other than
Administrator related to the invcstigatiOn ►111d (IetcllSC 01'a particular Claim.
xxi. Any similar scrvicc related to the investigation and defense (►f'a particular Claim, ()r
the protcclion o1' and collection ul' the subrogation rights Of' the Client, far which
Client shall have given prior approval.
xxii, Costs, Iccs and expenses incurred by Administrator tar services above and beyond
those Covcrcd by this agreement.
(c) "Claim" shall mcan ally OCCUITCncC fi-Onl which injury, dairta):;c, or expenses are sustained or
asserted or front which liability under various Missouri Tort Statutes is alleged.
(d) "Claimant" shall any person alleging or having a nigh! to file a claim against the client
tier damages as a result ol'clicnt's duty Or brCach Of duty un(ICr any various Civil laws.
(e) "Client Program" or the "Program" shall mean the C hCnt's sell=illSUrCd property/casualty
progra111 as till: Context i'C(11111•CS.
(f) "Claims Payment Account" shall mean a hank ICCUllnt to he C tabliSllCd by Client and to
which Client will contribute the anlc►u11tS lgl-CCd hereunder and From which Administrator
may draw Rinds to ilay claims and Allocated loss A(1juSlmCllt 1::xpeilses rCduired in the
administration of'Cliclit's Program covered by this Agreement.
(g) "Party" Shall ilican Client or Administrator as tl1c context 1'e(IuireS, and the terin "Parties"
Shall mean both Client and Administrator,
(h) "Loss Run" shall nlearl a computer gcnertltCd listing of clainis that have heen posted to
A(hllinistrator's Claims Adnlinistratioll Inli►rnlation `'ystCnl.
(1) "Loss Paylllent ACCOUnting RCCOrd" 111Ca11S a Computer gCnerate(i listi►lg o1' 11CCOU11tirig
activity in the C'lainls Payment Account, as (ICSCribCd bcloW, during the prCCCding month
that has posted to the Administrator's Claims Administration I11161'lllation System.
(j) "Administrator's Authority Ijillit" shall mean the amount o1' claim settlement authority
provided by the Client to Administrator lilt' each claimant, Set fi►rtli ill writing 11-olil tittle to
time, which Administrator play utiliv.0 in its sole ju(Igement to settle claims as described
herein.
2. Term
Administrator agrees to provide all services set forth herein to Client in connection with its
sClf=insured claims CxpOSUrCS reported during the period commencing November 1, 2004, and
ending October 31, 200;5, unless CurliCr tcrlllinatcd pursuant to Section 3 hereof'.
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3. '1'et711ination
Unless explicitly renewed by the Partics in writing, this Agreement shall lerminate on October 31,
2005, Any continuation or renewal of this Agreement shall he the subiect of further negotiation
between Client and Administrator, if renewal or continued, the price for Claims Administration
Services for the period of November 1, 2005 through Octohcr 31, 2006 will be based on the current
year's fi-cquency of Claims rcportcd, calculated at the per Claimant rates established in this
agreement plus an amount not to exceed the lesser of'(i) the change in the Broad Based Consumer
Price Index during the terns of'lhis agreement plus two percent (CPI + 2'rn) or(ii) six percent (6%0).
This Agrcenlent may be canceled at any time with or without cause by either Party giving. the other
Party written notice of'canccllation sixty(60) clays prior to the efl 0k c date of such cancellation.
if' this Agreement is can-.Ucd by Client bcibrc 00ohcr 31. 2005 Ibr any reason, C'licnt shall
exercise one of'thc hollowing options:
(a) Client may require Administrator to C011CILKIC the harldling of' all claims occurring during
the term of this Agreement whether reported before or after the term of this Agrcenlent,
subject, however, to the terms, conditions and limitations of this Agreement. No further
compensation shall he owcd to Administrator t6r Its handling of C'I:.tins reported prior to
the Termination ofthis Agrcenlent to their conclusion.
(b) Client may require Administrator to return all 011cn and/or finali;ccl tiles to the Client. SL1C11
return of open and/or finalized files shall riot result in a reduction in fees for all, Claims
referrccl to Administrator but not finalized prior to the effective date of termination.
4. Compensation
Client shall pay Administrator ices as follows as compensation for the administrative services
Administrator herein agrees to perform:
Administrator shall provide all claims administration services as detailed in this Agreement for
an annual fee of'`1;25,056.00 Ian• new claims reported during the term of the agreement.
Administrator reserves the right to offer Guaranteed Cost renewal pricing lilt subsequent years of'
this program contingent upon clallll 11-cciLte116cs rcportcd during the most recent past year.
Pricing for subsequent year:5 claims administration fees will be based upon the last year's actual
frequency, times the per-claimant Ilaf-rates detailed below, plus an amount equal to the change in
the broad-based Constmer Price IlldCX (CPI-U) plus 2 percent (2"O) during the previous 12
month period.
All fees will be billed quarterly during the 'ferns of the Agrcenlent, except as detailed below ill
this section.
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Guaranteed Cost Renewal pricing for subse(lucrtt years renewal of this program shall utilize tilt
following price schedule as a basis tier such pricing (plus the change in tile, ('PI-U Iglus two
percent during tile previous 12 moth period):
Type otTasc Expected Flat Rate Projected
1'l•c(luency Per Claimant 'Focal
General Liability --- x $457.00 $ --------
Auto Liability --- x $ 157,00 S --------
Auto Phys. Damage --- x $37.1.00 --------
Errors & Omissions --- x $457.00 ; --------
Personallnjury --- x $ 157,00 ; --------
Quarterly Management Claim Reviews No Charge
Monthly Loss Runs/Special Reports $ No Charge
Total Claims Adiiiinistration I,.xpcctc(I Cost - New C hints $ 25,056.00
ADDITIONAL FHES:
NONE APPIACA131.F
Client agrees to pay Administrator ;Ill Ices as outlined in this section. Dees liar Claims h;uldling shall
be billed cm the first of the month ol•C;ICII C;Ilcn(lar ({uartCI- during I.11C Term Of'tllk aL;1•ecnlent, 411(1
such billings will be paid by ( 'liens within thirty (30) (lays ol•suCll hitting,.
5. Services To 13C Perlbrnled
Ad1111111strator ~hall a(Ijust, s(IpCrvise, ;111(1 administer tally the C'lient's Program ill a planner so that
such Progralll Is at ;111 t1111Cs ill hill C0111111ia11CC with all CUITC11t atl(I lll(Ure applicable law~. Pules and
regulations governing such sell-insured programs; and, ill (611111ing tile, lclregoin , obligations,
Administrator will act as the indepelldc11t contractor and/or represc11tative of(.'licnt in 1111 matters
related to the administration ol'the Pi-ogram.
J
In addition to the foregoing obligations, Administrator hereby agrees to pulbrin fiilly rill of the
flollowing duties:
(a) To review rill cluing and/or loss reports with claim and/or dates incurred during the tarn cif
this Agreement flor all losses involving the hereinabovc stated exposures to tilt Client,
(b) To establish a file with respect to each claim.
(c) To investigate, to the extent deemed necessaly in the mutual judgement of the Panties, all
reported Claims as defined in Section i above.
(d) To provide each Claim file with a written chronology ol'all actions taken with respect to the
underlying Claim.
(c) To furnish all claim lorms necessary for proper claims administration.
(f) '1'o investigate, adjust, settle or resist all such losses and/or Claims as defined in Section 1
above within the per claim discretionary settlement authority limit of the Administrator as
agreed upon by Administrator in([ Client.
(g) To investigate, adjust, settle or resist all such losses and/or claims as defined in Section 1 in
excess ol'the discretionary settlement authority limit of'thc Administrator with specific prior
approval of'the Client.
(I,) To assist in all litigation or other proccedings involving;any Claim as directed by Client.
(i) To retain all Claim files fin• a period uf' two (2) years alter the apphcablc statute of
limitations has expired. After this period, files will be returned to the Client or destroyed as
Client r•ecfuests.
(j) To recommend adequate reserves and provide to Client a continuous review of such
reserves and any rccluil—W changes to such reserves.
(k) 'i"o monitor all treatment programs recommended to a Claimant by any care provider.
(1) To furnish to Client and/or its designees on a monthly basis, a Loss Run and LOSS Pay'ltlent
Accounting, Record Report. Administrator also shall Furnish to Client and/or designees oil
iln as re(ILICStCd baSiS WHIM I-Cports as Illay be available within its claillis administration
system.
(m) To pay on claims check stock provided by Client, all payments required to be made in the
administration of C'lient's Program and provide to Client a daily record of all such payments.
•
6
(n) To prepare and file all reports re(luire(I by ally current or filture applicable law, rule or
regulation.
(o) Discretionary settlement authority, as relcrrcd to Ill Section (I") & (Ci) above is $0.00 per
claitnanl.
6. Covenants and Agreements ol'Clicnt
Client covenants and igrecs ifs 161lows:
(a) Clieilt appoints Administrator as Its claims managcnlellt colllpany, as Its agent and
authorized Administrator to exercise in C'lient's behalf; Administrator's sole juc.lge 1 11 t and
discretion to pay, settle, or resist all claulis within Adnillllstrator's (llscrctlonary settlement
authority as stated :n Section (5.0) above. Client reserves the right to advise Administrator
to not pay ally part ic1lIll- claim of to pay a lessor alll(lUnt even within A(Inlinistrator's
discretionary settlement authority, i 1',111y.
(b) To pay to Administrator the Ices prescribed in Section 4. If client fails to pay Administrator
the tees prescribed 111 Section 4 and/or in accordance with the tinic franics set firth therein,
Administrator may terminate this Agrecrllent inmic(liately, notwithstanding the sixty (60)
days prior written notice set forth ill Section 3. In the event of such immediate Agreement
termination, file options Llp011 10'111lllatloll as set fil-th in Section shall not be available to
Client, but instead Administrator shall return to Clicnt all (:')aims and/or losses pending on
the date ofsuch tcrnlinailion for the Client to handle to a conclusion, and such handling shall
not result in any expense or reduction of lccs to Administrator.
(c) To pay all Allocated loss Adjustment i"xpense, as dctincd herein, in ad(lition to the fees to
he paid to Administrator as prescribe(1 ill Section 4 hcrcol'.
((I) To in(Ieninify, )rotect, save, defend and hold Administrator and Administrator's directors,
officers, attorneys, employees, shareholders, agents and other representatives wholly
harmless from and against any and all logs, cost. (laniage or expense (inelu(ling attorney's
ices and costs ll)elll'I'ed by A(iniinistrator in connection therCwith) arising out of the
administration or han(Iling of ally claims by reason of any negligent, grossly negligent or
willful act or omission of Client or of' Client's directors, officers, shareholders, attorneys,
employees, agents or other representatives, taken or omitte(l to be taken pursuant to this
Agreement, including, witll()ut limitation, any such loss, costs, damage or expense incurred
by reason of the: fi►llowing:
i. Any act or omission or Administrator ol'any ol'Adnlinistrator's directors, officer's,
attorneys, employees, agents or other representatives taken or omitted to be taken at
the direction of C'1►eni or ally o1'C'lient's directors, oflicers, shareholders, agents, or
other representatives,
7
ii, Administrators hcing minted ill litigation as the insurer of record or other capacity
based upon its present (sr past relationship with C'licnt,
iii. The failure of' Administrator or Administrator's directors, ofliccr:s, altorneys,
sharcholdcrS, cmployccs, agents or• other representatives to settle a claim that coul(1
have been sculed within Administrator's Authority Limit (so long as such fllilure
to-settle clues not result 111-otll a negligent, grossly negligeni, or willful act, en-or or
omission by Administrator or by any of Administrator's directors, officers,
shareholders, attorneys, employees, agents or other represental i ve), or
iv. The failure of Administrator or Administrator's directors, ol'licers, shareholders,
attorneys, employees, agents ()r' othei' rcpr'esetltative to hay any Claim or Allocated
Loss A(Ijustment I�.xhcnsc un a tinkly basis (]Lie to the failure of, Client or C'lient's
dircclor's, oflicers, shareholders, attorneys, employee~.. ,igents or other represeWatives
to comply with Section h, subparagraphs (C) and (t) frcrcunder.
In the event Administrator or any of its directors, ofliccrs, shareholders, attoreleys, employees,
agents or other representatives, is named as a defendant in, or is otherwise obligated to defend, any
such action asserting any C'lainl indetlltlilicd her•Clnl(fet•, Client will assume, at C'lient's expense, the
defenSC Of' such actions on behalf, of, Administrator and its directors, officers, shareholders,
attorneys, employees, agents or other representatives, as the casc may be. Client shall have the sole
discretion to select the attorneys who will (Icicnd any such action, provided, h0NVCVet•, that Client
shall exercise Stich discretion reasonably. Notwithsta )(ling the 1i61-cgoing. nothing herein shall
waive any rights of any party hereto to contributory negligence Claims or defenses with respect to
ally indemnity provided herein. ThiS in(lct»nity shall Surwi�.c termination ol'this Agreement.
(c) To provtdC sufficient funds to the C'lainls Payment Account to enable Administrator at all
times to pay Claims and Allocated boss Adjustment I',xhenses in accordance with the teems
and Conditions Contained herein.
(1) To authorize 111(1 hereby does authori/C Administrator to issue payments as may be
necessary to enable Administrator it) Iv.y Claims. Administrator may also make payments
as nlav be 11ccessary Io cnahle Administrator to p:iy Al Allocated loss Adjustment
Expenses.
Section 7 Covenants 111(1 AgrucnlenlS ufA(htlirtistr,ltor
Administrator co vunants and agrees as lidlows:
(a) To C'lient's right to assume the conlrol and handling of any Claim at any tinle, and
Administrator agrees to deliver promptly any Claim lilt to C'liVill which it nuly rC(11.10t, but
without any off=set or (IC(luction from any of'the lees or Charges pail or payable by Client to
A(11111111St1'ill(1ronder Seelion d above. 'I he parties agree that at all times prior to and lflcr the
cancellation ol•tllis Agreement, all Claim files arc owned by and arc the property of Client.
46
Ckilll filCS ere subjCCt to review by Client ruin its cnlployccs and authoti�.c l agents during
Administrator's regular business hollr•S, with reasonable prier notice.
(b) To exercise reasonable cffllrts to managc the services provided lIC1•CLII1dCr in such a way and
in such nluulurer Ws to insure that every adjuster, claims investigator, and/or employee used
by the Administrator or subcoo(ractcd to by file Administrator will adjust and/or investigate
every alleged Claim or matter covered by this Agreement in accordance with this
Agreement and any claim handling instructions as inlplcnlcntcd from untie to time.
(c) TO prirvide to Client, upon wriltcll request, certificate of insurance evidencing adequate
General Liability Insurance, Autonulhile Liability 111SLIrar1CC, Workers' Compensation
Insurance, Fidelity ("overage (Bond) and Fri-ors and Omissions Insurance (Professional
Liability Coverage).
(d) To provide all necessary personnel to 11cr1o1•Il; the scI•vices agreed upon herein.
(c) To indemnify, protect, save, defend and hold C'licnl and C'lient's directors, ot,ficcls,
shareholders, attorneys, employees, agents and other rcpreselltatives wholly harmless from
any and all loss, cost, darrfagc or cxpensc arising out of the administration or handling of
any claims by reason o1' rely negligent, grossly negligent oi• willful let or omission of
Administrator or of' Administrator's directors, officers, shareholders, attorneys, employees.
agents or other representatives, taken or omitted to be taken pursuant to this Agreement;
provided, however, that Administrator shall have no obligation to indemnify anyone
pursuant hereto with respect to the lollowing:
i. Any act or omission of Administrator or any Of' Administrator's directors, officers,
shareholders, attorneys, employees, agents or other representatives taken or omitted to be
taken at the direction of*Client or ally of'Client's directors, olfice•s, shareholder, attorneys,
employees, agents or other represe►ltatives,
ii. Administrator buing named in litigation as the insurer ofrecord,
iii. The failure ol• Administrator or Administrator's director:s. officers, shareholders, attorneys,
employees, agents or othe r►:pre,entntives to settle a C'luinl that could have been settled
within Administrator's Authority hillit (so iollg as arch fitilure to settle does not result from
a grossly negligent or willful act, error or omission by Administrator or by any of'
Administrator's directors, of•ficcl:S, shareholders. attorneys, employees. agents or other
representatives), or,
iv. The fililurc of Administrator or Administrator's directors, offices, shareholders, attorneys,
employees, agents or other representatives to pay ally Claim or Allocated Loss Adjuslnnent
Cxpense, on a timely hWSis clue to Client, to the fililurc of Client's directors, officers,
attorneys, cnlployccs, agents or other rcpresentativcs to comply with Section G,
® subparagraphs (c) and (1) ol'lhis Agreement.
9
In the event Client or any of its directors, officers, attorneys, employees, agents or other
representatives, is named as a defendant in, or is otherwise obligated to defend, any such action
asserting any Claim indemnified hereunder, Administrator will assume, at Administrator's expense,
the defense of such actions on behalf' of Client and its directors, officers, attorneys, employees,
agents or other representatives, as the case may be. Administrator has sole discretion to select the
attorneys who will defend any such actin 111, provided, however, that Administrator shall exercise
such discretion reasonably. Not withstanding the foregoing, nothing herein shall waive any rights of
any party hereto to contributory negligence claims or defenses with respect to any indemnity
provided herein.
8. Miscellaneous:
(a) This Agreement shall be governed and constructed in accordance with the fawS ofthe State
of Missouri.
(b) If any provision of this Agrccnlen! shall be held 1.0 be invalid or unenforceable for tiny
reason, such invalidity or unenfiorccability shall not affect any other provisions of this
Agreement.
(c) No waiver or mollification of this Agreement or of any covenant, condition or limitation
contained shall be valid unless in writing and duly csccutcd by the Pa►1ics.
(d) The failure of'either Party to insist, in any one or more instances, upon perfonmance ot'the
terms or conditions ol'this Agreement shall not be construed as a waiver or a relinquishment
of'any right granted hereunder or ol'the future pertornla nce of tiny such term, covenant, or
condition.
(e) ']'his Agreement is personal to the Parties and may not be assiggncd h, either Party in whole
or in part without prior written consent ol'lllc oflier Party.
(f) Any notice to be given }nercunder shall be deemed sul'ficie►t if in writing and delivered
either personally or by cerlific(I mail, return receipt rc(i(tcsted, tO the 1611Owing:
It to Administrator: Michael l). Greco, President
Corporate Claims Management, Inc.
782 Spirit 40 Park
C'lleste•ficld, Missouri 63005
Ifto Clicnt: Nathan M. NlckolauS
'i'hc City o1,Jct1'c1:son City, ivlissouri
320 F. McCarty Strect
Jefferson City, Missouri 65201
10
(g) The headings or this Agreement are intended solely lot' convenience of'reference and shall
have no effect c,n the construction or interpretation ill this Agreement.
(h) In the event (it' any litigation between the Parties, the prevailing party shell be entitled to
recover from the non-prevailing party ally attorney's (lees and expenses incurred.
(i) This Agreement shall be binding; upon and inure to the benefit oreach party hereto and their
respective permitted sueccssors and permitted assigns.
IN WITNESS WHEREDF, the parties by their authorized agents have caused this
Agreement to be executed as ol'the (late first written above.
On Hehalf'of Oil Behalfot'
'nic City or.lenerson City. Missouri Corporate Claims M"inagcmcnt, hie.
Jahn Laiulwehr, Mayor chacl [). (;rcco. President
1)AT1.'
' l
A'I-reS'"r. ATTI�.ST.
AV,
mss`----- `r t 1
City Clerk ' 'Title:
APPROWID AST I'()Izm:
City Counselor
a.a.
CITY OF JEFFERSON
AMENDMENT TO THE AGREEMENT FOR
WORKER'S COMPENSATION CLAIM SERVICES
WHEREAS,the City of Jefferson,Missouri,a municipal corporation,hereinafter designated"City,"with offices at
320 East McCarty Street, Jefferson City, Missouri, 65101, entered into an Agreement with Corporate Claims
Management, Inc., with offices at 782 Spirit 40 Park, Chesterfield, Missouri, 63005, hereinafter referred to as
"Administrator" on June 8, 2004.
WHEREAS, the Agreement was for the administration of workers'compensation claims; and
WHEREAS,both parties wish to extend the agreement for the first of three additional one-year renewal
periods as stipulated in Paragraph 3 of the agreement dated June 8, 2004;
NOW,THEREFORE,,—be it-agreed by the parties that the agreement is hereby renewed for the--first-of--
the three additional one-year periods to end June 30, 2007.
IN TESTIMONY WHEREOF, the parties have hereunto set their hands and seals this f day of May, 2006.
CITY OF JEjEFE4SON, MISSOURI CORPORATE CLAIMS MANAGEMENT
May President
ATTEST: ATTEST:
ACClerk
APP- - AS ORM:
City Counselor
HAContract FilesTrofessional ServicesTorporate Claims Management\amendment 2006-07.wpd