HomeMy WebLinkAboutC-2192 - Adjusting of City's Worker's Compensation ClaimsAGREEMENT FOR WORKERS' COMPENSATION
CLAIMS ADJUSTING SERVICES
BIERLY & ASSOCIATES, INC.
THIS AGREEMENT is made and entered into this 29th day
of June, 1987, by and between:
CITY OF NEWPORT BEACH,
A Municipal Corporation,
hereinafter "City,"
G-1]
BIERLY & ASSOCIATES, INC.,
hereinafter " Bierly,"
and the parties hereto agree as follows:
1. TERM OF AGREEMENT
The term of this Agreement shall be for a period of
twelve (12) months, commencing at 12:01 a.m, on July 1, 1987 and
ending 12 :00 midnight on June 30, 1988.
2. SERVICES TO BE PERFORMED BY BIERLY
of City:
Bierly shall perform the following services on behalf
A. Program Development
(1) Consult with City's personnel and assist
in developing the necessary procedures, practices and coordina
tion to implement City's self- insured program and to meet leeal
requirements of the State.
-1-
(2) Conduct or assist in conducting orienta-
tion meetings for City's personnel involved directly or indi-
rectly in the processing of industrial injury cases.
(3) Provide to City information on changes or
proposed changes in statutes, rules and regulations affecting
City's responsibility under a legally uninsured Workers' Compen-
sation program.
(4) Review with City's representatives
program progress, including identification of problem areas and
recommended solutions thereto.
(5) Sponsor and pay for a membership in the
California Index Bureau on City's behalf.
(6) Establish procedures and necessary
documentation to provide for the payment of benefits, medical
costs, legal fees and other related costs to enable either City
or Bierly to issue checks to cover such expenditures.
B. Claims Administration
(1) Review and process all claims for
Workers' Compensation benefits in accordance with the require-
ments of the Industrial Relations Department for reporting and
notification.
(2) Determine the compensability of claimed
injuries and illnesses in accordance with the State's Workers'
Compensation laws.
-2-
0 0
(3) Determine eligibility for and authorize
payments of medical benefits and authorize examinations to deter-
mine the nature and extent of disability when appropriate.
(4) Determine eligibility for and authorize
payment of temporary disability compensation in coordination with
medical advice and rehabilitation efforts.
(5) Determine the degree of permanent
disability, if any, of injured workers utilizing, as necessary
and desirable, advisory ratings of the Permanent Disability
Rating Bureau.
(6) Authorize the payment of permanent
disability compensation and death benefits in accordance with
advisory ratings, order of the Workers' Compensation Appeals
Board or Compromise and Release settlements.
(7) 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.
(8) Maintain current estimates of costs of
all anticipated benefits and related expenses on each case.
(9) 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.
-3-
0
0
( 10 ) Assure that sufficient claims personnel
are available so that no claims examiner will be required to
handle more than 250 open indemnity claims at any one time.
C. Medical Control
(1) Develop and recommend to City a panel of
physicians, dentists, chiropractors and other practitioners for
the initial treatment of injured employees and recommend a panel
of such specialists as may be required for long -term or other
disabilities requiring special treatment.
(2) Monitor treatment programs for injured
employees, including the review of all "Doctor's First Report of
Work Injury" to assure that treatment is related to a compensable
injury or illness.
(3) Maintain close IiAison with treating
physicians to assure that employees receive proper care to avoid
over - treatment situations.
(4) Review and make recommendations to City
on their utilization of in -house medical expertise.
(5) Consult with City's personnel and provide
guidance and evaluations of the physical capabilities of injured
employees to return to work.
(6) Recommend and assist in the development
of medical standards nad health requirements for the City's
occupational classifications.
-4-
0 0
D. Dnployee Services
(1) Provide information and guidance to
City's employees regarding Workers' Compensation benefits,
inquiries on specific injuries and permanent disability ratings
in accordance with City's policies.
(2) Assist in resolving employee problems
related to an industrial injury in non - litigated cases.
(3) When medically appropriate, develop
rehabilitation programs for injured employees for approval by
City. The employee and other agencies to provide rehabilitation,
retraining, or reassignment for employees with physical or per-
formance limitations resulting from industrial injuries.
on problem cases in
reasonable scope.
procedures to ensu
consistent with the
Board.
(4) Consult with employee groups and unions
accordance with the City's policies within a
(5) Develop and recommend policies and
re that the employee's ability to work is
findings of the Workers' Compensation Appeals
E. Fiscal Analysis
(1) Provide the City's administration with
continuing information on the progress of individual claims and
the effectiveness of safety and other cost control programs on
Workers' Compensation claims.
-5-
0
0
(2) Submit monthly statistical summaries and
narrative reports to assist in the evaluation of City's program.
(3) Provide periodic projections of cash flow
and actuarial projections of the annual incurred costs.
3. RENEWAL OF AGREEMENT
This Agreement may be renewed from year -to -year by
mutual consent. Provided, however, that any proposed revision in
the Agreement, by either party, be submitted in writing in a
reasonable time prior to the date of renewal.
4. TERMINATION OF AGREEMENT
This Agreement may be terminated by submitting written
notice of intention to terminate at least thirty (30) days prior
to the date of termination specified in the notice; provided,
however, that should the City determine not to renew this
Agreement on any annual renewal date, no advance notice of
termination need be given Bier ly. Bierly shall not be required
to perform any of its services beyond the date of termination.
Such notices of intent to terminate shall be sent to the parties
addressed as follows:
CITY CITY OF NEWPORT BEACH
Attention: City Manager
Post Office Box 1768
Newport Beach, CA 92658 -8915
BIERLY Bierly & Associates, Inc.
1400 East Fourth St., Suite 200
Santa Ana, Ca. 92701
0
5. FEES
0
City shall pay One Hundred Eighty Three Dollars
($183.00) for each claim filed durng the term of this Agreement,
or an annual fee of Thirty Seven Thousand Six Hundred Dollars
($37,600.00) whichever is less. Bierly will issue an arbitrary
quarterly billing of Nine Thousand Four Hundred Dollars
($9,400.00) which will be subject to an adjustment at the end of
12 months.
Bierly shall perform the services described in para-
graph 2 above, with respect to all existing open claim files,
without the payment of any compensation whatsoever.
The above fee shall include all services under this
Agreement, except for payments made by Bierly on City's behalf
for medical disability or other benefits and allocated loss
expense.
"Allocated loss expense" shall mean all Workers'
Compensation Appeals Board costs, Court costs, fees and expenses;
fees for service of process; fees to attorneys; fees for
independent adjusters or attorneys for investigation or
adjustment of claims not provided by salaried employees of
Bierly; costs of employing experts for the purpose of preparing
maps, photographs, diagrams, chemical or physical questions; cost
for copies of transcripts of testimony at Coroner's inquests or
private records; costs for depositions and Court reporters or
recorded statements and any similar costs or expenses properly
chargeable to the defense of a particular claim or to protection
of the subrogation rights of City. Provided, however, that any
of the above services performed by salaried employees of Bierly
-7-
0 0
shall not be considered allocated loss expense. "Allocated Loss
Expense" is not included in the annual service fee.
6. ADDITIONAL CONDITIONS
A. City shall not be liable to Bierly for personal
injury or property damage sustained by Bierly in the peformance
of this Agreement, whether caused by Bierly & Associates, its
officers, agents or employees, or by any third person.
B. Bierly agrees to defend any legal action commenced
against City caused directly or indirectly by wrongful or
negligent acts of Bierly, Bierly's officers, employees, agents or
others engaged by Bierly and to indemnify City against any loss,
liability, cost or damage, including attorney's fees resulting
therefrom.
C. City agrees to defend any legal action commenced
against Bierly caused directly or indirectly by wrongful or
negligent acts by City's officers, employees, agents or others
engaged by City, and to indemnify Bierly against any loss,
liability, cost of damage, including attorney's fees resulting
therefrom.
D. On or before the commencement of the term of this
Agreement, Bierly shall furnish the City with certificates
showing the type, amount, class of operations covered, effective
dates and dates of expiration of insurance policies. Such
certificates, which do not limit Bierly Adjusters
indemnification, shall also contain substantially the following
statement: "The insurance covered by this certificate will not
is
0 •
be cancelled or materially altered, except after ten (10) days'
written notice has been received by the City."
It is agreed that Bierly shall maintain in force
at all times during the performance of this Agreement all
policies of insurance required by this Agreement and that said
policies of insurance shall be secured from an insurance company
assigned Policyholders Rate "A" or higher and financial size
category Class VII or larger by an industry work standard and
licensed to do insurance business in the State of California.
Bierly Adjusters shall maintain the following insurance coverage:
(1) Liability Insurance. General liability
coverage in the following minimum limits:
Bodily Injury $250,000 each person
$500,000 each occurrence
$500,000 aggregate
Property Damage $100,000 each occurrence
$250,000 aggregate
(2) Errors and Emissions. Errors and
omissions insurance which includes coverage for professional
malpractice, in the amount of $1,000,000. The policy shall
provide for coverage of all claims occurring during ther term of
the policy notwithstanding the fact that the claim may be
asserted subsequent to the expiration of the policy.
-9-
(3) Subrogation
Waiver. Bierly
agrees
that
in the event of
loss due to
any of the
perils for
which it
has
agreed to provide
insurance,
that Bierly
shall look
solely to
its
-9-
insurance for recovery. Bierly hereby grants to City, on behalf
of any insurer providing insurance to either Bierly or the City
with respect to the services of Bierly herein, a waiver of any
right of subrogation which any insurer of said Bierly may acquire
against City by virtue of the payment of any loss under such
insurance Bierly may acquire against City by virtue of the
payment of any loss under such insurance.
(4) Failure to Secure. If Bierly at any time
during the term hereof, should fail to secure or maintain the
foregoing insurance, City shall be permitted to obtain such
insurance in Bier lyIs name or as agent of Bierly and shall be
compensated by Bierly for the costs of insurance premiums and
interest at the maximum rate permitted by law computed from the
date written notice is received that the premiums have been paid.
(5) Additional Insured. The City, its City
Council, boards and commissions, officers, agents, servants and
employees shall be named as an additional insured on all policies
of insurance required by this Agreement. The naming of an
additional insured shall not affect any recovery to which such
additional insured would be entitled under this policy if not
named as such additional insured and an additional insured named
herein shall not be held liable for any premium or expense of any
nature on this policy or any extension thereof. Any other
insurance held by an additional insured shall not be required to
contribute anything toward any loss or expense covered by the
insurance provided by this policy. Proceeds from any such policy
or policies shall be payable to the City primarily, and to Bierly
secondarily, if necessary.
-10-
• •
E. While performing service hereunder, Bierly is an
independent contractor and not an officer, agent or employee of
City.
F.
The services to be performed
by Bierly shall
specifically
exclude
any services which now,
or in the future,
are deemed to
be the
practice of law.
G. Al claim files, records, reports and other
documents and materials pertaining to City's claims shall be the
property of City and shall be delivered to City, or its designee,
by Bierly, upon termination of this Agreement. Bierly shall also
provide computer tapes containing all computerized data
pertaining to City and its claims, together with the format
thereof upon such termination.
H. City reserves the right to inspect and audit
Bier lyIs records relevant to City's account at any time upon
giving reasonable notice. City will permit Bierly to inspect and
audit City's payroll and Workers' Compensation Records at any
time, upon giving reasonable notice. City will provide necessary
information pertaining to claims reported for adjustment under
the provisions of any Agreement.
7. PROHIBITION AGAINST TRANSFERS.
Bierly shall not assign, sublease, hypothecate, or
transfer this Agreement or any interest therein directly, or
indirectly, by operation of law or otherwise. Any attempt to do
so without said consent shall be null and void; and any assignee,
sublessee, hypothecate or transferee shall acquire no right or
-11-
u
F- -I
L_j
interest by reason of such attempted assignment, hypothecation or
transfer.
8. WAIVER.
A waiver by the City of any breach of any term,
covenant, or condition contained herein shall not be deemed to be
a waiver of any subsequent breach of the same or any other term,
covenant, or condition contained herein whether of the same or a
different character.
IN WITNESS WHEREOF, the parties hereto have caused this
Agreement to be executed the day and year first above written.
APPROVED AS TO FORM:
CITY OF NEWPORT BEACH
A Municipal Corporation
ByC�l �L`�' I �• �� �'
ty��nager
BIERLY & ASSOCIATES, INC.
BYd 4 ZZ, ` v� 7
Bruce Miller
Vice President
-12-
•
TO: FINANCE DIRECTOR
FROM: CITY CLERK
DATE: June 23, 1986
•
CITY OF NEWPORT BEACH
OFFICE OF THE CITY CLERK
(714) 640 -2251
SUBJECT: Contract No. C -2192
Description of Contract Agreement for Workers' Compensation
Claims Adjusting Services
Effective date of Contract June 11. 1
Authorized by Minute Action, approved on N/A
Contract with Bierly and Associates, Inc.
Address 1400 East Fourth St.. Suite 200
Ana. CA 92701
Amount of Contract (See Agreement)
"
Wanda E. Andersen
City Clerk
WEA:lr
attach.
City Hall • 3300 Newport Boulevard, Newport Beach, California 92663
1
AGREEMENT FOR WORKERS' COMPENSATION
CLAIMS ADJUSTING SERVICES
BIERLY & ASSOCIATES, INC.
a
THIS AGREEMENT is made and entered into this If day of
12�, 1986, by and between:
CITY OF NEWPORT BEACH,
A Municipal Corporation,
hereinafter "City,"
I Mil
BIERLY & ASSOCIATES, INC.,
hereinafter " Bierly,"
and the parties hereto agree as follows:
1. TERM OF AGREEMENT
The term of this Agreement shall be for a period of
twelve (12) months, commencing at 12:01 a.m. on July 1, 1986 and
ending 12:00 midnight on June 30, 1987.
2. SERVICES TO BE PERFORMED BY BIERLY
of City:
Bierly shall perform the following services on behalf
A. Program Development
(1) Consult with City's personnel and assist
in developing the necessary procedures, practices and coordina
tion to im-lement City's self- insured program and to meet legal
requirements of the State.
-1-
0 0
(2) Conduct or assist in conducting orienta-
tion meetings for City's personnel involved directly or indi-
rectly in the processing of industrial injury cases.
(3) Provide to City information on changes or
proposed changes in statutes, rules and regulations affecting
City's responsibility under a legally uninsured Workers' Compen-
sation program.
(4) Review with City's representatives
program progress, including identification of problem areas and
recommended solutions thereto.
(5) Sponsor and pay for a membership in the
California Index Bureau on City's behalf.
(6) Establish procedures and necessary
documentation to provide for the payment of benefits, medical
costs, legal fees and other related costs to enable either City
or Bierly to issue checks to cover such expenditures.
B. Claims Administration
(1) Review and process all claims for
Workers' Compensation benefits in accordance with the require-
ments of the Industrial Relations Department for reporting and
notification.
(2) Determine the compensability of claimed
injuries and illnesses in accordance with the State's Workers'
Compensation laws.
-2-
C�
•
(3) Determine eligibility for and authorize
payments of medical benefits and authorize examinations to deter-
mine the nature and extent of disability when appropriate.
(4) Determine eligibility for and authorize
payment of temporary disability compensation in coordination with
medical advice and rehabilitation efforts.
(5) Determine the degree of permanent
disability, if any, of injured workers utilizing, as necessary
and desirable, advisory ratings of the Permanent Disability
Rating Bureau.
(6) Authorize the payment of permanent
disability compensation and death benefits in accordance with
advisory ratings, order of the Workers' Compensation Appeals
Board or Compromise and Release settlements.
(7) Refer litigated cases to attorneys
utilizing an agreed listing of legal firms. Assist in the
preparation of litigated cases, neeotiations of Compromise and
Release settlements and subrogation actions.
(8) Maintain current estimates of costs of
all anticipated benefits and related expenses on each case.
(9) 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.
-3-
0
0
(10) Assure that sufficient claims personnel
are available so that no claims examiner will be required to
handle more than 250 open indemnity claims at any one time.
C. Medical Control
(1) Develop and recommend to City a panel of
physicians, dentists, chiropractors and other practitioners for
the initial treatment of injured employees and recommend a panel
of such specialists as may be required for long -term or other
disabilities requiring special treatment.
(2) Monitor treatment programs for injured
employees, including the review of all "Doctor's First Report of
Work Injury" to assure that treatment is related to a compensable
injury or illness.
(3) Maintain close liaison with treating
physicians to assure that employees receive proper care to avoid
over - treatment situations.
(4) Review and make recommendations to City
on their utilization of in -house medical expertise.
(5) Consult with City's personnel and provide
guidance and evaluations of the physical capabilities of injured
employees to return to work.
(6) Recommend and assist in the development
of medical standards nad health requirements for the City's
occupational classifications.
-4-
0 0
D. Employee Services
(1) Provide information and guidance to
City's employees regarding Workers' Compensation benefits,
inquiries on specific injuries and permanent disability ratings
in accordance with City's policies.
(2) Assist in resolving employee problems
related to an industrial injury in non - litigated cases.
(3) When medically appropriate, develop
rehabilitation programs for injured employees for approval by
City. The employee and other agencies to provide rehabilitation,
retraining, or reassignment for employees with physical or per-
formance limitations resulting from industrial injuries.
(4) Consult with employee groups and unions
on problem cases in accordance with the City's policies within a
reasonable scoDA.
(5) Develop and recommend policies and
procedures to ensure that the employee's ability to work is
consistent with the findings of the Workers' Compensation Appeals
Board.
E. Fiscal Analysis
(1) Provide the City's administration with
continuing information on the progress of individual claims and
the effectiveness of safety and other cost control programs on
Workers' Compensation claims.
-5-
(2) Submit monthly statistical summaries and
narrative reports to assist in the evaluation of City's program.
(3) Provide periodic projections of cash flow
and actuarial projections of the annual incurred costs.
3. RENEWAL OF AGREEMENT
This Agreement may be renewed from year -to -year by
mutual consent. Provided, however, that any proposed revision in
the Agreement, by either party, be submitted in writing in a
reasonable time prior to the date of renewal.
4. TERMINATION OF AGREEMENT
This Agreement may be terminated by submitting written
notice of intention to terminate at least thirty (30) days prior
to the date of termination specified in the notice; provided,
however, that should the City determine not to renew this
Agreement on any annual renewal date, no advance notice of
termination need be given Bierly. Bierly shall not be required
to perform any of its services beyond the date of termination.
Such notices of intent to terminate shall be sent to the parties
addressed as follows:
CITY CITY OF NEWPORT BEACH
Attention: City Manager
Post Office Box 1768
Newport Beach, CA 92658 -8915
BIERLY Bierly & Associates, Inc.
1400 East Fourth St., Suite 200
Santa Ana, Ca. 92701
0
5. FEES
City shall pay One Hundred Seventy Five Dollars
($175.00) for each claim filed durng the term of this Agreement,
or an annual fee of Thirty Six Thousand Dollars ($36,000.00)
whichever is less. Bierly will issue an arbitrary quarterly
billing of Nine Thousand Dollars ($9,000.00) which will be
subject to an adjustment at the end of 12 months.
Bierly shall perform the services described in para-
graph 2 above, with respect to all existing open claim files,
without the payment of any compensation whatsoever.
The above fee shall include all services under this
Agreement, except for payments made by Bierly on City's behalf
for medical disability or other benefits and allocated loss
expense.
"Allocated loss expense" shall mean all W- rkers'
Compensation Appeals Board costs, Court costs, fees and expenses;
fees for service of process; fees to attorneys; fees for
independent adjusters or attorneys for investigation or
adjustment of claims not provided by salaried employees of
Bierly; costs of employing experts for the purpose of preparing
maps, photographs, diagrams, chemical or physical questions; cost
for copies of transcripts of testimony at Coroner's inquests or
private records; costs for depositions and Court reporters or
recorded statements and any similar costs or expenses properly
chargeable to the defense of a particular claim or to protection
of the subrogation rights of City. Provided, however, that any
of the above services performed by salaried employees of Bierly
dC
0 0
shall not be considered allocated loss expense. "Allocated Loss
Expense" is not included in the annual service fee.
6. ADDITIONAL CONDITIONS
A. City shall not be liable to Bierly for personal
injury or property damage sustained by Bierly in the peformance
of this Agreement, whether caused by Bierly & Associates, its
officers, agents or employees, or by any third person.
B. Bierly agrees to defend any legal action commenced
against City caused directly or indirectly by wrongful or
negligent acts of Bierly, Bierly's officers, employees, agents or
others engaged by Bierly and to indemnify City against any loss,
liability, cost or damage, including attorney's fees resulting
therefrom.
C. City agrees to defend any legal action commenced
against Bierly caused directly or indirectly by wrongful or
negligent acts by City's officers, employees, agents or others
engaged by City, and to indemnify Bierly against any loss,
liability, cost of damage, including attorney's fees resulting
therefrom.
D. On or before the commencement of the term of this
Agreement, Bierly shall furnish the City with certificates
showing the type, amount, class of operations covered, effective
dates and dates of expiration of insurance policies. Such
certificates, which do not limit Bierly Adjusters
indemnification, shall also contain substantially the following
statement: "The insurance covered by this certificate will not
be cancelled or materially altered, except after ten (10) days'
written notice has been received by the City."
It is agreed that Bierly shall maintain in force
at all times during the performance of this Agreement all
policies of insurance required by this Agreement and that said
policies of insurance shall be secured from an insurance company
assigned Policyholders Rate "A" or higher and financial size
category Class VII or larger by an industry work standard and
licensed to do insurance business in the State of California.
Bierly Adjusters shall maintain the following insurance coverage:
(1) Liability Insurance. General liability
coverage in the following minimum limits:
Bodily Injury $250,000 each person
$500,000 each occurrence
$500,000 aggregate
Property Damage $100,000 each occurrence
$250,000 aggregate
(2) Errors and Omissions. Errors and
omissions insurance which includes coverage for professional
malpractice, in the amount of $1,000,000. The policy shall
provide for coverage of all claims occurring during ther term of
the policy notwithstanding the fact that the claim may be
asserted subsequent to the expiration of the policy.
(3) Subrogation Waiver. Bierly agrees that
in the event of loss due to any of the perils for which it has
agreed to provide insurance, that Bierly shall look solely to its
. •
insurance for recovery. Bierly hereby grants to City, on behalf
of any insurer providing insurance to either Bierly or the City
with respect to the services of Bierly herein, a waiver of any
right of subrogation which any insurer of said Bierly may acquire
against City by virtue of the payment of any loss under such
insurance Bierly may acquire against City by virtue of the
payment of any loss under such insurance.
(4) Failure to Secure. If Bierly at any time
during the term hereof, should fail to secure or maintain the
foregoing insurance, City shall be permitted to obtain such
insurance in Bierly's name or as agent of Bierly and shall be
compensated by Bierly for the costs of insurance premiums and
interest at the maximum rate permitted by law computed from the
date written notice is received that the premiums have been paid.
(5) Additional Insured. The City, its City
Council, boards and commissions, officers, agents, servants and
employees shall be named as an additional insured on all policies
of insurance required by this Agreement. The naming of an
additional insured shall not affect any recovery to which such
additional insured would be entitled under this policy if not
named as such additional insured and an additional insured named
herein shall not be held liable for any premium or expense of any
nature on this policy or any extension thereof. Any other
insurance held by an additional insured shall not be required to
contribute anything toward any loss or expense covered by the
insurance provided by this policy. Proceeds from any such policy
or policies shall be payable to the City primarily, and to Bierly
secondarily, if necessary.
-10-
E. While performing service hereunder, Bierly is an
independent contractor and not an officer, agent or employee of
City.
F. The services to be performed by Bierly shall
specifically exclude any services which now, or in the future,
are deemed to be the practice of law.
G. Al claim files, records, reports and other
documents and materials pertaining to City's claims shall be the
property of City and shall be delivered to City, or its designee,
by Bierly, upon termination of this Agreement. Bierly shall also
provide computer tapes containing all computerized data
pertaining to City and its claims, together with the format
thereof upon such termination.
H. City reserves the right to inspect and audit
Bierly's records relevant to City's account at any time upon
giving reasonable notice. City will permit Bierly to inspect and
audit City's payroll and Workers' Compensation Records at any
time, upon giving reasonable notice. City will provide necessary
information pertaining to claims reported for adjustment under
the provisions of any Agreement.
7. PROHIBITION AGAINST TRANSFERS.
Bierly shall not assign, sublease, hypothecate, or
transfer this Agreement or any interest therein directly, or
indirectly, by operation of law or otherwise. Any attempt to do
so without said consent shall be null and void; and any assignee,
sublessee, hypothecate or transferee shall acquire no right or
-11-
interest by reason of such attempted assignment, hypothecation or
transfer.
3. WAIVER.
A waiver by the City of any breach of any term,
covenant, or condition contained herein shall not be deemed to be
a waiver of any subsequent breach of the same or any other term,
covenant, or condition contained herein whether of the same or a
different character.
IN WITNESS WHEREOF, the parties hereto have caused this
Agreement to be executed the day and year first above written.
AS TO FORM:
y Attorney
CITY OF NEWPORT BEACH
A Municipal Corporation
Ci anager
BIERLY & ASSOCIATES, INC.
-12-
Y
Bruce Miller
Vice President
•
CITY OF NEWPORT BEACH
OFFICE OF THE CITY CLERK
(714( 640 -2251
TO: FINANCE DIRECTOR ✓✓
FROM: CITY CLERK
DATE: June 28, 1985
SUBJECT: Contract No. C -2192
Description of Contract Agreement for Workers' Compensation
Claims Adjusting Services
Effective date of Contract June 25, 1985
Authorized by Minute Action, approved on N/A
Contract with Bierly and Associates
Address 1400 East Fourth St., Suite 200
Santa Ana, CA 92701
Amount of Contract (See Agreement)
i% /iii - /G -_ /• /.• _�
Wanda E. Andersen
City Clerk
WEA:lr
attach.
City Hall • 3300 Newport Boulevard, Newport Beach, California 92663
•
AGREEMENT FOR WORKERS' COMPENSATION CLAIMS ADJUSTING SERVICES
BIERLY AND ASSOCIATES. INC.
THIS AGREEMENT is made and entered into this_day of
,1985, by and between:
CITY OF NEWPORT BEACH
A Municipal Corporation,
hereinafter "City"
AND
BIERLY AND ASSOCIATES, INC.
hereinafter "Bierly ",
and the parties hereto agree as follows:
1. TERM OF AGREEMENT
The term of this Agreement shall be for a period of twelve (12)
months, commencing at 12:01 a.m. on July 1, 1985, and ending 12:00
midnight on June 30, 1986.
2. SERVICES TO BE PERFORMED BY BIERLY
Bierly shall perform the following services on behalf of the City:
A. Program Development
(1) Consult with City's personnel and assist in
developing the necessary procedures, practices and coordination to
implement City's self- insured program and to meet legal
requirements of the State.
0 0
-2-
(2) Conduct or assist in conducting orientation
meetings for City's personnel involved directly or indirectly in
the processing of industrial injury cases.
(3) Provide to City information on changes or
proposed changes in statutes, rules and regulations affecting
City's responsibility under a legally uninsured Workers'
Compensation program.
(4) Review with City's representatives program
progress, including identification of problem areas and
recommended solutions thereto.
(5) Sponsor and pay for a membership in the
California Index Bureau an City's behalf.
(6) Establish procedures and necessary
documentation to provide for the payment of benefits, medical
costs,legal fees and other related costs to enable either City or
Bierly to issue checks to cover such expenditures.
B. Claims Administration
(1) Review and process all claims for Workers'
Compensation benefits in accordance with the requirements of the
Industrial Relations Oepartment for reporting and notification.
(2) Oetermine the compensability of claimed
injuries and illnesses in accordance with the State's Workers'
Compensation Laws.
-3-
(3) Determine eligibility for and authorize pay-
ments of medical benefits and authorize examinations to determine
nature and extend of disability when appropriate.
(4) Determine eligibility for and authorize pay-
ment of temporary disability compensation in coordination with
medical advice and rehabilitation efforts.
(5) Determine the degree of permanent disability,
if any, of injured workers utilizing, as necessary and desirable,
advisory ratings of the Permanent Disability Rating
Bureau.
(6) Authorize the payment of permanent disability
compensation and death benefits in accordance with advisory
ratings, order of the Workers' Compensation Appeals Board or
Compromise and Release settlements.
(7) Refer litigated cases to attorneys utilizing
an agreed listing of legal firms. Assist in the preparation of
litigated cases, negotiations of Compromise and Release settle-
ments and subrogation actions.
(8) Maintain current estimates of costs of all
anticipated benefits and related expenses on each case.
(9) 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.
-4-
(10) Assure that sufficient claims personnel are
available so that no claims examiner will be required to handle
more than 250 open indemnity claims at any one time.
C. Medical Control
(1) Develop and recommend to City a panel of
physicians, dentists, chiropractors and other practitioners for
the initial treatment of injured employees and recommend a panel
of such specialists as may be required for long -term or other
disabilities requiring special treatment.
(2) Monitor treatment programs for injured
employees, including the review of all "Doctor's First Report
of Work Injury" to assure that treatment is related to a com-
pensable injury or illness.
(3) Maintain close liaison with treating
physicians to assure that employees receive proper care to
avoid over - treatment situations.
(4) Review and make recommendations to City on
their utilization of in -house medical expertise.
(5) Consult with City's personnel and provide
guidance and evaluations of the physical capabilities of in-
jured employees to return to work.
(6) Recommend and assist in the development of
medical standards and health requirements for the City's occu-
pational classifications.
-5-
D. Employee Services
(1) Provide information and guidance to City's
employees regarding Workers' Compensation benefits, inquiries on
specific injuries and permanent disability ratings in accordance
with City's policies.
(2) Assist in resolving employee problems related
to an industrial injury in non - litigated cases.
(3) When medically appropriate, develop rehabili-
tation programs for injured employees for approval by City. The
employee and other agencies to provide rehabilitation, retraining,
or reassignment for employees with physical or performance
limitations resulting from industrial injuries.
(4) Consult with employee groups and unions on
problem cases in accordance with the City's policies within a
reasonable scope.
(5) Develop and recommend policies and procedures
to ensure that the Employee's ability to work is consistent with
the findings of the Workers' Compensation Appeals Board.
E. Fiscal Analysis
(1) Provide the City's administration with
continuing information on the progress of individual claims and
the effectiveness of safety and other cost control programs on +
Workers' Compensation claims.
J • -6- •
(2) Submit monthly statistical summaries and
narrative reports to assist in the evaluation of City's program.
(3) Provide periodic projections of cash flow
and actuarial projections of the annual incurred costs.
3. RENEWAL OF AGREEMENT
This Agreement may be renewed from year -to -year
by mutual consent. Provided, however, that any proposed revision
in the Agreement, by either party, be submitted in writing in a
reasonable time prior to the date of renewal.
4. TERMINATION OF AGREEMENT
This Agreement may be terminated by submitting
written notice of intention to terminate least sixty (60) days
prior to the date of termination specified in the notice3
provided, however, that should the City determine not to renew
this Agreement on any annual renewal date, no advance notice of
termination need be given Bierly. Bierly shall not be required
to perform any of its services beyond the date of termination.
Such notices of intent to terminate shall be sent to the parties
addressed as follows:
CITY CITY OF NEWPORT BEACH
Attn: City Manager
P.O.Box 1768
Newport Beach, Cal.
92658 -8915
BIERLY Bierly and Associates
1400 East Fourth St.,
Suite 200
Santa Ana, Cal. 92701
• -7-
5. FEES
City shall pay One Hundred Thirty Dollars ($130.00)
for each claim filed during the term of this Agreement,
or an annual fee of Twenty Four Thousand Six Hundred and Seventy
Five Dollars ($24,675.00) whichever is less. Bierley will issue
an arbitrary quarterly billing of Six Thousand One Hundred Sixty
Eight Dollars and Seventy -Five Cents ($6,168.75) which will be
subject to an adjustment at the end of 12 months.
Bierly shall perform the services described in
paragraph 2 above, with respect to all existing open claim files,
without the payment of any compensation whatsoever.
The above fee shall include all services under this
Agreement, except for payments made by Bierly on City's behalf for
medical disability or other benefits and allocated loss expense.
"Allocated Loss Expense" shall mean all Workers'
Compensation Appeals Board costs, Court costs, fees and expenses;
fees for service of process; fees to attorneys; fees for
independent adjusters or attorney for investigation or adjustment
of claims not provided by salaried employees of Bierley; costs of
employing experts for the purpose of preparing maps, photographs,
diagrams, chemical or physical questions; cost for copies of
transcripts of testimony at Coroner's inquests or private records;
cost for depositions and Court reporters or recorded statements
and any similar costs or expenses properly chargeable to the
defense of a particular claim or to the protection of the
subrogation rights of City. Provided, however, that any of the
above services performed by salaried employees of Bierly shall not
be considered allocated loss expense. "Allocated Loss Expense" is
not included in the annual service fee.
6. AOOITIONAL CONDITIONS
A. City shall not be liable to Bierly for personal
injury or property damage sustained by Bierly in the performance
of this Agreement, whether caused by Bierly & Associates, its
officers, agents or employees, or by any third person.
B. Bierly agrees to defend any legal actior
commenced against City caused directly or indirectly by wrongful
or negligent acts of Bierly, Bierly's officers, employees, agents,
or others engaged by Bierly and to indemnify City against any
loss, liability, cost or damage, including attorney's fees
resulting therefrom.
C. City agrees to defend any legal action
commenced against Bierly caused directly or indirectly by wrongful
or negligent acts by City's officers, employees, agents or others
engaged by City, and to indemnify Bierly against any loss,
liability, cost of damage, including attorney's fees resulting
therefrom.
0 -9-
0. On or before the commencement of this term of
this Agreement, Bierly shall furnish the City with certificates
showing the type, amount, class of operations covered, effective
dates and dates of expiration of insurance policies. Such
certificates, which do not limit Bierly Adjusters indemnification,
shall also contain substantially the following statement: "The
insurance covered by this certificate will not be cancelled or
materially altered, except after ten (10) days written notice has
been received by the City."
It is agreed that Bierly shall maintain in
force at all times during the performance of this Agreement all
policies of insurance required by this Agreement and that said
policies of insurance shall be secured from an insurance company
assigned Policyholders Rate "A" or higher and financial size
category Class VII or larger by an industry work standard and
licensed to do insurance business in the State of California.
Bierly Adjusters shall maintain the following insurance coverage:
1) Liability Insurance. General liability
coverage in the following minimum limits:
Bodily Injury $250,000 each person
$500,000 each occurrence
$500,000 aggregate
Property Damage $100,000 each occurence
$250,000 aggregate
-10- •
2) Errors and Omissions. Errors and omissions
insurance which includes coverage for professional malpractice, in
! the amount of $1,000,000. The policy shall provide for coverage
of all claims occurring during the term of the policy
notwithstanding the fact that the claim may be asserted subsequent
to the expiration of the policy.
3) Subrogation Waiver. Bierly agrees that
in the event of loss due to any of the perils for which it has
agreed to provide insurance, that Bierly shall look solely to its
i
insurance for recovery. Bierly hereby grants to City, on behalf
of any insurer providing insurance to either Bierly or the City's
with respect to the services of Bierly herein, a waiver of any
right of subrogation which any insurer of said Bierly may acquire
against City by virtue of the payment of any loss under such
insurance Bierly may acquire against City by virtue of the payment
of any loss under such insurance.
4) Failure to Secure. If Bierly at any time
during the term hereof, should fail to secure or maintain the
foregoing insurance, City shall be permitted to obtain such
insurance in Bierly's name or as agent of Bierly and shall he
compensated by Bierly for the costs of insurance premiums and
interest at the maximum rate permitted by law computed from the
date written notice is received that the premiums have been paid.
5) Additional Insured. The City, its City
Council, boards and commissions, officers, agents, servants and
employees shall he named as an additional insured on all policies
9 -11- 0
of insurance required by this Agreement. The naming of an
additional insured shall not affect any recovery to which such
additional insured would be entitled under this policy if not
named as such additional insured and an additional insured named
herein shall not be held liable for any premium or expense of any
nature on this policy or any extension thereof. Any other
insurance held by an additional insured shall not be required to
contribute anything toward any loss or expense covered by the
insurance provided by this policy. Proceeds from any such policy
or policies shall be payable to the City primarily, and to Bierly
secondarily, if necessary.
E. While performing service hereunder, Bierly is
an independent contractor and not an officer, agent or employee of
the City.
F. Services to be performed by Bierly shall
specifically exclude any services which now, or in the future,
are deemed to be the practice of law.
G. All claim files, records, reports and other
documents and materials pertaining to City's claims shall be the
property of City and shall be delivered to City, or its designee,
by Bierly, upon termination of this Agreement. Bierly shall also
provide computer tapes containing all computerized data pertaining
to City and its claims, together with the format thereof upon such
termination.
0 -12- 0
H. City reserves the right to inspect and audit
Bierly's records relevant to City's account at any time upon
giving reasonable notice. City will permit Bierly to inspect
and audit City's payroll and Workers' Compensation records at any
time, upon giving reasonable notice. City will provide necessary
information pertaining to claims reported for adjustment under
the provisions of any Agreement.
7. PROHIBITION AGAINST TRANSFERS.
Bierly shall not assign, sublease, hypothecate, or
transfer this Agreement or any interest therein directly, or
indirectly, by operation of law or otherwise. Any attempt to do
so without said consent shall be null and void, and any assignee,
sublessee, hypothecate or transferee shall acquire no right or
interest by reason of such attempted assignment, hypothecation or
transfer.
B. WAIVER
A waiver by the City of any breach of any term,
covenant, or condition contained herein shall not be deemed to be
a waiver of any subsequent breach of the same or any other term,
covenant, or condition contained herein whether of the same or a
different character.
-13-
•
IN WITNESS WHEREOF, the parties hereto have caused
this Agreement to be executed the day and year first above
written.
APPROVED AS TO FORM:
City Attorney
CITY OF NEWPORT BEACH
A Municipal Corporation
By \`L4i�
City Manager
BIERLY AND ASSOCIATES, INC.
BY Bruce Miller
Miller
Vice - President
0
0
CITY OF NEWPORT BEACH
P.O. BOX 1768, NEWPORT BEACH, CA 92663.3884
TO: FINANCE DIRECTOR
FROM: CITY CLERK
DATE: June 19, 1984
SUBJECT: Contract No. C -2192
OFFICE OF THE CITY CLERK
(714) 640 -2251
Description of Contract Agreement for Workers' Compensation
Claims Adjusting Services
Effective date of Contract June 6, 1984
Authorized by Minute Action, approved on N/A (City Manager's Approval)
Contract with Bierly 6 Associates, Inc.
Address 1400 East Fourth St., Suite 200
Santa Ana. CA 92701
Amount of Contract (See page 7 of attached Agreement)
W"
Wanda E. Andersen
City Clerk
WEA:lr
attach.
3300 Newport Boulevard, Newport Beach
/140
. 0 •
AGREEMENT FOR WORKERS' COMPENSATION CLAIMS ADJUSTING SERVICES
BIERLY & ASSOCIATES, INC.
THIS AGREEMENT is made and entered into this _j�h day of
luAr—, 1984, by and between:
CITY OF NEWPORT BEACH,
A Municipal Corporation,
hereinafter "City,"
AND
BIERLY & ASSOCIATES, INC.,
hereinafter " Bierly,"
and the parties hereto agree as follows:
1. TERM OF AGREEMENT
The term of this Agreement shall be for a period of
twelve (12) months, commencing at 12:01 a.m. on July 1, 1984 and
ending 12:00 midnight on June 30, 1985.
2. SERVICES TO BE PERFORMED BY BIERLY
Bierly shall perform the following services on behalf of
City:
A. Program Development
(1) Consult with City's personnel and assist in
developing the necessary procedures, practices and coordination
to implement City's self- insured program and to meet legal
requirements of the State.
(2) Conduct or assist in conducting orientation
meetings for City's personnel involved directly or indirectly in
the processing of industrial injury cases.
0 0
(3) Provide to City information on changes or
proposed changes in statutes, rules and regulations affecting
City's responsibility under a legally uninsured Workers'
Compensation program.
(4) Review with City's representatives program
progress, including identification of problem areas and
recommended solutions thereto.
(5) Sponsor and pay for a membership in the
California Index Bureau on City's behalf.
(6) Establish procedures and necessary docu-
mentation to provide for the payment of benefits, medical costs,
legal fees and other related costs to enable either City or
Bierly to issue checks to cover such expenditures.
B. Claims Administration
(1) Review and process all claims for Workers'
Compensation benefits in accordance with the requirements of the
Industrial Relations Department for reporting and notification.
(2) Determine the compensability of claimed
injuries and illnesses in accordance with the State's Workers'
Compensation laws.
(3) Determine eligibility for and authorize
payments of medical benefits and authorize examinations to deter-
mine the nature and extent of disability when appropriate.
2
(4) Determine eligibility for and authorize
payment of temporary disability compensation in coordination with
medical advice and rehabilitation efforts.
(5) Determine the degree of permanent disability,
if any, of injured workers utilizing, as necessary and desirable,
advisory ratings of the Permanent Disability Rating Bureau.
(6) Authorize the payment of permanent disability
compensation and death benefits in accordance with advisory
ratings, order of the Workers' Compensation Appeals Board or
Compromise and Release settlements.
(7) 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.
(8) Maintain current estimates of costs of all
anticipated benefits and related expenses on each case.
(9) 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.
(10) Assure that sufficient claims personnel are
available so that no claims examiner will be required to handle
more than 250 open indemnity claims at any one time.
3
0
E
C. Medical Control
(1) Develop and recommend to City a panel of
physicians, dentists, chiropractors and other practitioners for
the initial treatment of injured employees and recommend a panel
of such specialists as may be required for long -term or other
disabilities requiring special treatment.
(2) Monitor treatment programs for injured
employees, including the review of all "Doctor's First Report of
Work Injury" to assure that treatment is related to a compensable
injury or illness.
(3) Maintain close liaison with treating
physicians to assure that employees receive proper care to avoid
over - treatment situations.
(4) Review and make recommendations to City on
their utilization of in -house medical expertise.
(5) Consult with City's personnel and provide
guidance and evaluations of the physical capabilities of injured
employees to return to work.
(6) Recommend and assist in the development of
medical standards and health requirements for the City's occu-
pational classifications.
4
0 0
D. Employee Services
(1) Provide information and guidance to City's
employees regarding Workers' Compensation benefits, inquiries on
specific injuries and permanent disability ratings in accordance
with City's policies.
(2) Assist in resolving employee problems related
to an industrial injury in non - litigated cases.
(3) When medically appropriate, develop reha-
bilitation programs for injured employees for approval by City.
The employee and other agencies to provide rehabilitation,
retraining, or reassignment for employees with physical or
performance limitations resulting from industrial injuries.
(4) Consult with employee groups and unions on
problem cases in accordance with the City's policies within a
reasonable scope.
(5) Develop and recommend policies and procedures
to ensure that the employee's ability to work is consistent with
the findings of the Workers' Compensation Appeals Board.
E. Fiscal Analysis
(1) Provide the City's administration with
continuing information on the progress of individual claims and
the effectiveness of safety and other cost control programs on
Workers' Compensation claims.
0 0
(2) Submit monthly statistical summaries and
narrative reports to assist in the evaluation of City's program.
(3) Provide periodic projections of cash flow and
actuarial projections of the annual incurred costs.
3. RENEWAL OF AGREEMENT
After the initial contract period this Agreement may be
renewed from year -to -year by mutual consent. Provided, however,
that any proposed revision in the Agreement, by either party, be
submitted in writing no later than 90 days preceeding the expira-
tion date of the Agreement.
4. TERMINATION OF AGREEMENT
After the first nine months either party may terminate
this Agreement or any renewal by submitting to the other party,
in writing, its intention to terminate, at least 90 days prior to
the date of termination. Bierly shall not be required to perform
any of its services beyond the date of termination. Such notices
of intent to terminate shall be sent to the parties addressed as
follows:
CITY CITY OF NEWPORT BEACH
3300 Newport Boulevard
Newport Beach, Ca. 92663
BIERLY Bierly & Associates, Inc.
1400 East Fourth St., Suite 200
Santa Ana, Ca. 92701
[:
5. FEES
City shall pay One Hundred Twenty Five Dollars ($125.00)
for each claim filed durng the term of this Agreement, or an
annual fee of Twenty Three Thousand Five Hundred Dollars
($23,500.00) whichever is less. Bierly will issue an arbitrary
quarterly billing of Five Thousand Eight Seventy Five Dollars
($5,875.00) which will be subject to an adjustment at the end of
12 months.
Bierly shall perform the services described in paragraph
2 above, with respect to all existing open claim files, without
the payment of any compensation whatsoever.
The above fee shall include all services under this
Agreement, except for payments made by Bierly on City's behalf
for medical disability or other benefits and allocated loss ex-
pense.
"Allocated loss expense" shall mean all Workers' Compen-
sation Appeals Board costs, Court costs, fees and expenses; fees
for service of process; fees to attorneys; fees for independent
adjusters or attorneys for investigation or adjustment of claims
not provided by salaried employees of Bierly; costs of employing
experts for the purpose of preparing maps, photographs, diagrams,
chemical or physical questions; cost for copies of transcripts
of testimony at Coroner's inquests or private records; costs for
7
0 0
depositions and Court reporters or recorded statements and any
similar costs or expenses properly chargeable to the defense of a
particular claim or to protection of the subrogation rights of
City. Provided, however, that any of the above services perform-
ed by salaried employees of Bierly shall not be considered allo-
cated loss ,expense. "Allocated Loss Expense" is not included in
the annual service fee.
6. ADDITIONAL CONDITIONS
A. City shall not be liable to Bierly for personal
injury or property damage sustained by Bierly in the peformance
of this Agreement, whether caused by Bierly & Associates, its
officers, agents or employees, or by any third person.
B. Bierly agrees to defend any legal action commenced
against City caused directly or indirectly by wrongful or negli-
gent acts of Bierly, Bierly's officers, employees, agents or
others engaged by Bierly and to indemnify City against any loss,
liability, cost or damage, including attorney's fees resulting
therefrom.
C. City agrees to defend any legal action commenced
against Bierly caused directly or indirectly by wrongful or neg-
ligent acts by City's officers, employees, agents or others
engaged by City, and to indemnify Bierly against any loss, liabi-
lity, cost of damage, including attorney's fees resulting there-
from.
91
• 0
D. Neither party shall assign this Agreement or any
part thereof without the written consent of the other party.
E. While performing service hereunder, Bierly is an
independent contractor and not an officer, agent or employee of
City.
F. The services to be performed by Bierly shall
specifically exclude any services which now, or in the future,
are deemed to be the practice of law.
G. All claim files, records, reports and other docu-
ments and materials pertaining to City's claims shall be the
property of City and shall be delivered to City, or its designee,
by Bierly, upon termination of this Agreement. Bierly shall also
provide computer tapes containing all computerized data pertain-
ing to City and its claims, together with the format thereof upon
such termination.
H. City reserves the right to inspect and audit
Bierly's records relevant to City's account at any time upon
giving reasonable notice. City will permit Bierly to inspect and
audit City's payroll and Workers' Compensation Records at any
time, upon giving reasonable notice. City will provide necessary
information pertaining to claims reported for adjustment under
the provisions of any Agreement.
E
1-1
IN WITNESS WHEREOF, the parties hereto have caused this
Agreement to be executed the day and year first above written.
APP /66,�ED AS TO FORM:
Cyff Attorney
CITY OF NEWPORT BEACH
A Municipal Corporation
i
BY��C�
City Manager
BIERLY & ASSOCIATES, INC.
By:
Bruce Vanner
Executive Vice President
10
0 0
' RECIYED
PE9? (�JfgEL
JU."' 184
CITY OF
NEVVI)o <T f�A H
�i; CALIF, °�.
0
CITY OF NEWPORT BEACH
P.O. BOX 1768, NEWPORT BEACH, CA 92663 -3884
OFFICE OF THE CITY CLERK
(714) 640 -2251
TO: FINANCE DIRECTOR
FROM: CITY CLERK
DATE: July 13, 1983
SUBJECT: Contract No. C -2192
Description of Contract Agreement for Workers' Compensation
Claims Adjusting Services for Fiscal Year 1983 -84
Effective date of Contract Mav 2,1983
Authorized by Minute Action, approved on Not approved by Council
Contract with Bierly & Associates. Inc.
Address 1400 East Fourth Street
to 200
Santa Ana, CA 92701
Amount of Contract $120.00 per claim or $22,500.00 annual fee, whichever less
kd,o4t
Wanda E. Andersen
City Clerk
WEA:lr
attach.
3300 Newport Boulevard, Newport Beach
C������'
AGREEMENT FOR WORKERS' COMPENSATION CLAIMS ADJUSTING SERVICES
BIERLY & ASSOCIATES, INC.
THIS AGREEMENT is made and entered into this day of
t0k -lf , 1983, by and between:
CITY OF NEWPORT BEACH,
A Municipal Corporation,
hereinafter "City,"
AND
BIERLY & ASSOCIATES, INC.,
hereinafter " Bierly,"
and the parties hereto agree as follows:
1. TERM OF AGREEMENT
The term of this Agreement shall be for a period of
twelve (12) months, commencing at 12:01 a.m. on July 1, 1983 and
ending 12:00 midnight on June 30, 1984.
2. SERVICES TO BE PERFORMED BY BIERLY
City:9
Bierly shall perform the following services on behalf of
A. Program Development
(1) Consult with City's personnel and assist
in developing the necessary procedures, practices and
coordination to implement City's self- insured program and to meet
legal requirements of the State.
Li
(2) Conduct or assist in conducting
orientation meetings for City's personnel involved directly or
indirectly in the processing of industrial injury cases.
(3) Provide to City information on changes or
proposed changes in statutes, rules and regulations affecting
City's responsibility under a legally uninsured Workers'
Compensation program.
(4) Review with City's representatives
program progress, including identification of problem areas and
recommended solutions thereto.
(5) Sponsor and pay for a membership in the
California Index Bureau on City's behalf.
(6) Establish procedures and necessary
documentation to provide for the payment of benefits, medical
costs, legal fees and other related costs to enable either City
or Bierly to issue checks to cover such expenditures.
B. Claims Administration
(1) Review and process all claims for
Workers' Compensation benefits in accordance with the
requirements of the Industrial Relations Department for reporting
and notification.
(2) Determine the compensability of claimed
injuries and illnesses in accordance with the State's Workers'
Compensation laws.
2
0
0
(3) Determine eligibility for and authorize
payments of medical benefits and authorize examinations to
determine the nature and extent of disability when appropriate.
(4) Determine eligibility for and authorize
payment of temporary disability compensation in coordination with
medical advice and rehabilitation efforts.
(5) Determine the degree of permanent
disability, if any, of injured workers utilizing, as necessary
and desirable, advisory ratings of the Permanent Disability
Rating Bureau.
(6) Authorize the payment of permanent
disability compensation and death benefits in accordance with
advisory ratings, order of the Workers' Compensation Appeals
Board or Compromise and Release settlements.
(7) 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.
(8) Maintain current estimates of costs of
all anticipated benefits and related expenses on each case.
(9) 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.
0 0
(10) Assure that sufficient claims personnel
are available so that no claims examiner will be required to
handle more than 250 open indemnity claims at any one time.
C. Medical Control
(1) Develop and recommend to City a panel of
physicians, dentists, chiropractors and other practitioners for
the initial treatment of injured employees and recommend a panel
of such specialists as may be required for long -term or other
disabilities requiring special treatment.
(2) Monitor treatment programs for injured
employees, including the review of all "Doctor's First Report of
Work Injury" to assure that treatment is related to a compensable
injury or illness.
(3) Maintain close liaison with treating
physicians to assure that employees receive proper care to avoid
over - treatment situations.
(4) Review and make recommendations to City
on their utilization of in -house medical expertise.
(5) Consult with City's personnel and provide
guidance and evaluations of the physical capabilities of injured
employees to return to wqork.
(6) Recommend and assist in the development
of medical standards nad health requirements for the City's
occupational classifications.
4
0 0
D. Employee Services
(1) Provide information and guidance to
City's employees regarding Workers' Compensation benefits,
inquiries on specific injuries and permanent disability ratings
in accordance with City's policies.
(2) Assist in resolving employee problems
related to an industrial injury in non - litigated cases.
(3) When medically appropriate, develop
rehabilitation programs for injured employees for approval by
City. The employee and other agencies to provide rehabilitation,
retraining, or reassignment for employees with physical or
performance limitations resulting from industrial injuries.
(4) Consult with employee groups and unions
on problem cases in accordance with the City's policies within a
reasonable scope.
(5) Develop and recommend policies and
procedures to ensure that the employee's ability to work is
consistent with the findings of the Workers' Compensation Appeals
Board.
E. Fiscal Analysis
(1) Provide the City's administration with
continuing information on the progress of individual claims and
the effectiveness of safety and other cost control programs on
Workers' Compensation claims.
E
(2) Submit monthly statistical summaries and
narrative reports to assist in the evaluation of City's program.
(3) Provide periodic projections of cash flow
and actuarial projections of the annual incurred costs.
3. RENEWAL OF AGREEMENT
After the initial contract period this Agreement may be
renewed from year -to -year by mutual consent. Provided, however,
that any proposed revision in the Agreement, by either party, be
submitted in writing no later than 90 days preceeding the
expiration date of the Agreement.
4. TERMINATION OF AGREEMENT
After the first nine months either party may terminate
this Agreement or any renewal by submitting to the other party,
in writing, its intention to terminate, at least 90 days prior to
the date of termination. Bierly shall not be required to perform
any of its services beyond the date of termination. Such notices
of intent to terminate shall be sent to the parties addressed as
follows:
CITY CITY OF NEWPORT BEACH
3300 Newport Boulevard
Newport Beach, Ca. 92663
BIERLY Bierly & Associates, Inc.
1400 East Fourth St., Suite 200
Santa Ana, Ca. 92701
(:
5. FEES
•
City shall pay One Hundred Twenty Dollars ($120.00) for
each claim filed durng the term of this Agreement, or an annual
fee of Twenty Two Thousand Five Hundred Dollars ($22,500.00)
whichever is less. Bierly will issue an arbitrary quarterly
billing of Five Thousand Six Hundred Twenty Five Dollars
($5,625.00) which will be subject to an adjustment at the end of
12 months.
Bierly shall perform the services described in paragraph
2 above, with respect to all existing open claim files, without
the payment of any compensation whatsoever.
The above fee shall include all services under this
Agreement, except for payments made by Bierly on City's behalf
for medical disability or other benefits and allocated loss
expense.
"Allocated loss expense" shall mean all Workers'
Compensation Appeals Board costs, Court costs, fees and
expenses; fees for service of process; fees to attorneys; fees
for independent adjusters or attorneys for investigation or
adjustment of claims not provided by salaried employees of
Bierly; costs of employing experts for the purpose of preparing
maps, photographs, diagrams, chemical or physical questions;
cost for copies of transcripts of testimony at Coroner's inquests
or private records; costs for depositions and Court reporters or
7
•
recorded statements and any similar costs or expenses properly
chargeable to the defense of a particular claim or to protection
of the subrogation rights of City. Provided, however, that any
of the above services performed by salaried employees of Bierly
shall not be considered allocated loss expense. "Allocated Loss
Expense" is not included in the annual service fee.
6. ADDITIONAL CONDITIONS
A. City shall not be liable to Bierly for personal
injury or property damage sustained by Bierly in the peformance
of this Agreement, whether caused by Bierly & Associates, its
officers, agents or employees, or by any third person.
B. Bierly agrees to defend any legal action commenced
against City caused directly or indirectly by wrongful or
negligent acts of Bierly, Bierly's officers, employees, agents or
others engaged by Bierly and to indemnify City against any loss,
liability, cost or damage, including attorney's fees resulting
therefrom.
C. City agrees to defend any legal action commenced
against Bierly caused directly or indirectly by wrongful or
negligent acts by City's officers, employees, agents or others
engaged by City, and to indemnify Bierly against any loss,
liability, cost of damage, including attorney's fees resulting
therefrom.
E
•
D. Neither party shall assign this Agreement or any
part thereof without the written consent of the other party.
E. While performing service hereunder, Bierly is an
independent contractor and not an officer, agent or employee of
City.
F. The services to be performed by Bierly shall
specifically exclude any services which now, or in the future,
are deemed to be the practice of law.
G. All claim files, records, reports and other
documents and materials pertaining to City's claims shall be the
property of City and shall be delivered to City, or its designee,
by Bierly, upon termination of this Agreement. Bierly shall also
provide computer tapes containing all computerized data
pertaining to City and its claims, together with the format
thereof upon such termination.
H. City reserves the right to inspect and audit
Bierly's records relevant to City's account at any time upon
giving reasonable notice. City will permit Bierly to inspect and
audit City's payroll and Workers' Compensation Records at any
time, upon giving reasonable notice. City will provide necessary
information pertaining to claims reported for adjustment under
the provisions of any Agreement.
E
0
IN WITNESS WHEREOF, the parties hereto have caused this
Agreement to be executed the day and year first above written.
APPROVED AS TO FORM:
City Attorney
CITY OF NEWPORT BEACH
A Municipal Corporation
By lilu_l 14
City Manager
BIERLY & ASSOCIATES, INC.
By:
Bruce Vanner
Executive Vice President
10
0
CITY OF NEWPORT BEACH
DATE: June 21, 1982
TO: FINANCE DIRECTOR
FROM: City Clerk
SUBJECT: Contract No. C -2192
Description of Contract
OFFICE OF THE CITY CLERK
(714) 640 -2251
Agreement for Workers'
Compensation claims adjusting services
Effective date of Contract June 18, 1982
Authorized by Resolution No. 82 -76 , adopted on 6/14/82
Contract with Bierly & Associates, Inc.
Address 1400 East Fourth St., Suite 200
Santa Ana. CA 92701
Amount of Contract See Agreement (Page 7)
Wanda E. Andersen
City Clerk
WEA:lr
City Hall • 3300 Newport Boulevard, Newport Beach, Califomia 92663
• •
CITY OF NEWPORT BEACH
OFFICE OF THE CITY MANAGER
JUN 14 1982 June 7, 1982
By iM CITY COUNCIL
CITY OF NEWPORT MACH
TO: MAYOR AND CITY COUNCIL
FROM: City Manager
SUBJECT: WORKERS' COMPENSATION SELF - INSURANCE PROGRAM
e -:)-Iq3_.�
COUNCIL AGENDA NO. F2(d)
RECOMMENDATION: Approve, by Resolution, a service agreement with
Bierly and Associates to administer work injury claims under the City's
Workers' Compensation Self Insurance Program.
DISCUSSION: On April 9, 1973, the Council approved the Workers'
Compensation Self- Insurance Program as recommended by the Staff and
directed that the necessary steps be taken to implement the program, one of
which was the employment of a workers' compensation claims adjusting
service agency.
Bierly and Associates performed claims adjusting services for the
City during the past year. Their service fee was $110.00 per claim
not to exceed $21,000.00. Bierly and Associates proposes a fee of
$115.00 per claim, not to exceed $21,500.00 in their renewal contract
for the coming year.
Staff considers this a reasonable increase in fees.
ROBERT L. WYNN
City Manager
• oRIGI14AL .
0, - a)q�
AGREEMENT FOR WORKERS' COMPENSATION CLAIMS ADJUSTING SERVICES
BIERLY & ASSOCIATES, INC.
THIS AGREEMENT is made and entered into this / day of
%;;__._, 1982, by and between:
G}� CITY OF NEWPORT BEACH,
A Municipal Corporation,
hereinafter "City,"
AND
BIERLY & ASSOCIATES, INC.,
hereinafter " Bierly,"
and the parties hereto agree as follows:
1. TERM OF AGREEMENT
The term of this Agreement shall be for a period of
twelve (12) months, commencing at 12 :01 a.m. on July 1, 1982 and
ending 12:00 midnight on June 30, 1983.
City:
2. SERVICES TO BE PERFORMED BY BIERLY
Bierly shall perform the following services on behalf of
A. Program Development
(1) Consult with City's personnel and assist
in developing the necessary procedures, practices and
coordination to implement City's self- insured program and to meet
legal requirements of the State.
0 0
(2) Conduct or assist in conducting
orientation meetings for City's personnel involved directly or
indirectly in the processing of industrial injury cases.
(3) Provide to City information on changes or
proposed changes in statutes, rules and regulations affecting
City's responsibility under a legally uninsured Workers'
Compensation program.
(4) Review with City's representatives
program progress, including identification of problem areas and
recommended solutions thereto.
(5) Sponsor and pay for a membership in the
California Index Bureau on City's behalf.
(6) Establish procedures and necessary
documentation to provide for the payment of benefits, medical
costs, legal fees and other related costs to enable either City
or Bierly to issue checks to cover such expenditures.
B. Claims Administration
(1) Review and process all claims for
Workers' Compensation benefits in accordance with the
requirements of the Industrial Relations Department for reporting
and notification.
(2) Determine the compensability of claimed
injuries and illnesses in accordance with the State's Workers'
Compensation laws.
2
0 0
(3) Determine eligibility for and authorize
payments of medical benefits and authorize examinations to
determine the nature and extent of disability when appropriate.
(4) Determine eligibility for and authorize
payment of temporary disability compensation in coordination with
medical advice and rehabilitation efforts.
(5) Determine the degree of permanent
disability, if any, of injured workers utilizing, as necessary
and desirable, advisory ratings of the Permanent Disability
Rating Bureau.
(6) Authorize the payment of permanent
disability compensation and death benefits in accordance with
advisory ratings, order of the Workers' Compensation Appeals
Board or Compromise and Release settlements.
(7) 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.
(8) Maintain current estimates of costs of
all anticipated benefits and related expenses on each case.
(9) 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.
3
0 0
(10) Assure that sufficient claims personnel
are available so that no claims examiner will be required to
handle more than 250 open indemnity claims at any one time.
C. Medical Control
(1) Develop and recommend to City a panel of
physicians, dentists, chiropractors and other practitioners for
the initial treatment of injured employees and recommend a panel
of such specialists as may be required for long -term or other
disabilities requiring special treatment.
(2) Monitor treatment programs for injured
employees, including the review of all "Doctor's First Report of
Work Injury" to assure that treatment is related to a compensable
injury or illness.
(3) Maintain close liaison with treating
physicians to assure that employees receive proper care to avoid
over - treatment situations.
(4) Review and make recommendations to City
on their utilization of in -house medical expertise.
(5) Consult with City's personnel and provide
guidance and evaluations of the physical capabilities of injured
employees to return to wgork.
(6) Recommend and assist in the development
of medical standards nad health requirements for the City's
occupational classifications.
4
0 0
D. Employee Services
(1) Provide information and guidance to
City's employees regarding Workers' Compensation benefits,
inquiries on specific injuries and permanent disability ratings
in accordance with City's policies.
(2) Assist in resolving employee problems
related to an industrial injury in non - litigated cases.
(3) When medically appropriate, develop
rehabilitation programs for injured employees for approval by
City. The employee and other agencies to provide rehabilitation,
retraining, or reassignment for employees with physical or
performance limitations resulting from industrial injuries.
(4) Consult with employee groups and unions
on problem cases in accordance with the City's policies within a
reasonable scope.
(5) Develop and recommend policies and
procedures to ensure that the employee's ability to work is
consistent with the findings of the Workers' Compensation Appeals
Board.
E. Fiscal Analysis
(1) Provide the City's administration with
continuing information on the progress of individual claims and
the effectiveness of safety and other cost control programs on
Workers' Compensation claims.
9
(2) Submit monthly statistical summaries and
narrative reports to assist in the evaluation of City's program.
(3) Provide periodic projections of cash flow
and actuarial projections of the annual incurred costs.
3. RENEWAL OF AGREEMENT
After the initial contract period this Agreement may be
renewed from year -to -year by mutual consent. Provided, however,
that any proposed revision in the Agreement, by either party, be
submitted in writing no later than 90 days preceeding the
expiration date of the Agreement.
4. TERMINATION OF AGREEMENT
After the first nine months either party may terminate
this Agreement or any renewal by submitting to the other party,
in writing, its intention to terminate, at least 90 days prior to
the date of termination. Bierly shall not be required to perform
any of its services beyond the date of termination. Such notices
of intent to terminate shall be sent to the parties addressed as
follows:
CITY CITY OF NEWPORT BEACH
3300 Newport Boulevard
Newport Beach, Ca. 92663
BIERLY Bierly & Associates, Inc.
1400 East Fourth St., Suite 200
Santa Ana, Ca. 92701
C
5. FEES
City shall pay One Hundred and Fifteen Dollars ($115.00)
for each claim filed durng the term of this Agreement, or an
annual fee of Twenty One Thousand Five Hundred Dollars
($21,500.00) whichever is less. Bierly will issue an arbitrary
quarterly billing of Five Thousand Three Hundred Seventy Dollars
($5,370.00) which will be subject to an adjustment at the end of
12 months.
Bierly shall perform the services described in paragraph
2 above, with respect to all existing open claim files, without
the payment of any compensation whatsoever.
The above fee shall include all services under this
Agreement, except for payments made by Bierly on City's behalf
for medical disability or other benefits and allocated loss
expense.
"Allocated loss expense" shall mean all Workers'
Compensation Appeals Board costs, Court costs, fees and
expenses; fees for service of process; fees to attorneys; fees
for independent adjusters or attorneys for investigation or
adjustment of claims not provided by salaried employees of
Bierly; costs of employing experts for the purpose of preparing
maps, photographs, diagrams, chemical or physical questions;
cost for copies of transcripts of testimony at Coroner's inquests
or private records; costs for depositions and Court reporters or
7
recorded statements and any similar costs or expenses properly
chargeable to the defense of a particular claim or to protection
of the subrogation rights of City. Provided, however, that any
of the above services performed by salaried employees of Bierly
shall not be considered allocated loss expense. "Allocated Loss
Expense" is not included in the annual service fee.
6. ADDITIONAL CONDITIONS
A. City shall not be liable to Bierly for personal
injury or property damage sustained by Bierly in the peformance
of this Agreement, whether caused by Bierly & Associates, its
officers, agents or employees, or by any third person.
B. Bierly agrees to defend any legal action commenced
against City caused directly or indirectly by wrongful or
negligent acts of Bierly, Bierly's officers, employees, agents or
others engaged by Bierly and to indemnify City against any loss,
liability, cost or damage, including attorney's fees resulting
therefrom.
C. City agrees to defend any legal action commenced
against Bierly caused directly or indirectly by wrongful or
negligent acts by City's officers, employees, agents or others
engaged by City, and to indemnify Bierly against any loss,
liability, cost of damage, including attorney's fees resulting
therefrom.
0
D. Neither party shall assign this Agreement or any
part thereof without the written consent of the other party.
E. While performing service hereunder, Bierly is an
independent contractor and not an officer, agent or employee of
City.
F. The services to be performed by Bierly shall
specifically exclude any services which now, or in the future,
are deemed to be the practice of law.
G. All claim files, records, reports and other
documents and materials pertaining to City's claims shall be the
property of City and shall be delivered to City, or its designee,
by Bierly, upon termination of this Agreement. Bierly shall also
provide computer tapes containing all computerized data
pertaining to City and its claims, together with the format
thereof upon such termination.
H. City reserves the right to inspect and audit
Bierly's records relevant to City's account at any time upon
giving reasonable notice. City will permit Bierly to inspect and
audit City's payroll and Workers' Compensation Records at any
time, upon giving reasonable notice. City will provide necessary
information pertaining to claims reported for adjustment under
the provisions of any Agreement.
4
C'
•
IN WITNESS WHEREOF, the parties hereto have caused this
Agreement to be executed the day and year first above written.
ATTEST:
City Clerk
APPROVED AS TO FORM:
City A torney
CITY OF NEWPORT BEACH
A Municipal Corporation
yo
BIERLY & ASSOCIATES, INC.
By:
V
Bruce Vanner
Executive Vice President
10
RESOLUTION NO. 8 2 - •
A RESOLUTION OF THE CITY COUNCIL
OF NEWPORT BEACH AUTHORIZING THE
CITY CLERK TO EXECUTE AN AGREEME',
CITY OF NEWPORT BEACH-AND BIERLY
FOR WORKERS' COMPENSATION CLAIMS
SERVICES (1982 -183)
OF THE CITY
MAYOR AND
qT BETWEEN THE
& ASSOCIATES
ADJUSTING
WHEREAS, there has been presented to the City Council
of the City of Newport Beach a certain Agreement between the City
of Newport Beach and Bierly & Associates for workers'
compensation claims adjusting services; and
WHEREAS, the City Council of the City of Newport Beach
has reviewed the terms and conditions of said Agreement and finds
them to be satisfactory and that it would be in the best
interests of the City of Newport Beach to execute said Agreement.
NOW, THEREFORE, BE IT RESOLVED by the City Council of
the City of Newport Beach that the Agreement above - described be
and hereby is approved and the Mayor and City Clerk are hereby
authorized and directed to execute same on behalf of the City of
Newport Beach.
ADOPTED this JUN 14 day of , 1982.
Mayor
ATTEST:
City Clerk
M
CITY OF NEWPORT BEACH
OFFICE OF THE CITY MANAGER
JUNE 22, 1981
TO: MAYOR AND CITY COUNCIL
FROM: City Manager
W
9.,
By tho CITY COUilCIL
CITY OF, i< WPO11T BRACH
COUNCIL AGENDA NO. F -2(a)
SUBJECT: WORKERS' COMPENSATION SELF - INSURANCE PROGRAM
RECOMMENDATION: Approve, by Resolution, a service agreement with
Bierly & Associates to administer work injury claims under the
City's Workers' Compensation Self Insurance Program.
DISCUSSION: On April 9, 1973, the Council approved the Workmen's
Compensation Self- Insurance Program as recommended by the Staff and
directed that the necessary steps be taken to implement the program
by July 1, 1973. The efficient administration of the program was
contingent upon acquiring the services of a professional workers'
compensation services agency.
Last year Council approved an agreement with Bierly & Associates for
their services, for a fee of $110.00 per claim, not to exceed $20,000.
Their fee for renewal of this agreement for the coming year is $110.00
per claim, not to exceed $22,000.
Bierly & Associates have provided the City excellent services. The
Staff considers the provision for the increase in fee limits appropriate.
Robert L. Wynn
0
AGREEMENT FOR WORKERS' COMPENSATION CLAIMS ADJUSTING SERVICES
BIERLY & ASSOCIATES, INC.
THIS AGREEMENT is made and entered into this 1st day of
July, 1981, by and between:
CITY OF NEWPORT BEACH,
A Municipal Corporation,
hereinafter "City,"
AND
BIERLY & ASSOCIATES, INC.,
hereinafter " Bierly,"
and the parties hereto agree as follows:
1. TERM OF AGREEMENT
The term of this Agreement shall be for a period of
twelve (12) months, commencing at 12:01 a.m. on July 1, 1981 and
ending 12:00 midnight on June 30, 1982.
City:
2. SERVICES TO BE PERFORMED BY BIERLY
Bierly shall perform the following services on behalf of
A. Program Development
(1) Consult with City's personnel and assist
in developing the necessary procedures, practices and
coordination to implement City's self- insured program and to meet
legal requirements of the State.
M •
(2) Conduct or assist in conducting
orientation meetings for City's personnel involved directly or
indirectly in the processing of industrial injury cases.
(3) Provide to City information on changes or
proposed changes in statutes, rules and regulations affecting
City's responsibility under a legally uninsured Workers'
Compensation program.
(4) Review with City's representatives
program progress, including identification of problem areas and
recommended solutions thereto.
(5) Sponsor and pay for a membership in the
California Index Bureau on City's behalf.
(6) Establish procedures and necessary
documentation to provide for the payment of benefits, medical
costs, legal fees and other related costs to enable either City
or Bierly to issue checks to cover such expenditures.
B. Claims Administration
(1) Review and process all claims for
Workers' Compensation benefits in accordance with the
requirements of the Industrial Relations Department for reporting
and notification.
(2) Determine the compensability of claimed
injuries and illnesses in accordance with the State's Workers'
Compensation laws.
PA
0 0
(3) Determine eligibility for and authorize
payments of medical benefits and authorize examinations to
determine the nature and extent of disability when appropriate.
(4) Determine eligibility for and authorize
payment of temporary disability compensation in coordination with
medical advice and rehabilitation efforts.
(5) Determine the degree of permanent
disability, if any, of injured workers utilizing, as necessary
and desirable, advisory ratings of the Permanent Disability
Rating Bureau.
(6) Authorize the payment of permanent
disability compensation and death benefits in accordance with
advisory ratings, order of the Workers' Compensation Appeals
Board or Compromise and Release settlements.
(7) 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.
(B) Maintain current estimates of costs of
all anticipated benefits and related expenses on each case.
(9) 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.
0
0
(10) Assure that sufficient claims personnel
are available so that no claims examiner will be required to
handle more than 250 open indemnity claims at any one time.
C. Medical Control
(1) Develop and recommend to City a panel of
physicians, dentists, chiropractors and other practitioners for
the initial treatment of injured employees and recommend a panel
of such specialists as may be required for long -term or other
disabilities requiring special treatment.
(2) Monitor treatment programs for injured
employees, including the review of all "Doctor's First Report of
Work Injury" to assure that treatment is related to a compensable
injury or illness.
(3) Maintain close liaison with treating
physicians to assure that employees receive proper care to avoid
over - treatment situations.
(4) Review and make recommendations to City
on their utilization of in -house medical expertise.
(5) Consult with City's personnel and provide
guidance and evaluations of the physical capabilities of injured
employees to return to wgork.
(6) Recommend and assist in the development
of medical standards nad health requirements for the City's
occupational classifications.
4
`J
D. Employee Services
40
(1) Provide information and guidance to
City's employees regarding Workers' Compensation benefits,
inquiries on specific injuries and permanent disability ratings
in accordance with City's policies.
(2) Assist in resolving employee problems
related to an industrial injury in non - litigated cases.
(3) When medically appropriate, develop
rehabilitation programs for injured employees for approval by
City. The employee and other agencies to provide rehabilitation,
retraining, or reassignment for employees with physical or
performance limitations resulting from industrial injuries.
(4) Consult with employee groups and unions
on problem cases in accordance with the City's policies within a
reasonable scope.
(5) Develop and recommend policies and
procedures to ensure that the employee's ability to work is
consistent with the findings of the Workers' Compensation Appeals
Board.
E. Fiscal Analysis
(1) Provide the City's administration with
continuing information on the progress of individual claims and
the effectiveness of safety and other cost control programs on
Workers' Compensation claims.
5
0 0
(2) Submit monthly statistical summaries and
narrative reports to assist in the evaluation of City's program.
(3) Provide periodic projections of cash flow
and actuarial projections of the annual incurred costs.
3. RENEWAL OF AGREEMENT
After the initial contract period this Agreement may be
renewed from year -to -year by mutual consent. Provided, however,
that any proposed revision in the Agreement, by either party, be
submitted in writing no later than 90 days preceeding the
expiration date of the Agreement.
4. TERMINATION OF AGREEMENT
After the first nine months either party may terminate
this Agreement or any renewal by submitting to the other party,
in writing, its intention to terminate, at least 90 days prior to
the date of termination. Bierly shall not be required to perform
any of its services beyond the date of termination. Such notices
of intent to terminate shall be sent to the parties addressed as
follows:
CITY CITY OF NEWPORT BEACH
3300 Newport Boulevard
Newport Beach, Ca. 92663
BIERLY Bierly & Associates, Inc.
1400 East Fourth St., Suite 200
Santa Ana, Ca. 92701
0
• 0
5. FEES
City shall pay One Hundred and Ten Dollars ($110.00) for
each claim filed durng the term of this Agreement, or an annual
fee of Twenty One Thousand Dollars ($21,000.00) whichever is
less. Bierly will issue an arbitrary monthly billing of One
Thousand Seven Hundred Fifty Dollars ($1,750.00) which will be
subject to an adjustment at the end of 12 months.
Bierly shall perform the services described in paragraph
2 above, with respect to all existing open claim files, without
the payment of any compensation whatsoever.
The above fee shall include all services under this
Agreement, except for payments made by Bierly on City's behalf
for medical disability or other benefits and allocated loss
expense.
"Allocated loss expense" shall mean all Workers'
Compensation Appeals Board costs, Court costs, fees and
expenses; fees for service of process; fees to attorneys; fees
for independent adjusters or attorneys for investigation or
adjustment of claims not provided by salaried employees of
Bierly; costs of employing experts for the purpose of preparing
maps, photographs, diagrams, chemical or physical questions;
cost for copies of transcripts of testimony at Coroner's inquests
or private records; costs for depositions and Court reporters or
recorded statements and any similar costs or expenses properly
7
M 0
chargeable to the defense of a particular claim or to protection
of the subrogation rights of City. Provided, however, that any
of the above services performed by salaried employees of Bierly
shall not be considered allocated loss expense. "Allocated Loss
Expense" is not included in the annual service fee.
6. ADDITIONAL CONDITIONS
A. City shall not be liable to Bierly for personal
injury or property damage sustained by Bierly in the peformance
of this Agreement, whether caused by Bierly & Associates, its
officers, agents or employees, or by any third person.
B. Bierly agrees to defend any legal action commenced
against City caused directly or indirectly by wrongful or
negligent acts of Bierly, Bierly's officers, employees, agents or
others engaged by Bierly and to indemnify City against any loss,
liability, cost or damage, including attorney's fees resulting
therefrom.
C. City agrees to defend any legal action commenced
against Bierly caused directly or indirectly by wrongful or
negligent acts by City's officers, employees, agents or others
engaged by City, and to indemnify Bierly against any loss,
liability, cost of damage, including attorney's fees resulting
therefrom.
I
El
0
D. Neither party shall assign this Agreement or any
part thereof without the written consent of the other party.
E. While performing service hereunder, Bierly is an
independent contractor and not an officer, agent or employee of
City.
F. The services to be performed by Bierly shall
specifically exclude any services which now, or in the future,
are deemed to be the practice of law.
G. All claim files, records, reports and other
documents and materials pertaining to City's claims shall be the
property of City and shall be delivered to City, or its designee,
by Bierly, upon termination of this Agreement. Bierly shall also
provide computer tapes containing all computerized data
pertaining to City and its claims, together with the format
thereof upon such termination.
H. City reserves the right to inspect and audit
Bierly's records relevant to City's account at any time upon
giving reasonable notice. City will permit Bierly to inspect and
audit City's payroll and Workers' Compensation Records at any
time, upon giving reasonable notice. City will provide necessary
information pertaining to claims reported for adjustment under
the provisions of any Agreement.
C
IN WITNESS WHEREOF, the parties hereto have caused this
Agreement to be executed the day and year first above written.
CITY OF NEWPORT BEACH
A Municipal Corporation
i
ATT ST:
City Clerk
APPROVED AS TO FORM:
Clty Attorney
070181
BIERLY & ASSOCIATES, INC.
By: I
Tit e
By:
10
0
RESOLUTION NO.1.O O 6,2'�
A RESOLUTION OF THE CITY COUNCIL
OF NEWPORT BEACH AUTHORIZING THE
CITY CLERK TO EXECUTE AN AGREEMEI
CITY OF NEWPORT BEACH AND BIERLY
FOR WORKERS' COMPENSATION CLAIMS
SERVICES (1981 -82)
OF THE CITY
MAYOR AND
4T BETWEEN THE
& ASSOCIATES
ADJUSTING
WHEREAS, there has been presented to the City Council
of the City of Newport Beach a certain agreement between the City
of Newport Beach and Bierly & Associates for workers'
compensation claims adjusting services; and
WHEREAS, the City Council has reviewed the terms and
conditions of said agreement and finds them to be satisfactory
and that it would be in the best interest of the City of Newport
Beach to execute said agreement,
NOW, THEREFORE, BE IT RESOLVED by the City Council of
the City of Newport Beach that the agreement above described is
approved and the Mayor and City Clerk are hereby authorized and
directed to execute the same on behalf of the City of Newport
Beach.
ATTEST:
City Clerk
ADOPTED this day of JUN?? , 1981.
Mayor
HRC /pr
6/22/81
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CITY OF NEWPORT BEACH
CALIFORNIA
City {fall
1700 W. Newport Blvd.
Area Code 714
DATE Jolt 1, 1980
TO: FINANCE DIRECTOR
FROM: City Clerk
SUBJECT: Contract No. 2192
Description of Contract A=eemunt for Workers' cmpmvmtic : Claims
Authorized by Resolution No. 9812 , adopted on Jtme 23, 1980
Effective date of Contract July 1. 1980
Contract with .- Bierly i Associates
Address 1400 E. BburLh st., Ste 200'
santa Ana, Ch 92701
Amount of Contract see contract
City Clerc
cc: Bill Brown
CITY OF NEWPORT BEACH
OFFICE OF THE CITY MANAGER
June 23, 1980
COUNCIL AGENDA NO. ff'oZG��
TO: MAYOR AND CITY COUNCIL
FROM: City Manager
SUBJECT: WORKERS' COMPENSATION SELF - INSURANCE PROGRAM
RECOMMENDATION: Approve, by Resolution, a service agreement with
Bierly and Associates to administer work injury claims under the
City's Workers' Compensation Self Insurance Program.
DISCUSSION: On April 9, 1973, the Council approved the Workmen's
Compensation Self- Insurance Program as recommended by the Staff and
directed that the necessary steps be taken to implement the Program
by July 1, 1973.
The Fred S. James & Company was selected at that time to administer
the work injury claims of City employees. The City has renewed the
contract with Fred S. James & Company each year since that date.
Thus, acceptance of this recommendation represents a change of
service agencies. Such a change is deemed appropriate due to the
more competitive offer of Bierly and Associates. Their service fee
is $110.00 per claim, not to exceed $20,000.00 while the service
fee of Fred S. James & Company is $115.00 Per claim with no upper
limit. It is also anticipated that the quality of services will
be improved.
ROBERT L. WYNN ✓
City Manager
• 062380
AGREEMENT FOR WORKERS' COMPENSATION
CLAIMS ADJUSTING SERVICES
(Bierly & Associates, Inc.)
r
THIS AGREEMENT is made and entered into this
day of .i,,,' 1980, by and between
CITY OF NEWPORT BEACH,
a municipal corporation,
hereinafter "City,"
A N D
BIERLY & ASSOCIATES, INC.,
hereinafter "Bierly,"
and the parties hereto agree as follows:
1. TERM OF AGREE 4ENT
The term of this Agreement shall be for a period
of twelve (12) months, commencing at 12:01 a.m. on July 1, 1980,
and ending 12:00 Midnight on June 30, 1981.
2. SERVICES TO BE PERFORMED BY BIERLY
Bierly shall perform the following services on
behalf of the City:
A. Program Development
(1) Consult with the City's personnel and
assist in developing the necessary procedures,
practices and coordination to implement the
City's self- insured program and to meet
legal requirements of the State.
(2) Conduct or assist in conducting
orientation meetings for the City's personnel
involved directly or indirectly in the
processing of industrial injury cases.
(3) Provide to the City information on
changes or proposed changed in statutes, rules
and regulations affecting the City's responsi-
bility under a legally uninsured Workers'
Compensation program.
(4) Review with the City's representatives
program progress, including identification of
problem areas and recommended solutions thereto.
(5) Sponsor and pay for a membership in the
California Index Bureau on the City's behalf.
(6) Establish procedures and necessary
documentation to provide for the payment of
benefits, medical costs, legal fees, and other
related costs to enable either the City or
Bierly to issue checks to cover such expendi-
tures.
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B. Claims Administration
(1) Review and process all claims for
Workers' Compensation benefits in accordance
with the requirements of the Industrial
Relations Department for reporting and noti-
fication.
(2) Determine the compensability of claimed
injuries and illnesses in accordance with the
State's Workers' Compensation laws.
(3) Determine eligibility for and authorize
payments of medical benefits and authorize
examinations to determine the nature and extent
of disability when appropriate.
(4) Determine eligibility for and authorize
payment of temporary disability compensation in
coordination with medical advice and rehabilita-
tion efforts.
(5) Determine the degree of permanent
disability, if any, of injured workers - utilizing,
as necessary and desirable, advisory ratings of the
Permanent Disability Rating Bureau.
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(6) Authorize the payment of permanent
disability compensation and death benefits
in accordance with advisory ratings, orders
of the Workers' Compensation Appeals Board,
or compromise and release settlements.
(7) Refer litigated cases to attorneys
utilizing an agreed listing of legal firms.
Assist in the preparation of litigated cases,
negotiations of compromise and release settle-
ments, and subrogation actions.
(8) Maintain current estimates of costs
of all anticipated benefits and related expenses
on each case.
0 0
(9) Investigation or arrange for investi-
gation of, as necessary and appropriate, ques-
tionable cases and the status of disabled
employees in order to adjust all cases and to
assist in the trial or settlement of litigated
cases.
(10) Assure that sufficient claims personnel
are available so that no claims examiner will be
required to handle more than 250 open indemnity
claims at any one time.
C. Medical Control
(1) Develop and recommend to the City a panel
of physicians, dentists, chiropractors and other
practitioners for the initial treatment of
injured employees and recommend a panel of such
specialists as may be required for long -term or
other disabilities requiring special treatment.
(2) Monitor treatment programs for injured
employees, including the review of all "Doctor's
First Report of Work Injury" to assure that treat-
ment is related to a compensable injury or illness.
(3) Maintain close liaison with treating
physicians to assure that employees receive proper
care and to avoid over - treatment situations.
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(4) Review and make recommendations to the
City on their utilization of in -house medical
expertise.
(5) Consult with the City's personnel and
provide guidance and evaluations of the physi-
cal capabilities of injured employees to return
to work.
(6) Recommend and assist in the development
of medical standards and health requirements for
the City's occupational classifications.
D. Employee Services
(1) Provide information and guidance to the
City's employees regarding Workers' Compensation
benefits, inquiries on specific injuries, and
permanent disability ratings in accordance with
the City's policies.
(2) Assist in resolving employee problems
related to an industrial injury in nonlitigated
cases.
(3) 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
limitations resulting from industrial injuries.
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(4) Consult with employee groups and
unions on problem cases in accordance with
the City's policies within a reasonable scope.
(5) Develop and recommend policies and
procedures to ensure that the employee's
ability to work is consistent with the findings
of the Workers' Compensation Appeals Board.
E. Fiscal Analysis
(1) Provide the City's administration with
continuing information on the progress of indivi-
dual claims and the effectiveness of safety and
other cost control programs on Workers' Compensa-
tion claims.
(2) Submit monthly statistical summaries and
narrative reports to assist in the evaluation of
the City's program.
(3) Provide periodic projections of cash flow
and actuarial projections of the annual incurred
costs.
3. RENEWAL OF AGREEMENT
After the initial contract period, this Agreement
may be renewed from year to year by mutual consent; provided,
however, that any proposed revisions in the Agreement by either
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party be submitted in writing no later than 90 days preceding
the expiration date of the Agreement.
4. TERMINATION OF AGREEMENT
After the first nine months, either party may
terminate this Agreement of any renewal by submitting to the
other party in writing its intent to terminate at least 90
days prior to the date of termination. Bierly shall not be
required to perform any of its services beyond the date of
termination. Such notices of intent to terminate shall be
sent to the parties addressed as follows:
To City City of Newport Beach
3300 Newport Boulevard
Newport Beach, CA 92663
To Bierly Bierly & Associates, Inc.
1400 East Fourth Street
Suite 200
Santa Ana, CA 92701
5. FEES
City shall pay One Hundred Ten Dollars ($110.00)
for each claim filed during the term of this Agreement, or an
annual fee of Twenty Thousand Dollars ($20,000.00), whichever
is less. Bierly will issue an arbitrary monthly billing of
One Thousand Six Hundred Fifty Dollars ($1,650.00) which will
be subject to an adjustment at the end of 12 months.
W-M
Bierly shall perform the services described in
paragraph 2 with respect to all existing open files without
the payment of any compensation whatsoever.
The above fee shall include all services under
this Agreement except for payments made by Bierly on the City's
behalf for medical disability, or other benefits and allocated
loss expense.
"Allocated loss expense" shall mean all
Workers' Compensation Appeals Board or court costs, fees and
expenses; fees for services of process, fees to attorneys;
fees of independent adjusters or attorneys for investigation
or adjustment of claims not provided by salaried employees of
Bierly; the costs of employing experts for the purpose of
preparing maps, photographs, diagrams, checmical or physical
questions; the cost of copies of transcripts of testimony at
coroner's inquests or private records; the cost of depositions
and court reporter or recorded statements and any similar costs
or expenses properly chargeable to the defense of a particular
claim or to protection of the subrogation rights of the City;
provided, however, that any of the above services performed by
salaried employees of Bierly shall not be considered allocated
loss expense. "Allocated loss expense" is not included in the
annual service fee.
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6. ADDITIONAL CONDITIONS
A. City shall not be liable to Bierly for
personal injury or property damage sustained by Bierly
in the performance of this Agreement, whether caused
by Bierly & Associates, its officers, agents or employees,
or by any third person.
B. Bierly agrees to defend any legal action
commenced against City caused directly or indirectly
by wrongful or negligent acts of Bierly, Bierly's
officers, employees, agents or others engaged by
Bierly, and to indemnify City against any loss, lia-
bility, cost or damage,including attorney's fees,
resulting therefrom.
C. City agrees to defend any legal action
commenced against Bierly caused directly or indirectly
by wrongful or negligent acts of City's officers,
employees, agents or others engaged by City, and to
indemnify Bierly against any loss, liability, cost or
damage, including attorney's fees, resulting therefrom.
D. Neither party shall assign this Agreement
or any part hereof without the written consent of the
other party.
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E. While performing service hereunder,
Bierly is an independent contractor and not an officer,
agent or employee of the City.
F. The services to be performed by Bierly
shall specifically exclude any which now or in the
future are deemed to be the practice of law.
G. All claim files records, reports, and
other documents and material pertaining to the City's
claims shall be the property of the City and shall be
delivered to the City or its designee by Bierly upon
termination of this Agreement. Bierly shall also pro-
vide computer tapes containing all computerized data
pertaining to the City and its claims, together with
the format thereof upon such termination.
H. The City will reserve the right to inspect
and audit Bierly's records relevant to the City's
account at any time upon giving of reasonable notice.
The City will permit Bierly to inspect and audit the
City's payroll and workers' compensation records at
any time upon giving reasonable notice. The City will
provide necessary information pertaining to claims
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reported for adjustment under the provisions of any
agreement.
IN WITNESS WHEREOF, the parties hereto have caused
this Agreement to be executed the day and year first above
written.
ATTEST:
City Cler 4
CITY OF NEWPORT BEACH
A Municipal Corporation
CITY
APPROVED AS TO FORM: BIERLY & ASSOCIATES, INC.
By fl�rt-
City Attor ey Its
By
Its
4
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RESOLUTION NO. 9812
A RESOLUTION OF THE CITY COUNCIL OF THE CIT_'Y
OF NEWPORT BEACH AUTHORIZING THE MAYOR AND
CITY CLERK TO EXECUTE AN AGREEMENT BETWEEN
THE CITY OF NEWPORT BEACH AND BIERLY & ASSO-
CIATES FOR WORKERS' COMPENSATION CLAIMS
ADJUSTING SERVICES
WHEREAS, there has been presented to the City
Council of the City of Newport Beach a certain agreement
between the City of Newport Beach and Bierly & Associates
for workers' compensation claims adjusting services; and
WHEREAS, the City Council has reviewed the terms
and conditions of said agreement and finds them to be
satisfactory and that it would be in the best interest of
the City to execute said Agreement,
NOW, THEREFORE, BE IT RESOLVED by the City Council
of the City of Newport Beach that the agreement above
described is approved, and the Mayor and City Clerk are
hereby authorized and directed to execute the same on behalf
of the City of Newport Beach.
ADOPTED this 23rd day of June, 1980.
Mayor
ATTEST:
City Clerk
kv
6/19/80