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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 a f 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. -2- 0 0 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. -3- (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. -5- (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. 0 0 (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 -7- a 0 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. IM 0 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. -10- • s 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 -11- a 0 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 -12- 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