2022/08/31 Council Agenda Packet

electronically. (d) To the extent required by applicable statute or otherwise agreed in writing by CorVel, CorVel will file additional reports on earlier -filed First Reports of Loss ("Subsequent Reports"). (e) Unless agreed to otherwise in writing by the parties, any questions or concerns from an industrial accident board or commission concerning First Reports of Loss forms completed by CorVel hereunder will be handled directly by CorVel. All such inquiries will receive an initial response within the next business day following CorVel's receipt of the inquiry. CorVel will keep Customer apprised of any inquiries it receives and the response thereto. CorVel will send a written response to the inquiry within five (5) business days outlining the nature of the inquiry and the resolution of same by CorVel. A copy of such response will also be sent to the attention of the designated Customer representative if requested in writing by Customer. Customer shall have the right, but not the obligation, at any time and at Customer's expense, to interject itself into the inquiry between CorVel and the industrial accident board or commission, and in connection therewith to resolve the inquiry in a manner acceptable to Customer at its sole discretion, in which case Customer shall defend, indemnify and hold harmless CorVel from and against any claim, liability, damages or costs arising from Customer's handling of such inquiry or the resolution thereof. III. DELIVERY OF CLAIMS MANAGEMENT SERVICES (a) Customer shall arrange so that all claims and all related bills of any type, as well as all other correspondence that Customer receives relating to such claims, are sent directly to CorVel. CorVel shall perform all of the following "Claims Services" in connection with each portion of a Claim related to Workers' Compensation benefit payments shall be defined as: Claims requiring work beyond the standard scope for each claim type will be invoiced at the next higher rate. The following section indicates the basis for the categorization of claims fees. You will be provided with reports that provide full transparency of the fees invoiced. (i) Record Only — system notation of an event that does not require any claims handling, including contact or investigation. These are used solely for the purpose of record keeping. (ii) Medical Only — claims where time -off does not exceed the state waiting period and the scope of work is within the parameters noted in the Pricing section ("Fees"), Exhibit B. (iii) Indemnity — claims not otherwise classified as either Record Only or Medical Only. (b) All Claims Services provided by CorVel under this Agreement shall be performed in accordance with the guidelines set forth in Sections II -IX of this Exhibit A: (i) CorVel shall immediately assign each new Indemnity Claim and Medical Only Claim to CorVel's designated claims professional. (ii) Utilizing CorVel's CareMC Application or other applicable CorVel Online System, CorVel shall maintain a chronological record of all Claims Services performed by CorVel. (iii) CorVel shall make all filings related to Indemnity Claims and Medical Only Claims with the appropriate state Workers' Compensation regulatory authorities. (iv) CorVel shall maintain a complete and accurate claim file for each Indemnity Claim and Medical Only Claim (v) CorVel shall perform reasonable and necessary administrative and clerical work including, without limitation, the following: IV. Investigate all Indemnity Claims and Medical Only Claims. . V. Determine and evaluate any coverage and/or compensability issues and provide Customer with appropriate recommendations and advice regarding the same. City of Everett, WA — CorVel EC Amendment 3 7-25-2022