Intercare Holdings Insurance Services, Inc 5/8/2026

City of Everett RFP #2026-001 for Third Party Claims Administrator (TPA) Services Reserving of Claims The establishment of reserves is one of the most important tasks we perform for our clients – it impacts critical areas, such as funding levels and budgets. Our philosophy is to set reserves on a “most probable outcome” basis. Our best practice is to establish separate reserves for indemnity and expense; however, we will reserve according to the City’s policy. Adjusters are required to set initial file reserves for indemnity and expenses (legal and adjusting) within five (5) days of assignment. Adjusters review claim reserves each time they interact with a file, and specifically on each diary date. Reserves take into consideration liability as to the City and comparative fault of the claimant/plaintiff, type of injury, damages, prognosis, expenses, and any anticipated general damages. Litigated files include separate reserves for legal expenses based on a current litigation plan and budget. Updating Clients on Major Reserve Changes The City will receive monthly reports which include reserves and/or reserve changes. ClaimsXpress will send push notifications when the reserve change meets the threshold that George Hills and the City have established. Our best practices dictate that all reserve changes be entered as soon as the adjuster becomes aware of the need for a change. Supervisory Approval of Reserve Changes Supervisors must approve all reserves set by an adjuster. The decision-making authority on revising the reserve is initially set at the level where the work is being done. However, large increases in reserves will be reported immediately to the supervisor and/or the City as required. Notification and Updating of Excess Insurers It is the responsibility of the adjuster to promptly report (within 30 days of receiving notice of a reportable claim) any case meeting the reporting requirements of the excess carrier, or as instructed by the City. The adjuster will also provide status reports to the excess carrier/pool (including reports from defense counsel) at the required intervals. Intercare will notify the City’s excess carrier(s) in any number of situations according to the requirements of the excess policy carrier’s stipulations. First, the excess carrier is notified no later than 30 days after receipt of a reportable claim. Second, notification is sent when reserves are set on any reportable claim or suit involving multiple claims or suits arising out of one occurrence, or any claims or reserves amounting to 50 percent or more of the retained limit. Third, excess carriers are notified regarding Title 42 USC 1983 cases in which a complaint has been served and the plaintiff is represented by legal counsel or with reserves of 25 percent or more of the retained limit. Lastly, regardless of the reserve, notification is sent on any claim involving the following: One or more fatalities Loss of a limb Loss of use of any sensory organ Quadriplegia or Paraplegia Third degree burns involving 10 percent or more of the body Serious facial disfigurement Paralysis Closed Head injuries 22