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Page 9 of 22 <br />b) the schedule of services and fees; <br />c) the type and frequency of claims summary to be provided, on an as-and-when-required basis, and <br />d) the overall level of service and performance provided by the TPA. <br />2.7 OVERVIEW OF SCOPE OF SERVICES <br />The TPA services to be provided will include, but not be limited to, the following. <br />A. CLAIMS ADMINISTRATION <br />1. Provide high-quality liability claims-adjusting services with qualified adjusters experienced in <br />public-entity claims adjusting. <br />2. Coordinate claims handling activities with the City’s Risk Manager. <br />Note: The city’s involvement is significant and may exceed that of other clients; therefore, <br />proposers should factor this into staffing requirements. <br />3. Set up a claim file within 24 business hours of receipt of the claim. <br />4. Send an acknowledgment letter for all new files opened. <br />5. Review the claim to verify that the claim complies with Washington state filing requirements. <br />6. With prior approval of the city’s Risk Manager on a per-claim basis, issue appropriate letters <br />and notices to the claimant advising us of any deficiencies, claim rejections, claim denials, or <br />any other pertinent correspondence as required. <br />7. Maintain a complete claim file for each reported claim. This file must be available for the <br />city's review at any time. The claim file should include, at a minimum, liabilities with reserves, <br />claimant contacts, notes, regular follow-up, investigatory steps, plan of action, and <br />recommendations on claim disposition. The claims file must be made available electronically <br />in the format required by the city Risk Manager for viewing by city staff. <br />8. Establish claims calendar diaries so that all claims are reviewed at a minimum of every thirty <br />(30) calendar days. Record in the file that the claims review was conducted. <br />9. Document all correspondence relating to the claim, including phone conversations, in-person <br />meetings, and electronic communication. Include the date, names of individuals involved, the <br />content of the discussion, and next steps. <br />10. Assign an initial reserve within 15 calendar days of claims assignment. Maintain adequate <br />claim reserves and provide periodic updates on regular reserves to the city. Note: The reserve <br />formulas and practices are subject to review and approval of the city’s Risk Manager <br />11. Establish and document in the claim file the initial direction on the claims handling and <br />investigation within five (5) working days of receipt of the claim. <br />12. Coordinate investigations of litigated claims with attorneys approved by the city and, where <br />appropriate, with adjusters and attorneys of the excess insurance carrier. <br />13. Review all claimed damages for causal relationship and reasonableness of charges. <br />14. Provide prompt resolution of non-contested claims. <br />15. If the claim is to be accepted, gather damages documentation and, with prior written <br />approval on a per-claim basis from the city, negotiate a reasonable settlement for final <br />presentation to the city for approval or ratification. All settlement discussions with the <br />claimant must be conducted in accordance with the city's guidelines, subject to the city's <br />approval.