HomeMy WebLinkAboutPalmer & Cay/Carswell Inc
Augusta Richmond GA
DOCUMENT NAME: POJ I /'nli' -+- til-'j / f2 C...r~ kXi ( -Z n c.
. DOCUMENT TYPE: Lonfr{i..ci/
YEAR: ) q 0; (fl
BOX NUMBER: I
FILE NUMBER: ) 9- Lp B 7
, NUMBER OF PAGES:
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PALMER & CAY/CARSWELL, INC.
CONTRACT FOR SERVICES
PARTIES
City of Augusta (hereinafter "CLIENT") hereby retains Palmer & Cay/Carswell, Inc, (hereinafter
"P&C/C") to perform the services listed on Schedule V.
TERM
This contract shall be in effect from 5/1196 to 1/1197
and effect unless amended or terminated,
and shall remain in full force
ATTACHMENTS
Attached hereto and made a part hereof are the following schedules:
I. OBLIGATIONS OF THE PARTIES
II. BANKJNG
III, TERMS AND CONDITIONS
IV, DEFINITIONS
V. SERVICES AND FEES
PALMER & CA Y /CARSWELL, INC.
By:
Title:
Date: A p r ill 6, 1 996
Date:
ADDRESS: 530 Greene Street
ADDRESS: P.O. Box 847
Augusta. Georgia 30911
Savannah. Georgia 31402
PALMER & CAy/CARSWELL
Established 1868
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SCHEDULE I
OBLIGATIONS OF THE PARTIES
A. Obligations of P&C/C
P&C/Cagrees to perform the following services;
1, With regard to Claims Administration, P&C/C shall:
a, Review each claim and loss report submitted by the ClIENT during the
term of this contract.
b, Conduct an investigation of each qualified claim or loss to the extent
deemed necessary by P&C/C.
c. Maintain a file for each qualified claim or loss which shall be available for
review by the CLIENT.
d. Adjust, settle or resist all qualified claims or losses:
1) within the stated discretionary settlement. authority limit;
2) with specific approval of the CLIENT, if outside the stated
authority limit.
e. .Perform necessary and customary administrative and clerical work in
connection with each qualified claim or loss, including the preparation of
checks or vouche~s, releases, agreements and other documents needed to
finalize a claim.
f. Establish and update claim reserves as needed.
g, Assist the CLIENT in establishing a banking arrangement for loss and
expense payments as set forth in Schedule II.
h, Notify CLIENT, CLIENT's agent or carriers, as designated by the
CLIENT, of all qualified claims or losses which may exceed the CLIENT's
retention and, if requested, provide information on the status of those
claims or losses,
1. Coordinate investigations on litigated claims with attorneys representing the
CLIENT and with representatives of the excess carrier, as required, It is
expressly understood that all legal costs and loss payments will be charged
to the CLIENT,
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PALMER & CAy/CARSWELL
Established J 868
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J, Have P&C/C's internal support staff review large and unusual claims at no
additional cost to the CLIENT, unless specified in Schedule V,
k. Investigate and pursue subrogation possibilities on behalf of the CLIENT
in all states permitting subrogation. Funds received from all subrogation
collections shall be considered revenue of the CLIENT,
1. Maintain an automated loss and information system, and provide the
CLIENT with reports as set forth in Schedule V.
m. Provide forms, as determined by P&C/C, needed to administer the
CLIENT's program,
n, Provide additional ad hoc information, analysis, reports and services on a
time and expense basis.
o. Assist the CLIENT in selecting appropriate experts or specialists as the
claims may require.
. p, Provide personnel needed to perform the services agreed to herein.
2, With regard;to Risk Management Consulting and Appraisals, P&C/C shall provide
the services ,set forth in Schedule V.
3.. . Provide other services as set forth in Schedule V,
B, Oblie:ations of CLIENT
1. CLIENT shall pay P&C/C for services the annual sum set forth on Schedule V,
as agreed to under the "Billing and Payment Terms" section. At the end of each
contract period, the annual compensation shall be subject to adjustment.
Where applicable, P&C/C shall audit the claim counts at the 12th, 18th and 24th
month, CLIENT shall pay P&C/C any additional fees due as a result of these
audits,
2, CLIENT shall provide funds for the payment of qualified claims or losses,
allocated loss expenses, and any cost containment fees, if applicable. P&C/C shall
not be required to advance funds to pay losses, allocated loss expenses, bank
charges, or cost containment fees.
3, Fees are payable upon receipt of invoice, P&C/C reserves the right to charge 1%
per month on balances unpaid after 30 days.
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PALMER & CAy/CARSWELL
Established 1868
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SCHEDULE II
BANKING
P&C/C will provide an on-line check issuance and banking communication system which
provides for automated payments and control. The account will be funded by client and in the
client's name at a bank of the client's choice. P&C/C will provide weekly check listings and
monthly reconciliation reports.
It is expressly understood that P&C/C shall not be required to advance its own funds to pay any
of the CLIENT's obligations,
In the event of cancellation or nonrenewal of this contract, CLIENT agrees to fund the account
in an amount sufficient to fund all of the CLIENT's outstanding obligations,
SCHEDULE III
TERMS AND CONDITIONS
A. Discretionary Settlement Authority - The limit on any settlement payment by P&C/C shall
be Five Thousand and no/100 Dollars ($5.000.00). It is agreed the P&C/C shall have full
authority in all matters pertaining to the payment, processing, investigation and
administration of qualified claims or losses within this limit. Failure of P&C/C to settle
~a qualified claim oLloss within such limit shall not subject P&C/C to liability to any party
in the event ofan.adverse judgment entered by any court or the settlement of such claim
or loss for an.amount in excess of such limit.
B. Terms of Cancellation or Nonrenewal - Either party shall have the right to cancel or
renegotiate the contract after each contract period by giving the other party written notice
of intent to cancel or renegotiate at least sixty (60) days in advance. If timely notice of
cancellation is given, this contract shall terminate upon the expiration of the current term.
In the event of cancellation or nonrenewal of this contract, P&C/C will continue to
manage all pending claims and claims occurring in this service term but not reported prior
to the date of termination for a period of one year. Thereafter, should client elect to have
P&C/C continue to handle the "run-off cases," client will be billed at a rate of $150 per
open case per year.
Should the CLIENT elect to have the files returned to them, P&C/C will provide a tape
or paper copy of the claim information. Upon delivery of this information to CLIENT,
claim information will be deleted from the system,
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PALMER & CAY ,CARSWELL
Established J 868
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If the CLIENT fails to pay any amounts billed, including but not limited to P&C/C's
service fee during the contract period, the service fee to continue handling claims past
termination date or bank charges, within 30 days, P&C/C shall have the right to terminate
the contract by giving the CLIENT ten (10) days' notice in writing. P&C/C will then
return all files to the CLIENT in an orderly manner. Costs for file transfer shall be the
obligation of the CLIENT,
C. Practice of Law - P&C/C will not perform any servIces which may constitute the
unauthorized practice of law,
D. Indemnification - P&C/C agrees to defend, indemnify, protect, save and keep harmless
CLIENT from any and all loss, cost, damage or exposure arising from the negligent acts
or omissions of P&C/C.
The foregoing indemnification provisions shall survive termination of this Agreement.
E. Notices - Any notice required to be given under this contract shall be sent by certified
mail to the following in the case of P&C/C:
Mr. Ronald W, Nolting
Vice President
.Palmer & Cay/Carswell of Georgia, Inc,
P.O, .Box 847
, Savannah, GA 31402
and in the case of the CLIENT:
Mr. Charles T. Dillard
Acting City Administrator
City of Augusta
530 Greene Street
Augusta, GA 30911
F. Successors - This contract shall be binding upon and shall inure to the benefit of all
assigns, transferees and successors in interest of the parties.
G, Modification - This contract represents the entire agreement between the parties and may
be modified only in writing. P&C/C reserves the right to modify fees with the mutual
consent of client or to terminate this agreement upon 60 days advance written notice, if:
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PALMER & CAy/CARSWELL
Established /868
~A
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· It is determined that the historical data upon which P&C/C fees and service
charges developed were based upon erroneous, obsolete or insufficient information,
or that a change in CLIENT's business will materially change the nature and/or
volume of its business or claims as contemplated at the inception of the
Agreement.
· During the term of the Agreement, legislative and/or regulatory requirements
materially impact or change the scope of P&C/C's services or responsibilities.
H, Confidentiality of Data - All data furnished by the CLIENT, or generated as a result of
services performed under this agreement, and other information designated by the
CLIENT in writing, shall be treated as confidential. P&C/C reserves the right to use
statistical information or other data, so long as the CLIENT's name and/or confidential
data are adequately protected,
1. ! Status - It is understood that P&C/C is engaged to perform services under this contract
as an independent contractor and not as an agent of the CLIENT. This contract shall be
governed by the laws of the State of Georgia,
J. Cost Containment - If upon the advance written request of client, P&C/C provides cost
,containment services for the CLIENT's program, either directly or indirectly through an
'independent.contractor, CLIENT agrees to pay P&C/C an additional fee for these services
,and to"comply with the procedures for utilizing any such cost containment services,
. provided, however, that P&C/C shall advise the CLIENT in advance as to the amount of
such costs, Specifically, if P&C/C provides CLIENT access to Affordable Healthcare
Concepts Preferred Provider Organization, CLIENT agrees to comply with the procedures
for utilizing the Affordable Healthcare Concepts PPO Program,
K, Reporting - P&C/C will not assume that other coverage (unknown to P&C/C) exists for
a qualified claim or loss. P&C/C shall not be responsible for reporting to carriers on a
type of claim or loss not managed by P&C/C.
L. Property Catastrophe Charges - Any property loss involving multiple locations as a result
of natural disasters from a covered peril will be billed at time and expense at P&C/C's
prevailing hourly rate.
M, Casualty (Liability/Workers' Compensation) Catastrophe/Multiple Claim Occurrence
Charges - Any accident or occurrence will be billed on a per claim basis.
N, Fines and Penalties - P&C/C shall not be responsible for any fines or penalties assessed
by any governmental agency because of the acts or omissions of the CLIENT, or by
previous or successor claim administrators,
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PALMER & CAY/CARSWELL
Established /868
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o. Solicitation of Emplovees - CLIENT agrees that, during the term of the Agreement and
for a two-year period thereafter, CLIENT shall not, without the consent of P&C/C, solicit
to hire, or hire any employee of P&C/C who, during the term of the Agreement, has
performed, or contributed to the performance of, services hereunder.
p, Claim File Records - P&C/C will retain claim files for 24 months following date of
closure. Thereafter, files will be returned to the CLIENT or forwarded to such location
as may be designated by the CLIENT for continued storage,
Q, Subrogation - To the extent P&C/C is involved in pursuing recoveries against third parties
or otherwise undertaking subrogation activities on behalf of CLIENT, P&C/C is
authorized to collect, in the name of the CLIENT or in the name of P&C/C, all funds due
as a result of such recovery or subrogation activities. P&C/C shall not be required to
establish any trust accounts for the benefit of CLIENT, but shall promptly and fully
account for all funds so received,
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PALMER & CAy/CARSWELL
Established /868
l!l
SCHEDULE IV
DEFINITIONS
Claim - Any report of an accident (first or third party) alleging or resulting in injury, damage,
or loss which could give rise to a demand for the payment of money, The claim charge is
applicable on a per occurrence, per claimant, per line of coverage basis.
Discretionary Settlement Authority - P&C/C is authorized to make payment, for loss or
expense, up to this amount, as P&C/C deems necessary.
Qualified Claim or Loss - P&C/C will investigate and adjust any loss or claim occurring within
the service term, provided the loss or claim type is identified in Schedule V.
Allocated Expenses - Shall be the responsibility of the CLIENT and shall include, but not be
limited to:
. legal fees . medical examinations
. professional photographs . extraordinary travel made at CLIENT's
. medical records request
. experts' rehabilitation costs . court reporters
. accident reconstruction . fees for service of process
. .architects, contractors . pre- and post-judgment interest paid
. ~engmeers . chemists
. police, fire, coroner, weather, . collection costs payable to third parties on
or other such reports subrogation
. property damage appraisals . any other similar cost, fee or expense
. extraordinary costs for witness reasonably chargeable to the investigation,
statements .negotiation, settlement or defense of a claim
. official documents and transcripts or loss which must have the explicit prior
. sub rosa investigations approval of the CLIENT
Cost Containment - Cost containment services shall include but not be limited to:
..
preferred provider organization'
networks
automated state fee scheduling
medical case management and
vocational rehabilitation network
· utilization review services
· light duty and return to work programs
· -prospective injury management services
· hospital bill audit services .
.
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PALMER & CAy/CARSWELL
Established 1868
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SCHEDULE V
SERVICES AND FEES
Client: City of Augusta
Service Period: From 5/1/96
to
1/1/97
SERVICES PROVIDED:
Inel.
SERVICES PROVIDED:
Incl.
A. Claims Administration
Other:
Auto Liability-Bodily Injury (AB)
Auto Liability-Property Damage (AD)
Auto Physical Damage (APD)
General Liability-Bodily Injury'(GB)
General Liability-Property Damage (GO)
Products Liability
Professional Liability
Property (PR)
Workers' Compensation (We)
Medical Only
Indemnity
Other:
C. Loss Funding
P&C/C Owned Banking
Client Owned Banking
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D. Supplemental
Run-Off One Year.From Date of Accident
All Claims
Assumption
Other:
~
150 annual
Meetings
Discretionary Settlement
Authority
Index Bureau
Coordination
Set Up/Program
Incident Processing
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~
75
440
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5,000
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~
25
Record Only Processing
Update Appraisals
Risk Inspections
B. Information Services
Corporate Systems
Standard Package
Non-Standard Reports
Tenninals & Printers
Data Transfer
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TOTAL
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TBD
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ADDITIONAL SERVICE TERMS AND CONDITIONS:
There will be a minimum fee of $24,000 and a maximum of $40,000 for new cases subject to audit annually. An audit of files will be
conducted at year-end to detennine any additional money due P&C/C based on above schedule of costs per claim, A workers'
compensation medical only case that exceeds $500 will be considered at the indemnity rate.
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BILLING AND PAYMENT TERMS:
Payable within 30 days of invoice.
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PALMER & CAy/CARSWELL
Established 1868