Specifications include, but are not limited to: The contract will require the selected TPA to operate under the general direction of the District’s Compliance and Risk Manager. The TPA will perform all services and related work necessary for claims administration and statistical reporting. TPA services shall include, but are not limited to general, automobile, and property liability claims administration, investigations, research, analysis, recording, reporting, subrogation, litigation management, liability trust account management and reconciliation, and related support services. Program Administration A. Provide professional and technical staff to perform the General Liability Claims Administration services. B. Represent the District in all matters related to the set-up, investigation, adjustment, processing, negotiation, and resolution of liability claims against the District. C. Inform the District of changes or proposed changes in statutes, rules, regulations, and case law affecting its general liability claims program. D. Provide information and guidance regarding the general liability claims program and specified claims. E. Provide copies of file correspondence and documentation as requested by the District. F. Inform the District of problem areas or trends, both potential and perceived, and provide recommendations and/or solutions to address problem areas or trends. G. Attend appointments, including, but not limited to meetings, court appearances, and scene investigations at the request of the District. H. Provide 24-hour on-call service to be used as necessary including, but not limited to, first-party property loss response and catastrophic emergency. I. Coordinate semi-annual claim reviews to discuss the status of ongoing claims and to make case strategy recommendations. Claims Administration A. Take in and retain claims filed against the District. B. All claims management shall adhere to the requirements of the California Government Code and District Board Policies for accepting, denying, and rejecting claims. C. Review the status of claims to ensure adequate reserves have been set on all active cases at least every ninety (90) calendar days. D. Review all claims for liability and provide first investigative report within thirty (30) calendar days of receipt of claim to Risk Manager. E. Provide narrative reports when recommending rejection or settlement of a claim, when going to trial, or other significant events have or will occur. Reports must be clear and concise
