MB-10364 - USA (California) - Workers\' Compensation Claims Administration Service - Deadline October 1,2026

(1) Vendor needs to provide workers' compensation claims administration service.• Review and adjust all workers' compensation claims in accordance with all applicable state laws as well as the terms of the contract.• Continue to administer and adjust all existing open files.• Obtain expert medical opinion when necessary and as authorized by City to evaluate the nature, extent, and causation of injuries.• Assist the attorneys in the preparation of all litigation and negotiations of settlements including, but not limited to, actions against third parties.• Report all claims that may reach the excess layer of insurance coverage to the appropriate insurance carrier in accordance with their respective requirements.• Coordinate return–to–work and medical rehabilitation programs with City's staff.• This report should identify the medical evaluator’s treatment philosophy, timeliness, and areas of medical expertise.• Provide copies in each claim file of all checks, vouchers, or warrants drawn to pay benefits and claims expenses on behalf of City.• Maintain a claim file on each potential or actual claim reported to Proposer.• Negotiate appropriate agreements on all claims to effect settlements in a timely manner.• Receipt and examination of all reports of accidents, incidents, claims or cases which are or may be the subject of claims.• The investigation of accidents, incidents, claims or cases where Proposer's initial examination indicates such action is warranted.• Assist in resolving employee problems related to an industrial injury in non–litigated cases.• Review and document subrogation potential on all files.