October 25, 2017
For this particular RFP, the State seeks to engage the services of a Third Party Administrator to investigate, document and otherwise assist in the adjustment of claims or potential claims for damages to or loss of property, personal injury or death caused by the negligent act or omission of the State or a State Employee (as defined below) while acting within the scope of employment. The type of claims covered by this RFP are limited to incidents involving motor vehicles, e.g., incidents involving the alleged negligent operation of a motor vehicle by a State Employee, or any personal property damage to a motor vehicle allegedly caused by the negligence of the State or a State Employee. Heavy equipment and machinery are not considered motor vehicles for purposes of this RFP. Further, workers’ compensation claims are specifically excluded from the scope of this RFP. It is the desire of the State to modernize its approach to the adjudication of such claims, utilize a framework of Best Practices, and create the appropriate outcome for the claimant regarding his/her situation and damages, based on fair standards and statutory provisions, at the least cost to the State.
In general, a high level description of the services requested from the Third Party Administrator include:
· Desk Adjustment, which includes all communication with the State Employee, point of contact, potential or actual claimant(s), file handling to conclusion of all assignments made under the Pro Forma Contract (RFP Attachment 6.6.) that can be accomplished from the inside desk position.
· Appraisal of Vehicles from the field, which includes covering the outside inspection, appraisal, total loss workup, salvage value, and reaching an agreement on repair cost with the body shop that provides the repairs.
· Outside Field Investigations, which includes securing recorded statements from claimants, witnesses, State Employee(s); scene investigations; procuring police reports, fire reports, and photographs of scene of accident/incident; and all that is required and/or necessary to establish who was at fault for the accident/incident. This does not include accident reconstructions or surveillance, which are specifically excluded from the scope of this RFP.
· Subrogation, which includes identifying subrogation opportunity, and providing the investigation information to support the subrogation efforts and placing the other parties on notice.
· Providing instructions to potential claimants on how to file a claim with the State.
We estimate approximately 300 of these types of accidents/incidents per contract year.
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