17 - Laserfiche WebLink

Exhibit A A. Claims Administration. ICS shall adhere to the following claims administration standards and procedures: 1. ICS shall review and process reported claims for workers' compensation benefits that have not been closed as of the Effective Date of this Agreement and closed claims that reopen on or after the Effective Date ICS shall have no responsibility other than custody of files and statistical reporting for claims closed prior to the Effective Date 2. Determine liability for claimed injuries and illnesses in accordance with California Workers' Compensation Laws. 3. Review and process all claims in accordance with rules and regulations established by the Division of Industrial Relations, Department of Self - Insurance Plans. 4. Establish files containing medical and factual information on each reported claim together with complete accounting records and maintain same in accordance with statutory time requirements. 5. ICS shall make all workers compensation disability payments and send all notices in a timely and accurate manner and in conformance in all material respects with all applicable provisions of the Califomia Labor Code and the California workers' compensation laws, rules and regulations. 6. Determine nature and extent of permanent disability and arrange for informal disability rating whenever possible to avoid Workers' Compensation Appeals Board litigation. 7. Explain to and assist employee in completing necessary forms for permanent disability ratings 8. Review compute and pay all informal rating, findings and awards, life pensions or compromise and release settlements. 9. Maintain and establish reserve estimates for each reported claim. 10. Arrange for and supervise all necessary investigations to determine eligibility for compensation benefits and/or liability of negligent, third parties. 11. Identify, recommend and obtain special fraud investigations after obtaining advance authority from the CLIENT. 12. As a service to the CLIENT, ICS will report all excess claims to excess reinsurance carrier, although the final responsibility for reporting such claims is that of the CLIENT' s.