Sedgwick Claims CSA Amnd 1 20230925

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Consulting Services Agreement between City of San Leandro and Last revised 09/25/2023 Sedgwick Claims Management Services, Inc. for Claims Handling Services Exhibit A – Page 3 of 5 EXHIBIT A SCOPE OF SERVICES A. Claims Handling Promptly set up claim files within five (5) workdays after receipt of the general liability claim for damages against the City of San Leandro from the City. Investigate general liability claims and recommend acceptance/rejection of submitted claims with estimated reserves. 1. Assume all open claims existing at the beginning of the contract term. 2. Assess and evaluate the nature and extent of each claim, and propose recommended claim reserves for general damages, investigation expenses and legal expenses; City of San Leandro must approve all reserves. 3. Ensure timely claim handling, including follow-up for all investigations to ensure timely and expeditious processing. 4. Determine the need for defense representation, recommend legal counsel, and monitor litigation activity. Selection of defense counsel shall be by the City of San Leandro with input from the Claims Administrator. 5. Report claims to the excess insurer for claims that may exceed the City of San Leandro’s self-insured retention of $750,000.00, and work with the insurer on a claim’s progress, in accordance with the insurer’s reporting requirements. 6. Comply with California Joint Powers Risk Management Authority (CJPRMA) the excess insurer, claims reporting requirements. 7. Penalties incurred as a result of the failure of Claims Administrator to comply with any statutory laws and regulations shall be the sole responsibility of Claims Administrator. The City shall be notified in writing within 10 days of any penalty assessed the Claims Administrator and the reason for the penalty. 8. Mandated notices under California Government Code Section 910 (i.e. late notices, insufficient claims, etc.) will be sent by Sedgwick except for rejection and non-jurisdiction notices which will come from the City. Recommendations from the Claims Administrator will be sent to the City’s Risk Manager for handling. 9. Comply with the mandatory reporting requirements of Section 111 (“Medicare Secondary Payer”) of the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA) effective July 1, 2009. 10. When a claim is filed, the Claims Administrator is expected to adjudicate the claim before recommending assignment to defense counsel. If unable to settle, Claims Adjuster must recommend Defense Counsel to the City’s Risk Manager for decision of assigning to Defense Counsel. DocuSign Envelope ID: F9647D7F-7B34-488C-AAE1-832760177A38