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Document
RFP - Claims Adjusting & Administration Service 2007
Year Created: 2007
DOCUMENT
RFP - SOW for Insurance Broker Services
- ENTITY TYPE: State
- TYPE OF DOCUMENT: RFP - Request for Proposals
- Finance
- Healthcare
The document is a solicitation for insurance and risk management services, specifically claims adjusting, for a Fund. The contractor is required to provide monthly and annual reports to the Board, including information on total claims reported, closed, open, in litigation, paid, denied, indemnity paid, loss expense paid, total payments, current reserves, and new claims reported. The contractor is also responsible for calculating and paying unearned premium claims and returned premium claims, as well as handling other related activities as required by the Board. Prompt and professional responses to inquiries concerning Fund claims are expected. The contractor must ensure payment of covered claims on a weekly basis and payment of claims-related expenses within 30 days. Each claim file should contain relevant information compiled in a chronological format. Claims must be handled in accordance with applicable statutes and policy provisions, and the Fund has the ultimate right and responsibility to determine claim payment. The contractor is responsible for determining if the insolvent insurer was authorized in Arizona and if a claim is a "covered claim." The contractor may not retain legal counsel, consultants, interpreters, or experts without approval, except for limited routine field investigations. Reporting of payments made on behalf of the Fund to the IRS is required upon request. The contractor must utilize the Uniform Data Standards for reporting claims data. Upon termination or expiration of the contract, the contractor must continue to handle remaining open claims unless directed otherwise by the Fund. The contractor and each adjuster assigned to handle the Fund's claims should have at least five years of experience in adjusting property and casualty insurance claims, as well as special education, formalized training, or experience in settling such claims. The document also includes a price sheet for the offeror to provide pricing information.