Third Party Administration of Claims Service for General and Automobile And PR

The City seeks a USA-based vendor to provide offsite third-party administration of claims services for general, automobile, and property claims. The vendor must assign key local personnel for service calls, provide telephonic and electronic claim reporting, maintain complete claim files, and supply accounting for the program. Scope requirements include complete handling of loss adjustments, investigations, and settlements within City-approved limits. Adjusters must adhere to maximum claim counts: 225 for liability, 300 for property, 150 for Workers’ Compensation lost time, and 200 for Workers’ Compensation medical-only. Loss adjustment duties require state-mandated electronic reporting, 48-hour three-point contact, liability or compensability investigations, exposure-based reserving, agency inquiries, Medicare secondary payor reporting, subrogation management, settlement recommendations, and immediate risk manager notification for excess coverage exposure. The vendor must provide the City Risk Manager and City Solicitor with online real-time access to the claims system. The buyer seeks proposals for the budget, and no key dates or evaluation details are provided.