REQUEST FOR PROPOSAL FOR LIABILITY CLAIMS AUDIT SERVICES FOR VENTURA COUNTY SCHOOLS SELF-FUNDING AUTHORITY

Transcription

1 REQUEST PROPOSAL LIABILITY CLAIMS AUDIT SERVICES VENTURA COUNTY SCHOOLS SELF-FUNDING AUTHORITY RETURN PROPOSALS TO: Elizabeth Atilano Pool Administrator Ventura County School Self-Funding Authority 5189A Verdugo Way Camarillo, CA DEADLINE FILING: September 14, 2012

2 REQUEST PROPOSAL LIABILITY CLAIMS AUDIT SERVICES VENTURA COUNTY SCHOOLS SELF-FUNDING AUTHORITY TABLE OF CONTENTS I. INTRODUCTION... 3 II. SCOPE OF SERVICES... 3 III. PROPOSAL REQUIREMENTS... 3 IV. INDEMNIFICATION... 5 V. INSURANCE REQUIREMENTS... 6 VI. SELECTION PROCESS

3 I. INTRODUCTION The Ventura County Schools Self-Funding Authority is seeking proposals from qualified firms to audit the claims administration of the liability program to determine the efficiency, effectiveness, and the consistency of claims adjusting service and the accuracy of loss runs. The Ventura County Schools Self-Funding Authority began self-insuring its liability exposures in It currently self-insures 30 school districts and charter schools up to $250,000 in liability coverage and purchases excess insurance above that amount. Ventura County Schools Self-Funding Authority provides the claims administration through its Third Party Administrator s office, York Risk Services Group, in Oxnard, CA. They have handled the claims since January Currently, there are 166 open general liability claims. Claim payments are processed by York Risk Services Group and reimbursed by Ventura County Schools Self Funding Authority (VCSSFA), and checks are issued by York Risk Services Group. II. SCOPE OF SERVICES The audit should include a review of 90 open liability claims, approximately 55%, with at least 45 (i.e., one half) of the claims having an incurred loss in excess of $25, Also, the audit should include a review of 25 open property, and 25 closed property and liability claims. We request the ability to select a portion of the claims prior to the fieldwork being completed. The files selected for the audit will consist of a sampling from each member entity with an audit of both immature and mature claims. The claims audited will include most types of exposures, i.e. employment practices, dangerous condition, failure to supervise, assaultive behavior, negligent driving, etc. as well as a few property claims. Individual audit sheets will be prepared for all files audited with significant findings notated. The audit should include a review of loss runs (open and closed), your memorandum of coverage, and your procedures and forms manual. The report should thoroughly address the purposes of the report and areas outlined above. III. PROPOSAL REQUIREMENTS The general objectives of the claims audit are: 1. To assess the efficiency and effectiveness of the present claims administrator; 2. To evaluate the adjuster s experience, competence, and staffing levels; 3. To obtain suggestions for improvement in claims handling, reserving, and reporting; and 4. To ensure that all provisions of the contract for services are met. 3

4 The claims audit report must address the following areas: ADMINISTRATION 1. Evaluate legal sufficiency and timeliness of claims; 2. Accuracy of the claim reserves; 1. Effectiveness and thoroughness of the claims investigation techniques, including the appropriateness of the use of outside investigative services; 2. Adequate review of available governmental immunities; 3. Adequacy, if any, of early disposition evaluation; 4. Proper case monitoring procedures; 5. Timely claims reporting to excess carriers; 6. Case loads of adjusters; 7. Areas of deficiencies in claims handling procedures; 8. Procedures for meeting critical deadlines such as payment of claims, denial of claims, subrogation notices and others; 11. Early analysis as to the conformance of the complaint to the allegations in the claim, if litigated; 12. Control of litigation costs; 13. Evaluation of defense attorney s handling of the case, if litigated; 14. Adequate communication between the administrator, litigation manager, and members as to the status and development of claims; 15. Effective use of diary system; 16. Adequate claim file documentation; 17. Adequate insurance, including errors and omissions coverage and fidelity coverage; and 18. General competence of the administration services being used. PERSONNEL 1. Technical competence and expertise of personnel handling the claims. PAYMENTS 1. Timeliness of payments; 2. Accuracy or excessiveness of payments; 3. Review of the claims payment process identifying any weakness in the procedures; 4. Claim file financial reconciliation with loss run; and 5. Evaluation of timely recognition and preservation of subrogation rights. Each proposer shall submit a complete proposal with all information requested. The content of the proposal will be as follows: 4

5 A. Consultant Corporate Data This section should include: 1. A description of at least two similar or related contracts under which the proposer has provided services within the last year 2. A brief description of the experience and qualifications of the proposed staff member(s) who will be conducting the audit 3. A brief description of the organization 4. A list of references B. Work Plan This section should contain the proposer's work plan for providing the services required. C. Cost Data This section should contain a complete breakdown of all costs relating to the contents of the proposal, including the maximum total cost, as well as an itemized breakdown of the compensation required to accomplish the full performance of all tasks outlined in the proposal. All proposals shall remain firm for at least ninety (90) days from the date set for proposal opening. IV. INDEMNIFICATION The Consultant shall indemnify, defend and hold harmless the Client, its member districts, and additional covered parties from any and all claims, demands, losses, damages, and expenses, including legal fees and costs, or other obligations or claims arising out of any liability or damage to property, if any, suffered by the Client, its member districts, and additional covered parties solely and exclusively by reason of the Consultant s proven gross negligence or willful misconduct. 5

6 V. INSURANCE REQUIREMENTS Proposers shall take out and maintain during the entire term of the agreement insurance pertaining to the activities associated with the agreement. Proposers will be required to obtain, at its own cost and expense, all insurance coverage and endorsements required below and shall provide evidence of such insurance and endorsements to the Ventura County Schools Self-Funding Authority prior to commencing work. Insurance: Workers Compensation and Employer s Liability Coverage: Workers Compensation Insurance and Employer s liability insurance, on all of its employees to be engaged in work related to the performance of this Agreement, in accordance with applicable California law. Commercial General Liability Coverage: Commercial General Liability Insurance for bodily injury, personal injury, and property damage, in an amount not less than one million dollars ($1,000,000.00) per occurrence, with not less than two million dollars ($2,000,000) aggregate. Consultant s Commercial General Liability Insurance shall name VCSSFA, its member districts, and additional covered parties as additional insured. Automobile Liability Coverage: Automobile Liability Insurance covering bodily injury and property damage for all activities of the Consultant arising out of or in connection with the work to be performed under this Agreement, including coverage for owned, hired and nonowned vehicles, in an amount not less than one million dollars ($1,000,000.00), combined single limit. Professional Liability Coverage: Professional Liability Insurance for protection against claims arising out of the negligent acts, errors, or omissions of Consultant s operations under this Agreement, in an amount not less than one million dollars ($1,000,000.00). 6

7 VI. SELECTION PROCESS Upon receipt of the proposal, Ventura County Schools Self-Funding Authority staff will review each firm s response to this Request for Proposal. Failure to properly address all the items set forth above may disqualify the prospective auditor s proposal. Ventura County Schools Self-Funding Authority reserves the right to reject any or all proposals at its sole discretion. At their discretion, staff may interview one or more firms to further assist in the review process. Ventura County Schools Self-Funding Authority reserves the right to award the contract to the auditor at its discretion depending upon multiple areas of criteria. All proposals must be received in our office by 5:00 p.m. on September 4, Late proposals will be rejected. Please send ten (10) copies of your proposal and correspondence to: Elizabeth Atilano 5189A Verdugo Way Camarillo, CA Questions concerning this Request for Proposal should be addressed to: Elizabeth Atilano 5189A Verdugo Way (805) eatilano@vcoe.org The following is the selection timetable: September 14, 2012 September 17-21, 2012 October 9, 2012 October 16, 2012 Proposals due by 5:00 p.m. Review proposals Selection will be made by Executive Committee Board approves selection of the firm The Ventura County Schools Self-Funding Authority reserves the right to cancel and/or modify the above dates at anytime or to make a dual appointment. 7