SERVICE AGREEMENT (7) SERVICE AGREEMENT
THIS SERVICE AGREEMENT (the "Agreement") is made and entered into by and
between COMMERCIAL RISK MANAGEMENT, INC. (referred to as the "Company") and
CITY OF CLEARWATER(referred to herein as the"Self-Insured").
In consideration of the covenants and conditions set forth below to be performed and
observed by the parties hereto, it is agreed as follows:
1. So long as this Agreement remains in effect,the Company will furnish claims handling
and statistical data, including filing of all forms and reports (from data supplied by the Self-
Insured) as required by the Florida Department of Financial Services, Division of Workers'
Compensation,
2. The Company will handle to a conclusion all claims that occur during the period that
this Agreement remains in effect. The cost of handling the tail for the initial one year term of this
Agreement and for each one-year renewal of the term of this Agreement will be considered to be
included in the Annual Service Fee to be paid upon each renewal of the term of this Agreement.
However, in the event of any cancellation of this Agreement, the Self-Insured shall pay to the
Company an administrative fee for handling the tail in an amount to be negotiated between the
Company and the Self-Insured, which administrative fee shall not exceed ten percent (10%) of
paid loss, and which administrative fee shall be payable on a monthly basis as invoiced by the
Company.
In the event claims files and claims servicing responsibilities are transferred to a new
service company, the Company will provide an accounting of all claims and claims activity to
the new service company. Upon the transfer of the files and final accounting of the claims
activity, the Company shall be released from all further responsibility and liability under this
Agreement.
The Company acknowledges that files containing the records of the Self-Insured's claims
shall belong to the Self-Insured, provided that the Company shall have the right to retain copies
of any and all such records to the extent determined appropriate by the Company.
All claim expenses commonly referred to in the insurance industry as "Allocated Claims
Expenses" shall be the responsibility of, and paid by, the Self-Insured. Without limiting the
generality of the immediately preceding sentence, the term "Allocated Claims Expenses" shall
include such items as attorneys' fees, court costs, independent investigative claims costs, and
managed care services as provided by the company of the Self-Insured's choice. The Self-
Insured shall be responsible for service charges that accrue to the claims paying checking
account if the account is maintained by the Company.
3. The Self-Insured shall pay to the Company, for the Company's services under this
Agreement, a Service Fee payable as invoiced by the Company. The Company will handle any
and all claims that the City of Clearwater sends to our office, and this will be charged in
accordance with the fees as outlined below:
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FEES:
Administrative Fee
• Yearly Administrative Fee for consultations regarding compensability,
medical/indemnity and legal issues as well as assistance with calculations and any
and all other workers' compensation related matters: $2,500.
Claim Fees
• Indemnity/Lost Time Claim: $1,000 per claim.
• Medical Only Claim for handling routine or overflow medical only claims: $250
per claim.
• Complicated Medical Only Claim
Claim forwarded for complex medical issues and/or investigative purposes: $500
per claim.
• Loss Control
Optional-Loss Control Services are available and Commercial Risk
Management, Inc. will provide up to two (2)visits per year: Fee $1,800.
Any medical only claim,routine or complex,that becomes a lost time claim,the difference in the
fee up to the$1,000 will be charged.
It is the intention of our Agreement that the City of Clearwater will forward to our office for
handling claims that they wish us to handle. The parameters or indicators include but are not
limited to the following:
1) Lost Time Claims.
2) Medical Only Claims that turn into Lost Time Claims.
3) Claims that require Impairment Benefit Payments.
4) Compensability Issues.
5) Complex Medical Claims.
6) Claims that become Legal.
7) Claims that need investigation.
8) Heart-Lung Presumption Claims or Exposure Claims that require Affidavit.
9) Subrogation Claims.
10)New claims with multiple employees involved where initial excess reporting is
necessary.
11)Medical Only Claims when City personnel are away from the office.
The Service Fees shall be payable quarterly as invoiced by the Company.
Since the basis of the Service Fee is not predicated on payroll or premium, an annual payroll
audit is not included as a part of this Service Agreement.
4. The initial term of this Agreement shall be three (3) years with such term being
deemed to have commenced at 12:01 a.m. on February 1, 2022, and with such term to terminate
at 12:01 a.m. on February 1, 2025. Any renewal of the term of this Agreement shall be
documented by an instrument in writing signed on behalf of both the Company and the Self-
Insured and can be renewed for up to three(3)additional periods of one (1)year each.
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Notwithstanding the foregoing provisions of this paragraph, either the Self-Insured or the
Company shall have the right to cancel this Agreement solely by giving the other not less than
sixty (60) days' advance written notice of the proposed date of cancellation. Any such
cancellation of this Agreement shall be subject to all of the applicable terms and provisions of
this Agreement.
5. Each notice, request, demand, consent, approval, or other communication required or
permitted under this Agreement (collectively a "notice") shall be valid only if it is (a) in writing
[or sent by telex, telegram, or telecopy and promptly confirmed in writing] and (b) addressed by
the sender to the other party at its address and in the manner set forth below:
(a)If to the Company: COMMERCIAL RISK MANAGEMENT, INC.
Post Office Box 18366
Tampa FL 33679-8366
(b)If to the Self-Insured: Risk Management Department
CITY OF CLEARWATER
P.O. Box 4748
Clearwater FL 33758
Except as otherwise provided herein, each notice shall be effective on the earlier of its
receipt, if delivered personally or by courier, or the third day after it(or the written confirmation
of it) is postmarked for dispatch by first-class, postage prepaid, certified or registered, United
States mail, with return receipt requested (whether or not the return receipt is subsequently
received by the sender).
Any party wishing to change the person or address to which notices are to be given may
do so by complying with the notice provisions of this paragraph.
6. This Agreement embodies the entire Agreement and understanding between the
parties with respect to the subject matter hereof, expressly superseding all prior Agreements and
understandings, whether oral or written. No amendment, modification or attempted waiver of
any provisions of this Agreement shall be binding upon either party to this Agreement unless
reduced to writing and signed by or on behalf of each of the parties to this Agreement. The
waiver by either party of any breach of any covenant or condition of this Agreement shall not be
construed as a waiver of any subsequent breach of such covenant or condition or of the breach of
any other covenant or condition contained in this Agreement. Any number of counterparts of this
Agreement may be signed and delivered, each of which shall be considered an original and all of
which, together, shall constitute one and the same instrument. This Agreement shall be governed
by and shall be construed in accordance with the laws of the State of Florida. The provisions of
this Agreement shall be'binding upon, and shall inure to the benefit of, the parties hereto, and
their respective successors and assigns.
7. The Company agrees to notify the excess workers' compensation and employers
liability insurance companies on all claims in accordance with the reporting requirements
contained in each insurance policy so long as the City of Clearwater provides the copies of
necessary excess policies. Furthermore, the Company agrees to notify the Self-Insured of any
recoveries received from the Special Disability Trust Fund and the excess insurance Companies
and to make timely requests for reimbursements with the excess insurance companies.
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8. Confidentiality of Business, Employment and Medical Records Information. The
Company agrees that it and all Company personnel shall treat all patient, medical, and/or City of
Clearwater business information to which it/they become privy as confidential and proprietary to
the City and will not, at any time, directly or indirectly, divulge to any unauthorized person or
entity or use for their own personal gain any confidential information acquired by them during
the term of this Agreement. The Company also agrees that it and all Company personnel shall
comply withal applicable laws and regulations concerning the confidentiality and disclosure of
medical records and medical record information.
9. The Company will maintain professional liability/E & O insurance coverage with
limits of $5,000,000 per occurrence and supply proof of such insurance on a yearly basis as
coverage renews.
IN WITNESS WHEREOF,the Company has caused this Agreement to be executed by its
undersigned officer duly authorized this 9th day of June, 2022, but effective as of February 1,
2022.
COMMERCIAL RISK MANAGEMENT, INC.
By:
/ Susan E. Theis
President/CEO
IN WITNESS WHEREOF, the Self-Insured has caused this Agreement to be executed by
the undersigned duly authorized this f day of , 2022 , but effective as of
February 1, 2022.
CITY OF CLEARWATER
By: t
Monica Mitchell
Acting Risk Manager
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