HomeMy WebLinkAboutItem 09d - Third-Party General Liability Claims Administration
STAFF REPORT
HUMAN RESOURCES DEPARTMENT
DATE: September 15, 2026
TO: Honorable Mayor and City Council
FROM: Sairy Stepanian, Acting Human Resources Director
SUBJECT: PROFESSIONAL SERVICES AGREEMENT WITH GEORGE HILLS COMPANY,
INC. FOR THIRD-PARTY GENERAL LIABILITY CLAIMS ADMINISTRATION
SERVICES IN AN AMOUNT NOT TO EXCEED $215,420 FOR A FIVE-YEAR
TERM
CEQA: Not a Project
Recommendation: Approve
SUMMARY
The City of Arcadia utilizes a Third-Party Administrator (“TPA”) to provide professional
claims administration services for its general liability program. On September 21,
2021, the City Council approved a five-year Professional Services Agreement
(“Agreement”) with George Hills Company, Inc. (“George Hills”) for third-party general
liability claims administration services for the period of October 1, 2021, through
September 30, 2026.
Under the current Agreement, George Hills has provided claims administration and
related services to the City in coordination with the California Insurance Pool
Authority (“CIPA”), the City’s municipal risk-sharing pool. George Hills has developed
familiarity with the City’s operations, claims history, risk exposures, and claims
management practices, and has provided the professional expertise necessary to
administer the City’s general liability claims.
With the existing Agreement scheduled to expire on September 30, 2026, it is
recommended that the City Council approve, authorize, and direct the City Manager
to execute a five-year Professional Services Agreement with George Hills Company,
Inc. for third-party general liability claims administration services for the period of
PSA for Third-Party General Liability Claims Administration
September 15, 2026
Page 2 of 5
October 1, 2026, through September 30, 2031, in an amount not to exceed $215,420
over the five-year term.
BACKGROUND
The City is a member of the CIPA, who operates as a Joint Powers Authority and
provides pooled risk-sharing and insurance programs to its member agencies. As
part of the City’s participation in CIPA, the City utilizes professional third-party claims
administration services to manage the day-to-day administration of its general
liability claims.
In 2021, the City transitioned its general liability claims administration services to
George Hills following CIPA’s evaluation and selection of the firm as a preferred
provider for its member agencies. On September 21, 2021, the City Council approved
a five-year Agreement with George Hills for the period of October 1, 2021, through
September 30, 2026.
George Hills is an established third-party claims administrator specializing in claims
administration and risk management services for public agencies. Since assuming
responsibility for administering the City’s general liability claims, George Hills has
worked closely with City staff, CIPA, defense counsel, claimants, and other parties
involved in the administration and resolution of claims.
DISCUSSION
The effective administration of general liability claims is an important component of
the City’s overall risk management program. General liability claims can involve a
broad range of matters, including bodily injury, property damage, dangerous
conditions of public property, automobile liability, and other allegations arising from
City operations. Proper claims administration requires timely investigation,
evaluation of liability and damages, coordination with legal counsel and insurance
representatives, maintenance of appropriate reserves, and development of
strategies to resolve claims efficiently and appropriately.
During the current contract term, George Hills has provided the City with
comprehensive general liability claims administration services and has established
institutional knowledge regarding the City’s claims, operations, and risk profile.
PSA for Third-Party General Liability Claims Administration
September 15, 2026
Page 3 of 5
George Hills also maintains familiarity with CIPA’s policies, procedures, reporting
requirements, and coverage structure, which facilitate coordination among the City,
CIPA, defense counsel, and other parties involved in the claims process.
Under the proposed Agreement, George Hills will continue to provide services that
include, but are not limited to:
• Managing and administering general liability claims;
• Investigating and evaluating claims and potential liability;
• Establishing and monitoring appropriate claim reserves;
• Monitoring defense counsel and litigation activity;
• Attending mediations, settlement conferences, arbitrations, trials, small claims
proceedings, and other proceedings, as appropriate;
• Coordinating and communicating with City staff, CIPA, defense counsel,
claimants, and other involved parties;
• Providing recommendations regarding claim resolution and settlement;
• Providing reports and information regarding the status and development of
claims;
• Advising the City regarding material developments affecting claims and
potential risk exposure;
• Providing training and technical assistance, as requested; and
• Performing other administrative and management functions necessary for the
effective administration of the City’s general liability claims program.
Continuation with George Hills will also provide consistency in the administration of
existing open claims and minimize disruption that could otherwise result from
transitioning the City’s claims inventory to a new administrator. Maintaining
continuity is particularly beneficial for complex and litigated claims where the claims
professionals have developed knowledge of the underlying facts, litigation history,
potential exposure, and resolution strategy.
Based upon George Hills’ performance during the existing Agreement, its experience
administering public agency liability claims, familiarity with the City and CIPA, and
ability to provide continuity in the administration of the City’s general liability
program, it is recommended that the City Council approve, authorize, and direct the
City Manager to execute a new five-year Agreement with George Hills Company, Inc.
PSA for Third-Party General Liability Claims Administration
September 15, 2026
Page 4 of 5
for third-party general liability claims administration services for the period of
October 1, 2026, through September 30, 2031.
ENVIRONMENTAL ANALYSIS
The proposed action does not constitute a project under the California
Environmental Quality Act (“CEQA”), based on Section 15061(b)(3) of the CEQA
Guidelines, as it can be seen with certainty that it will have no impact on the
environment.
FISCAL IMPACT
The total cost of the proposed five-year Agreement with George Hills Company, Inc.
is not to exceed $215,420 for the period of October 1, 2026, through September 30,
2031.
Under the terms of the proposed agreement, annual fees are as follows:
• FY 2026-27: $40,575
• FY 2027-28: $41,790
• FY 2028-29: $43,050
• FY 2029-30: $44,335
• FY 2030-31: $45,670
Sufficient funding for the first year of the Agreement has been included in the Fiscal
Year 2026-27 Operating Budget. Funding for subsequent years will be incorporated
into the annual operating budget, subject to City Council approval.
RECOMMENDATION
It is recommended that the City Council determine that this action does not
constitute a project under the California Environmental Quality Act (“CEQA”); and
approve, authorize, and direct the City Manager to execute a five-year Professional
Services Agreement with George Hills Company, Inc. for third-party general liability
claims administration services for the period of October 1, 2026, through September
30, 2031, in an amount not to exceed $215,420.
PSA for Third-Party General Liability Claims Administration
September 15, 2026
Page 5 of 5
Attachment: Proposed Professional Services Agreement
page 1 of 26
AGREEMENT FOR LIABILITY CLAIMS ADMINISTRATION SERVICES
BETWEEN CALIFORNIA INSURANCE POOL AUTHORITY
ON BEHALF OF MEMBER AGENCIES
AND GEORGE HILLS COMPANY, INC.
Article 1. GENERAL
This agreement is entered into effective October 1, 2026 by and between the California Insurance
Pool Authority (“CIPA”), a California Public Joint Powers Authority, on behalf of the Cities of
Arcadia, Brea, Buena Park, Cypress, Irvine, La Habra, Laguna Beach, Montclair, Orange, Tustin
and Yorba Linda (“Member Agencies or Member Agency”) and George Hills Company, Inc.
(“Consultant”).
In consideration of the mutual obligations hereby assumed, CIPA and Consultant (hereinafter
referred to as a “Party” or collectively as the “Parties”) agree to the following:
Article 2. SCOPE OF APPOINTMENT/RELATIONSHIP OF THE PARTIES
Consultant, its agents and employees are hereby appointed as CIPA and Member Agencies’
agents and representatives in connection with the investigation, adjustment, processing,
supervision and resolution of its liability claims, including general liability, employment practices
liability, automobile liability claims and potential claims for money damages asserted by third
parties against CIPA or any Member Agency for whom CIPA or Member Agency is alleged to be
legally responsible, and agrees to provide all services set forth in this Agreement.
The relationship of Consultant to CIPA and Member Agencies established by this Agreement is
that of independent contractors, and nothing contained in this Agreement shall be construed to
establish an employer/employee relationship or to constitute the Parties as partners, joint
ventures, co-owners, or otherwise as participants in a joint and common undertaking. Consultant,
its agents and employees are representatives of CIPA and/or Member Agencies only for the
purpose of administering the liability program claims as set forth in this Agreement, and they have
no power or authority as agent, employee, or in any other capacity to represent, act for, bind or
otherwise create or assume any obligation on behalf of CIPA and/or Member Agencies for any
purpose whatsoever, except as specifically required to perform Consultant's obligations under
this Agreement.
Article 3. DURATION
This Agreement applies to all work performed by Consultant which is described in Article 4,
whether performed in anticipation of or following the execution of this Agreement. The initial term
shall begin on October 1, 2026 at 12:01 a.m. and shall expire October 1, 2031 at 12:00 midnight.
Subsequent annual terms from, October 1, to October 1, may be mutually agreed upon between
the Parties.
The Agreement is subject to termination by either party at any time during the life of the
Agreement upon sixty (60) days written notice. CIPA maintains the right to terminate this
Agreement if CIPA determines that it is in the best interest to do so, in CIPA’s sole discretion and
with or without cause. When this Agreement is terminated, the Parties shall, as necessary, make
an adjustment to the payment schedule in Article 11 to prorate fees through date of termination.
Thereafter, Member Agencies shall pay Consultant moneys due and owing after such adjustment,
if any, or Consultant shall refund moneys due and owing Member Agencies after such
adjustment, if any. Adjustments due and owing shall be paid within thirty (30) days after
termination of the Agreement.
Upon notice of termination of the Agreement, Consultant will fully cooperate with the new claims
administrator, CIPA and Member Agencies in providing required information and service.
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Article 4. WATCHLIST CLAIMS
CIPA shall identify and notify Consultant of claims that are designated to be watchlist claims. The
criteria for designation of a watchlist claim includes the following:
A. Claims that are reportable to CIPA, by a Member Agency, with total incurred reserves or
potential payments, including defense costs that are 50% or more of a Member Agency’s
self-insured retention, or involving specified types of claims (as defined in it Memorandum
of Coverage).
B. Claims which CIPA designates to be assigned in accordance with the Agreement for
Litigation Management Services between CIPA, on behalf of Member Agencies, and
Consultant.
CIPA designated watchlist claims shall be assigned to a Litigation Manager in accordance with
the Agreement for Litigation Management Services between CIPA, on behalf of Member
Agencies, and Consultant.
The Litigation Manager shall administer and manage all watchlist claims as part of the scope of
duties encompassed in this Agreement and the Agreement for Litigation Management Services.
Article 5. CLAIMS ADMINISTRATION SERVICES
Consultant shall provide Member Agencies with the following services related to claims:
A. Manage claims in accordance with claims administration best practices and CIPA’s
Policies & Procedures including the Minimum Performance Standards for Liability
Claims Administration Policy, as contained in Exhibit 1. Policy revisions adopted by
CIPA’s Board of Directors shall be automatically incorporated into this Agreement.
Any such revisions will be reviewed with Consultant prior to adoption by CIPA.
B. Monitor defense counsel in accordance with CIPA’s Liability Program Defense
Counsel Policy, as contained in Exhibit 2. Any such revisions will be reviewed with
Consultant prior to adoption by CIPA.
C. Attend mediations, mandatory and voluntary settlement conferences, arbitrations,
trials, small claims and other proceedings at the request of Member Agencies.
D. Attend Member Agency meetings as requested.
E. Communicate with CIPA, Member Agencies, defense counsel and all other parties as
required to effectively manage claims.
F. Conduct training at the request of Member Agencies.
G. Advise Member Agencies of any material information impacting claims or need for
improvements in any matter related to this Agreement, including advice relating to
changes and proposed changes in statutes, regulations and rules affecting Member
Agencies’ liability claims.
H. Perform other general administrative functions and management oversight to provide
for the services in this Agreement.
I. Notify CIPA General Manager and the Litigation Manager of any claims with potential
exposure to CIPA.
Article 6. STATISTICAL LOSS DATA
A. In coordination with CIPA and/or Member Agencies, develop management reports
that assist CIPA and/or Member Agencies and Consultant in effectively managing the
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liability claims program. Standard reports will be provided within ten (10) days after
the end of the month.
B. IMetrics report will be provided to members at least semi-annually and as requested
by Member Agencies.
C. Loss reports shall be provided to actuaries, financial auditors and brokers as
requested.
D. CIPA and Member Agencies reserve the right to request additional reports required
to manage the liability claims program.
Article 7. SELECTION OF PERSONNEL
CIPA and Member Agencies shall maintain final approval in the selection of staff assigned to
CIPA’s account and the right to request new staff if the service is unacceptable to CIPA and/or
Member Agencies for any reason. Claims examiners assigned to the account must have a
minimum of five years full-time experience as a liability claims examiner, unless waived by CIPA
or Member Agencies.
Caseloads for claims examiners shall not exceed 175 claim occurrences, unless approved in
writing by the Member Agency and/or CIPA. Administrator shall provide CIPA and Member
Agency with an accounting of caseloads each June 30 and December 31. The accounting for
each examiner shall include (1) the name or pseudo name of all assigned clients; and (2) the
number of claim occurrences for each client. Each examiner shall sign acknowledgement of their
claims count and provide to CIPA and Member Agency.
Article 8. CONFIDENTIALITY
Consultant shall treat information, reports and analyses obtained or developed pursuant to this
Agreement as confidential. Prior written consent from CIPA shall be required before any
information, in any format, is disclosed to any third party. Consultant shall produce, maintain and
dispose of all such information reports and analyses in a manner to guarantee reasonable
safeguards to such confidentiality.
Article 9. AUDITS
Consultant agrees to cooperate with CIPA in making all claim files and records available to CIPA
for audit by CIPA or Member Agency’s appointed representatives including auditors. Audits
conducted onsite shall be done during normal office hours and CIPA and/or Member Agency’s
representatives, including auditors shall have reasonable access to the necessary portions of
Consultant's facilities, files and records for review or audit purposes, so as not to interfere with
Consultant's normal business.
Article 10. RIGHTS TO DATA
All claim files, paper and electronic, are and shall remain the property of CIPA and/or Member
Agencies. CIPA and/or Member Agencies reserve the right to obtain original claim files, data
discs, copies of reports and other documents applicable to CIPA and/or Member Agencies in the
event this Agreement is terminated.
Upon termination of this Agreement, Consultant shall transfer all claims data to either CIPA or to
a recipient designated by CIPA, within 90 days of termination. CIPA and Consultant may agree
via a separate signed agreement to retain records and/or data for a longer period of time, but in
the absence of such separate agreement, Consultant will remove all data received, held, used, or
stored in relation to George Hill’s performance pursuant to this Agreement, from its system after
90 days from termination. No documents shall be destroyed unless they have been scanned into
the system. Original documents received after termination of this agreement shall be forwarded
to the new claims administrator.
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Article 11. DOCUMENTS/CORRESPONDENCE
Each Member Agency will designate documents/correspondence they require for their files and a
timeframe for receipt of such documents/correspondence.
Article 12. FEE
The fee for this Agreement includes the claims count for all claims, including watchlist claims.
CIPA may elect to transfer watchlist claims to another consultant. The fee for this Agreement will
be mutually re-negotiated to reflect the reduced claims count if the watchlist claims are
transferred to another consultant.
In addition to the scope of services described in Articles 5 and 6, mileage and the set-up of claims
are included in the flat annual fee for all claims, including watchlist claims. The Fee also includes
the following services for non-watchlist claims and no fees related to the services under this
Agreement are chargeable to the Agreement for Litigation Management Services between CIPA,
on behalf of Member Agencies, and Consultant.
1. Client calls/meetings
2. Member communication
3. File review
4. Reports
5. Internal training and direction
6. Litigation management
7. Audits
8. Supervision/oversight
9. Internal communication
A. Member Agency Fees
Member Agencies shall be responsible for the payment of all fees stated herein. The flat
annual fee for each Member Agency is shown in the chart on the next page. Member
Agencies shall pay the fees quarterly within 30 days of receipt of an invoice from
Consultant.
Member 2026/2027 2027/2028 2028/2029 2028/2030 2030/2031
Arcadia $40,575.00 $41,790.00 $43,050.00 $44,335.00 $45,670.00
Brea $13,900.00 $14,330.00 $14,750.00 $15,200.00 $15,650.00
Buena Park $27,825.00 $28,650.00 $29,515.00 $30,405.00 $31,315.00
Cypress $16,225.00 $16,715.00 $17,220.00 $17,735.00 $18,270.00
Irvine $88,100.00 $90,750.00 $93,470.00 $96,275.00 $99,165.00
Laguna Beach $47,525.00 $48,950.00 $50,425.00 $51,940.00 $53,495.00
La Habra $24,350.00 $25,075.00 $25,825.00 $26,605.00 $27,400.00
Montclair $12,750.00 $13,135.00 $13,530.00 $13,935.00 $14,350.00
Orange $27,340.00 $28,165.00 $29,010.00 $29,875.00 $30,775.00
Tustin $37,100.00 $38,210.00 $39,355.00 $40,535.00 $41,750.00
Yorba Linda $5,800.00 $5,970.00 $6,150.00 $6,335.00 $6,525.00
Total $341,490.00 $351,740.00 $362,300.00 $373,175.00 $384,365.00
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B. MMSEA Section 111 Mandatory Reporting
Medicare reporting in compliance with MMSEA Section 111 shall be a $150 set-up fee
per Member Agency and an annual fee of $250.
C. Vendor Services
All services provided by outside providers/vendors shall be approved by CIPA or
appropriate Member Agency and billed at Consultant’s actual cost with no “mark-up”.
D. Catastrophic Claim
If a claim involves more than ten claimants, the fee shall be mutually agreed upon
between CIPA and/or the Member Agency and Consultant.
E. Client Trust Accounting
This service is available to any Member Agency for an additional fee. Currently, no
Member Agencies use this service. Prior written approval from a Member Agency is
required before fees are charged.
.
Article 13. ALLOCATED EXPENSES
Member Agencies agree to pay for the cost of all extraordinary investigative services where
expert and professional assistance is required, such as professional photography, independent
medical examinations, professional engineering services, and laboratory services. Consultant
shall order such services only upon written authorization of the General Manager or Member
Agency’s designated representative. Such authority may be given orally where such services are
urgently required. Allocated loss adjustment expenses may include the following:
A. Fees to attorneys for claims in suit and for representation at hearings or pre-trial
conferences
B. All court costs, court fees and court expenses
C. Fees for service of process
D. Costs of undercover operative and detective services
E. Costs for employing experts for the preparation of maps and professional photographs
F. Accounting, chemical or physical analysis, diagrams and any other type of expert used in
the preparation of litigation.
G. Costs for independent medical examinations and bill review, evaluations for rehabilitation
(vocational or physical), pre-certification activities, utilization reviews and other medical
cost containment measures to determine the extent of the client's liability
H. Costs of legal transcripts of testimony taken at coroner's inquests, criminal or civil
proceedings, including court reporter fees
I. Costs for copies of any public records and medical records
J. Costs and expenses of subrogation when referred to outside attorneys
K. Excess expenses incurred on salvaged vehicles, where costs exceed value
L. Cost of automobile appraisals
M. Costs associated with any necessary investigation, or in connection with attendance at
mediations, settlement conferences, trials etc. which are performed 100 miles or more
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from any Member Agency and more than 50 miles from any of Consultant’s office
locations. This will be subject to prior approval from Member Agency and actual
expenses will be submitted with receipts on a monthly basis. Mileage is paid at the
current IRS rate.
N. Bank service fees, check stock printing costs, and any other related fees to any fund
account utilized for the payment of claims for the client
O. Filings with the Index Bureau, NATB, or PILR, or other regulatory filings
P. Costs for certified mail, special delivery charges, or other extraordinary expenses when
requested by the client or justified by circumstances beyond our control
Q. Allocated expenses shall be billed at actual cost with no markup by Consultant, with the
exception of Index Bureau Requests which will be billed at $10 per request.
Article 14. INDEMNIFICATION
Consultant shall defend, indemnify and hold harmless CIPA and/or Member Agencies including
its governing board, directors, officers, administrators, employees, and agents, from any and all
claims, losses and liabilities against or incurred by CIPA and/or Member Agencies arising out of
the actions, omissions to act or other conduct of Consultant, its agents, employees or
subcontractors, in the performance of its duties under this Agreement or otherwise in connection
with its activities pursuant to this Agreement. This includes, but is not limited to, any breach by
Consultant of its duties or responsibilities under the Agreement, as well as any losses occasioned
by a failure of Consultant to provide the services contracted for by CIPA pursuant to this
Agreement. In addition, Consultant agrees to assume the defense, at Consultant's expense,
using attorneys reasonably acceptable to CIPA and Member Agencies of any lawsuit or other
proceeding which names CIPA and/or Member Agencies or its directors, officers, employees and
agents as defendants arising out of the actions, omissions to act or other conduct of Consultant,
its agents, employees or subcontractors, in the performance of its duties under this Agreement or
otherwise in connection with its activities pursuant to this Agreement
Wherein Consultant is named in a filed or verified complaint simply by virtue of the fact it is the
claims administration firm on a given claim, CIPA and/or Member Agencies will defend
Consultant, at no cost to Consultant, provided that a joint defense can be provided by counsel
representing CIPA and/or Member Agencies, and further provided that Consultant will reasonably
cooperate with such defense.
Article 15. ARBITRATION
CIPA and Consultant agree that in the event of any dispute arising out of or relating to the
provisions of this Agreement, the services rendered, the amount of George Hill’s compensation,
or any other matters, and the dispute cannot be settled through informal negotiation, the Parties
agree first to try in good faith to settle the dispute by through non-binding mediation before
resorting to arbitration.
The Parties agree that any and all disputes, claims or controversies arising out of or relating to
this Agreement shall be submitted to JAMS, unless another agency is mutually agreed to in
writing and selected by both Parties, for mediation. If the matter is not resolved through
mediation, then it shall be submitted to JAMS, or its successor, or another agency is mutually
agreed to in writing and selected by both parties for binding arbitration.
Either Party may commence mediation by providing to JAMS and the other Party a written
request for mediation, setting forth the subject matter of the dispute, the position of the Party
requesting mediation, and the relief requested. The Parties shall cooperate with JAMS and with
one another in selecting a mediator from the JAMS panel of neutrals and in scheduling the
mediation proceedings within forty-five days of the mediator’s appointment, unless otherwise
agreed in writing by the Parties. If the Parties are unable to agree informally on a mediator,
JAMS shall provide a strike list of no fewer than ten neutrals qualified in the subject matter for the
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Parties to strike three and rank the remaining neutrals in order of preference and return their
strike lists only to JAMS by a date set by JAMS to do so. The neutral with the highest combined
ranking shall be the neutral assigned as mediator. The Parties will share equally in JAMS and
the mediator’s fees and costs. All offers, promises, conduct and statements, whether oral or
written, made in the course of the mediation by any of the Parties, their agents, employees,
experts and attorneys, and by the mediator or any JAMS employees, are confidential, privileged
and inadmissible for any purpose, including impeachment, in any arbitration or other proceeding
involving the Parties, provided that evidence that is otherwise admissible or discoverable shall not
be rendered inadmissible or non-discoverable as a result of its use in the mediation.
Either Party may initiate arbitration with respect to the matters submitted to mediation by filing a
written demand for arbitration at any time following the initial completion of mediation. session.
Mediation or informal settlement efforts may continue after the commencement of arbitration but
shall not be admissible in or disclosed by any Party in the arbitration unless both Parties agree
and memorialize the proposed disclosure a signed writing. Any arbitration shall be conducted in
accordance with the Expedited Procedures set forth in the JAMS’ Comprehensive Arbitration
Rules & Procedures in effect as of the execution of this Agreement, including Rules 16.1 and 16.2
of those Rules. The Parties shall attempt to mutually agree upon a single arbitrator or may, in
their discretion, agree to three arbitrators and select those individuals. If unable to do so, there
shall be one arbitrator and either Party may request a strike list from JAMS to select that
arbitrator from in accordance with JAMS procedures. The arbitrator shall award to the prevailing
Party, if any, the costs, litigation expenses and reasonable attorneys' fees reasonably incurred by
the prevailing Party in connection with the arbitration, and the JAMS’ fees and costs as well as
those of the selected arbitrator paid by the prevailing Party.
The arbitration shall be governed by California law. In addition, the parties agree that any
mediation and arbitration shall be conducted in the JAMS’ offices in Orange County, California as
the exclusive forum.
Article 16. INSURANCE REQUIREMENTS
Insurance requirements are contained in Exhibit 3 attached to and forming a part of this
Agreement.
Article 17. LEGAL RESPONSIBILITIES
Consultant shall comply with all State and Federal laws, as well as all county and municipal
ordinances and regulations which in any manner affect the performance of services pursuant to
this Agreement, or persons employed by Consultant.
Consultant agrees that in the performance of the terms of this Agreement, no discrimination shall
be made in the employment of persons because of race, ethnicity, ancestry, national origin,
citizenship, religion, age, sex, including gender identification, sexual orientation or preference,
pregnancy, preexisting medical condition, physical or mental disability or handicap or any other
factor prohibited under applicable federal or state law.
Article 18. CONFLICT OF INTEREST
In the event a third-party claimant or a cross-complainant is also a client of Consultant and there
is a dispute as to the third-party claimant or cross complainant’s liability, Consultant shall
immediately notify CIPA for directions on handling of the claim.
Consultant agrees to disclose to CIPA any potential conflicts of interest, including but not limited
to other sources of income which could create a potential conflict.
Article 19. MMSEA REPORTING
All penalties assessed for failure to comply with reporting requirements under MMSEA Section
111 shall be paid, whether directly or through reimbursement, by the party responsible for the
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assessment of the penalty. If either party disputes the liability for payment of the penalty, the
Parties shall negotiate to resolve the dispute. If the dispute is not resolved within thirty (30) days
after notice to both Parties of the penalty, then such dispute shall be submitted to arbitration for
determination of the party responsible for the assessment and payment of the penalty. The
provisions of this Article shall survive any termination of this Agreement.
Article 20. BUSINESS LICENSE.
Consultant shall maintain a business license for each Member Agency as required.
Article 21. ASSIGNMENT OF AGREEMENT
Consultant shall not assign, sublease, hypothecate, or transfer this Agreement or any interest
therein directly, or indirectly, by operation of law or otherwise. Any attempt to do so shall be null
and void, and any assignee, sublessee, hypothecate or transferee shall acquire no right or
interest by reason of such attempted assignment, hypothecation or transfer.
Article 22. WAIVER
A waiver by CIPA of any breach of any term, covenant, or condition contained herein shall not be
deemed to be a waiver of any subsequent breach of the same or any other term, covenant, or
condition contained herein whether of the same or a different character.
Article 23. ENTIRE AGREEMENT
This instrument contains the entire Agreement between the Parties relating to the rights herein
granted and the obligations herein assumed. Any oral representations or modifications
concerning this instrument shall be of no force or effect. Such representations or modification
shall be made in writing.
Article 24. SEVERABILITY
If any provision of this Agreement is held by a competent court to be invalid, void or
unenforceable, the remaining provisions shall nevertheless continue in full force and effect. The
validity of this Agreement and of any of its terms and provisions shall be interpreted pursuant to
the Laws of the State of California.
Article 25. MISCELLANEOUS
This Agreement shall be governed by, and construed in accordance with, the laws of the State of
California. If any of the provisions of this Agreement shall be held by a court or other tribunal of
competent jurisdiction to be unenforceable, the remaining portions of this Agreement shall remain
in full force and effect.
Any modifications of this Agreement must be in writing and signed by both Parties.
Each Member of CIPA identified herein shall be a third-party beneficiary of this Agreement with
the right to enforce the provisions of this Agreement against Consultant.
CIPA and Consultant intend to benefit the Member Agencies through the execution of this
Agreement and agree that any Member Agency may enforce any obligation of Consultant set
forth herein.
Article 26. NOTICES
All notices required or permitted hereunder shall be sent to the other party at the following
addresses, or at such other address as may be provided in writing to the other party from time to
time:
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To Consultant: Agnes Hoeberling
Chief Client Officer
George Hills Company, Inc.
P.O. Box 120
Rocklin, CA 95677
AHoeberling@intercareins.com
To CIPA: Janet D. Kiser
General Manager
California Insurance Pool Authority
567 San Nicholas Drive
Suite 300
Newport Beach, CA 92660
jk@kiserco.com
In witness whereof the Parties hereto have signed this Agreement as of the date set forth in
Article 1.
CIPA: California Insurance Pool Authority
_______________________________
Authorized Signature
_______________________________
Print Name
_______________________________
Title
_______________________________
Date
CONSULTANT: George Hills Company, Inc.
______________________________
Authorized Signature
_______________________________
Print Name
_______________________________
Title
____________________________
Date
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EXHIBIT 1
CALIFORNIA INSURANCE POOL AUTHORITY
MINIMUM PERFORMANCE STANDARDS FOR
LIABILITY CLAIMS ADMINISTRATION POLICY
Member Agencies shall either incorporate these minimum performance standards into signed
agreements with their claims administrator or obtain a signed acknowledgement from their claims
administrator that they will comply with the Minimum Performance Standards established by
California Insurance Pool Authority (CIPA). Copies of the agreements or signed
acknowledgments shall be provided to CIPA. Claims will be audited for conformance with this
Policy.
This Policy is divided into the following sections:
1. CASELOADS
2. COMMUNICATION
3. INVESTIGATIONS
4. FILE REVIEW & DOCUMENTATION
5. REPORTING
6. LITIGATION MANAGEMENT
7. CLAIM RESOLUTION AND SETTLEMENT AUTHORITY
8. PAYMENTS & RESERVES
9. EXCESS INSURANCE REPORTING
10. SUPERVISORY REVIEW
11. SUBROGATION
12. MEDICARE REPORTING
1. CASELOADS
A. Caseloads for claims examiners shall not exceed 175 claims, unless approved in writing
by the Member Agency and/or CIPA.
B. Supervisory personnel shall not handle a caseload. Exceptions may be made for a small
number of claims involving special issues.
C. Administrator shall provide CIPA and Member Agency with an accounting of caseloads
each June 30 and December 31. The accounting for each examiner shall include (1) the
name or pseudo name of all assigned clients; and (2) the number of claims for each
client. Each examiner shall sign acknowledgement of their claims count and provide to
CIPA and Member Agency.
2. COMMUNICATION
A. If claimant is not represented by an attorney, contact claimant within twenty-four (24)
hours of receipt of a claim and maintain appropriate contact with them until the claim is
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closed, unless otherwise directed by the Member Agency. If claimant not contacted, the
reason shall be documented in file.
B. Telephone calls will be returned within twenty-four (24) hours. If the staff member called
is not available within this timeframe, another designated staff member will return the call.
C. All written communications received shall be stamped with date of receipt.
D. Respond to emails within forty-eight (48) hours, unless an immediate response is
required. If staff member does not have the information being requested at the time they
respond, the response should include a date by which they will provide the requested
information.
E. Claims Administrator shall respond to all other written communications within five (5)
business days of receipt or sooner if an immediate response is required.
3. INVESTIGATIONS
A. When required on non-litigated claims, statements from or interviews with claimant(s) and
witnesses shall be taken within three (3) business days of receipt of a claim. Statements
will be preserved by recording or taking hand-written signed statements and interviews
shall be documented.
B. Examiner shall take steps to ensure proper preservation of evidence.
C. Further investigate claims where the initial review indicates that it is warranted. Further
investigation may include, but not be limited to, on-site investigation, taking photographs,
interviewing witnesses, taking signed or recorded statements, verifying damage or loss,
taking measurements, or obtaining maps/diagrams, medical releases, police reports,
vendor contracts, third-party contracts, insurance documents, internal operations
investigations, paramedic reports, marine department reports, building permits, or other
records as required. Initial investigations shall be completed within forty-five (45) calendar
days of receipt. The efforts to complete the initial investigation and any further
investigations shall be documented in the file, including any reason for delay.
D. Within forty-five (45) calendar days, identify and document in the file all liability issues,
including but not limited to immunities, comparative negligence, joint tortfeasors, and joint
and several liability
E. Within forty-five (45) calendar days, identify and document in the file all damages,
including property damage, nature and extent of injuries, medical costs, lost wages, and
non-economic damages. The efforts to complete shall be documented in the file,
including any reason for delay.
F. Evaluate need to utilize experts and obtain approval from Member Agency, and CIPA if
indicated.
G. Within fifteen (15) calendar days of receipt of claim, report bodily injury cases to the Index
Bureau and re-index as needed. If not reported, the reason shall be documented in file.
H. Within three (3) business days of receipt of a claim, arrange for appraisal of damaged
property when indicated. If appraisal not obtained, the reason shall be documented in
file.
I. Investigative assignments to outside vendors will only be made with approval from
Member Agency, and CIPA if indicated
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J. All notices, including claim insufficiency, late claims, rejections, etc., shall be done in
accordance with the relevant Governmental Code provisions.
4. FILE REVIEW & DOCUMENTATION
A. Claims will be initially reviewed and entered in the computer system within twenty-four
(24) hours of receipt.
B. Calendar all files at appropriate intervals and no less frequently than every sixty (60)
calendar days to allow for timely completion of required activity. Rejected claims shall be
diaried every ninety (90) days or as directed by Member Agency.
C. All activity, including phone calls, correspondence and the rationale for decisions shall be
clearly and concisely documented in the files.
D. All correspondence shall be contained in the file.
E. Notes and activities entered in the computer system must be dated and identify who
completed the entry.
F. File notes shall not be copied from prior entries without reviewing for relevance and
accuracy.
G. An active case strategy shall be documented in the file until closure.
H. Maintain accurate and complete records of all payments.
I. Provide Member Agency and CIPA with copies of file correspondence and
documentation as requested.
J. All files shall be reviewed for closure and closed within seven (7) calendar days from date
all issues have been resolved.
5. REPORTING
A. Provide first status report within thirty (30) calendar days of receipt of claim to Member
Agency. Send report to CIPA General Manager when claim meets designated criteria.
B. Subsequent status reports shall be provided no less than every ninety (90) calendar
days. Status reports shall focus on changes in liability analysis, damages, and reserves.
C. Provide Member Agency and CIPA, if applicable, with a status report outlining the facts of
the case, results of investigations, primary issues, requested action and any related
documentation within fourteen (14) calendar days of receipt of lawsuit.
D. Provide clear and concise narrative reports when recommending rejection or settlement
of a claim, when claim is going to trial, or when other significant events occur.
E. CIPA shall be provided with closing documents and an accounting of the final paid
amounts within fifteen (15) calendar days from the day the final defense bill is paid on
claims involving CIPA funds.
6. LITIGATION MANAGEMENT
A. Forward Litigation Acknowledgement Form to defense attorneys when case assigned (do
not wait until lawsuit filed). The claims administrator shall follow-up no less than every
five (5) business days for receipt of Litigation Acknowledgement Form, as expenses
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incurred prior to receipt do not count toward a Member Agency’s self-insured retention
(SIR).
B. If the billed amount of attorney’s fees and costs exceed seventy-five (75) percent of the
total budget, then Consultant shall request an updated budget.
C. Defense attorneys shall copy CIPA on all correspondence related to reportable claims.
Consultant shall immediately notify the defense attorney if CIPA is not copied on any
correspondence.
D. Assist trial attorney in preparation of litigation and negotiation of settlements at request of
Member Agency and/or CIPA and provide trial attorney with all necessary documentation.
E. Assist trial attorney in answering interrogatories.
F. Attend mediations, mandatory and voluntary settlement conferences, and arbitrations as
requested.
G. Assist Member Agency’s designated representative in small claims actions.
H. Monitor performance of vendors for appropriateness of work and cost effectiveness. Any
deficiencies should be reported to Member Agency and, if applicable, to CIPA.
I. Claims Administrator is responsible for monitoring compliance with the Liability Program
Defense Counsel Policy. The Member Agency and CIPA, if applicable, shall be copied on
follow-up requests to defense attorneys when out of compliance. All claims
administrators are responsible for being fully knowledgeable of requirements in the
Liability Program Defense Counsel Policy.
7. CLAIM RESOLUTION AND SETTLEMENT AUTHORITY
A. Process any claim or potential claim for settlement in accordance with instructions and
policies of Member Agency and in accordance with the California Government Code.
B. Obtain a fully executed release on all settlements and dismissals.
C. All settlement offers requiring any payment or potential payment from CIPA must be
approved in writing in advance by CIPA. Neither the examiner nor legal counsel shall
make any recommendations or commitments to injured employees or their legal counsel
for settlements that involve or potentially involve CIPA funds without CIPA’s prior
approval.
D. Proof of settlement authorization from the Member Agency and CIPA, if applicable, shall
be maintained in the file.
8. PAYMENTS & RESERVES
A. Review and process payments within authority level within twenty (20) calendar days of
receipt.
B. Each claim shall be reserved at the most probable outcome and evaluated based on the
merits of the claim. This includes but is not limited to damages, past and future medical
expenses, loss of income, pain and suffering, plaintiff’s attorney fees, defense costs,
comparative negligence, facts of loss, defense counsel evaluations, and jury verdicts.
The file shall document the rational for the reserves.
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C. At all times, reserves shall reflect the current information in the file and reserves shall be
reviewed for adequacy at each diary review and no less frequently than every ninety (90)
calendar days and the file shall document this required review of reserves.
D. Review proposed reserve changes with CIPA General Manager prior to making changes
on any claims with potential exposure to CIPA.
9. EXCESS INSURANCE REPORTING
A. Claims administrator shall report to the reinsurance/excess insurance carrier(s), including
CIPA, in accordance with reporting requirements established by CIPA and each
insurance carrier above CIPA.
B. Quarterly reporting shall be in a format prescribed by CIPA, as may be modified from
time to time.
C. As defined by CIPA’s Memorandum of Coverage, all claims with reserves or potential
payments, including defense costs that are 50% or more of a Member Agency’s SIR, or
involving any of the following, shall be considered “excess claims” and reported in writing
to the General Manager of CIPA within two (2) business days after receipt by claims
administrator.
1) Paralysis – Paraplegia, Quadriplegia
2) Loss of eye(s) or limb(s)
3) Spinal cord or brain injury
4) Sensory organ or nerve injury, or neurological deficit
5) Serious burns
6) Substantial disability or disfigurement
7) Death
8) Amputation or loss of use of a major extremity
9) Rape, sexual abuse offense/molestation of any individual
10) Any disability where it appears reasonably likely that there will be disability that
lasts for more than one year
11) Class Action
12) Employment Practices Liability claims regardless of claim reserves
10. SUPERVISORY REVIEW
A. Supervisors shall review claims no less frequently than every 120 calendar days. The
supervisor shall document the scope of the review and include any recommendations.
11. SUBROGATION
A. Subrogation possibilities will be identified within five (5) business days after a claim is
opened, or within five (5) business days after information is available that subrogation
may exist. The claim file shall document subrogation possibilities and all action related to
pursuing.
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B. The party responsible for the injury shall be notified of the Member Agency’s or CIPA’s
right to subrogation within fourteen (14) calendar days after the identity of the responsible
party is known by claims administrator.
C. Contact with the responsible party and/or insurer to provide notification of the amount of
estimated recovery shall be made at least every sixty (60) calendar days or sooner if
costs escalate.
D. Member Agency’s approval is required to waive pursuit of subrogation or agree to a
settlement of a third-party recovery. This approval shall be documented in the claim file.
E. CIPA’s approval is required to waive pursuit of subrogation or agree to a third-party
settlement if there is potential for the claim to exceed the Member Agency’s SIR.
12. MEDICARE REPORTING
A. Claims Administrator shall report all claims in compliance with Medicare, Medicaid, and
SCHIP Extension Act (MMSEA) Section 111 Mandatory reporting.
B. Medicare eligibility shall be documented in the file no later than at the time the file is
evaluated for settlement.
Amended and Approved by the Board of Directors on June 29, 2020
Repeals April 10, 2018 Minimum Claims Performance Standards for Third Party Liability
Claims Administration Policy
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EXHIBIT 2
CALIFORNIA INSURANCE POOL AUTHORITY
LIABILITY PROGRAM DEFENSE COUNSEL POLICY
INTENT
The Board of Directors of California Insurance Pool Authority (the “Authority”) adopted the
Liability Program Defense Counsel Policy (the “Policy”) by resolution on April 30, 2018.
The Policy is intended as a tool for both Member Agencies and the Authority to equitably manage
and control expenses and shall apply to all defense counsel defending a claim brought against a
Member Agency, regardless of whether there is any exposure to the Authority. The Authority will
not reimburse a Member Agency for any defense costs incurred that are not in conformance with
this Policy.
Defense counsel shall review, acknowledge, and comply with the terms of this Policy, which is
divided into the following sections:
INTENT
LITIGATION MANAGER
GENERAL MANAGER
DEFENSE COUNSEL ACKNOWLEDGEMENT
REPORTING REQUIREMENTS
BILLING LEGAL EXPENSES
A. BILLING PROCEDURES
B. TRAVEL EXPENSES
C. STAFFING
D. RESEARCH
E. BILLABLE EXPENSES
F. OVERHEAD EXPENSES NOT BILLABLE
G. EXCEPTIONS
LITIGATION MANAGER
The third-party adjuster for each Member Agency shall be referred to herein, individually, and
collectively, as the “Litigation Manager.” The Litigation Manager is responsible for monitoring
compliance with this Policy.
The Authority has contracted with its own third-party administrator, who acts as the Litigation
Manager on behalf of the Authority, to handle claims with potential exposure to the Authority.
Defense counsel shall copy the Authority’s Litigation Manager and General Manager on all
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correspondence and status reports. The Authority’s Litigation Manager is responsible for
providing direction on all claims identified as having potential exposure to the Authority.
GENERAL MANAGER
The General Manager of the Authority is directed to require adherence to the Policy for all
counsel retained by a Member Agency and appointed by the Authority for the defense of a
covered claim that is identified as reportable to the Authority. As used herein, “Reportable
Claim” means any claim reportable to the Authority pursuant to the Excess Liability Program
Claims Handling Policy.
DEFENSE COUNSEL ACKNOWLEDGEMENT
Prior to commencing work on a claim, written acknowledgement and acceptance of the Policy
shall be required of any law firm, or in-house counsel, retained by a Member Agency or the
Authority. The Litigation Manager will provide defense counsel with the acknowledgement form
for signature. A copy of the signed acknowledgement shall be sent to the General Manager for
all Reportable Claims.
REPORTING REQUIREMENTS
Defense counsel shall provide the following written status reports to the Litigation Manager,
Member Agency, and General Manager (if a Reportable Claim):
A. Within 45 days of defense counsel’s receipt of a claim, a report that summarizes the legal
issues presented, a litigation budget, an evaluation of liability, and the potential for
settlement or other resolution, in the form reasonably requested by the Litigation
Manager.
B. Every 90 days (“Quarterly Reports”) and whenever there are significant developments in
the case, a report that sets forth counsel’s analysis of the case, and a revised budget, if
necessary. With respect to the Quarterly Reports, defense counsel shall only include a
short summary of the pertinent facts and any new developments since the last report. It
is not necessary to repeat information previously reported. An informal email report is
encouraged for Quarterly Reports with minimal case developments since the prior report.
C. At least 30 days prior to any settlement conference, arbitration, mediation or trial, a report
that outlines the posture of the case, pros and cons of proceeding, probability of an
adverse result, and likely range of the award or verdict. Any requests for settlement
authority shall also be included in this report.
D. Within 20 days after trial or settlement, provide an evaluation of the case, including
prospects for appeal.
Defense counsel shall promptly send copies of all pleadings, motions, settlement offers, and
other relevant legal documents and correspondence to the Litigation Manager, Member Agency,
and General Manager (if a Reportable Claim). Additionally, defense counsel shall obtain the
advance approval of the Litigation Manager prior to scheduling depositions, retaining experts,
hiring outside investigators, and any other activities in accordance with the Policy.
Prior to settling any claim or lawsuit or making a settlement offer in any amount, defense counsel
shall obtain the advance approval of the Litigation Manager and Member Agency. If the
settlement amount plus defense costs exceeds a Member Agency’s self-insured retention, then
defense counsel shall also seek settlement authority from the General Manager.
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Defense counsel may be notified that excess insurance or reinsurance, above the Authority,
needs to be included on all status reports and correspondence. If so, defense counsel shall
include all required parties.
BILLING LEGAL EXPENSES
Billing of legal expenses shall include a full description of services provided, along with a clear
explanation of the purpose of the work performed. No expenses considered to be overhead will
be charged. Reasonable expenses will be reimbursed with proper documentation.
A. BILLING PROCEDURES
1. Frequency of billing: A complete, detailed statement for services rendered
shall be submitted monthly. If an invoice balance is less than $500 (other than a
final invoice), counsel should skip the invoice cycle, and include the amount in
the next regularly scheduled legal invoice. However, if that next invoice would
still be in an amount under $500, counsel may submit that amount for payment.
2. Billing increment: The minimum billing increment is .10 of an hour.
3. Billing information: All bills shall contain the following information:
a. Case name
b. Claim number
c. Dates of service
d. Full description of services
e. Attorney or other person providing services
f. Billing rate for each person providing service
g. Actual time spent by each person on each activity
h. Itemized list of disbursements and totals
i. Total fees and expenses on current invoice
j. Cumulative costs since inception
k. Amounts paid to date and current outstanding balance
4. Description of work performed: Each legal activity must be clearly defined.
Vague descriptions of services which do not describe the precise nature of the
work performed will not be paid. Vague descriptions include, but are not limited
to, the following:
a. Research
b. Strategy
c. Analysis
d. Discovery
e. Conference
f. Preparation
g. Review
Examples of detailed descriptions include, but are not limited to, the following:
a. The identity of participant(s), what was discussed and purpose
(telephone calls, correspondence, meetings)
b. The purpose of a court hearing/conference, and name(s) of attendees
c. The identity of each deponent/interviewee
d. The purpose of extensive review of transcripts (deposition or trial)
e. The specific issue researched
f. The specific non-deposition discovery worked on and the nature of the
work performed
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g. The specific trial preparation performed
h. The specific motion worked on and the nature of the work performed
i. The identity of material/documents reviewed
5. Block billing: Multiple activities lumped together will not be paid. Each activity
must be shown and charged for separately. Time entries should be grouped only
where activity takes less than one tenth of an hour, and grouping is necessary to
avoid minimum increment billing.
6. Value billing or task specific flat charges: No minimum time amounts should
be allocated to any task. All task entries should reflect the actual amount of time
spent performing such tasks.
7. Excessive time: All motions exceeding eight hours require advance written
approval. The Litigation Manager must be contacted before proceeding with
demurrers, motions for summary judgement, and any other motions for which
significant research and preparation time will be required, or which can seriously
impact the direction of a case. The time to summarize discovery and depositions
and prepare correspondence must also be reasonable when compared to the
content and purpose. Deposition summaries shall include a concise analysis of
the credibility of the witness and evaluation of the impact of critical deposition
testimony but shall be no longer than three pages in length.
8. Quarterly Reports: No more than one and a-half hours per case for this
summary should be billed without advance written approval.
9. Apportioning time: When work is performed on multiple matters in addition to
the case being billed, only that portion of actual time spent on the matter should
be billed. Such situations often arise during delays at court appearances, and
other situations where delays are unavoidable.
10. Reimbursement of cost items: Expenses under $1,000 will be paid by the law
firm and included in the monthly billings for reimbursement. Written approval for
deposition, experts, and outside investigators must be obtained in advance.
Actual receipts for expenses over $25 must accompany the request for
reimbursement. Reasonable costs will be reimbursed at the actual cost, with no
markup. Each expense must be itemized to determine the exact nature,
purpose, and necessity of expense.
11. Preparation of invoices: Preparation of invoices, review by attorney, and
negotiation of billing questions are considered overhead and shall not be charged
separately.
12. Review of Invoices: Counsel shall review all invoices before they are finalized.
No invoices shall be increased without documentation and justification.
13. Interest charges: Undisputed invoices in the required format will be promptly
processed. Interest will not be paid for any late payment of fees or
disbursements.
14. Rate increase: Rate increases will only be paid with advance written approval.
15. Submission of Invoice: All invoices shall be submitted to the Litigation Manager
for review and processing. Thereafter, the Litigation Manager will either directly
pay the invoice or distribute the invoice to the Member Agency for payment.
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16. Final Invoice: The last legal invoice submitted to the Litigation Manager on a
resolved matter shall be marked “FINAL INVOICE.” Upon receipt of this invoice,
the Litigation Manager will close the file.
B. TRAVEL EXPENSES
1. Travel time: Travel time by automobile will be compensated at the full hourly
rate when work cannot be performed. Travel time by airplane will be
compensated at one-half the hourly rate, however, when work is performed on
our behalf on the airplane, travel time will be reimbursed at the full hourly rate.
No billing shall occur during time working for other clients.
2. Out of town travel: Out of town travel must be approved in advance. Each
expense must be separately identified with the amount and date incurred, and
receipts for all items over $10 must be provided. Travel expenses must be
apportioned between all clients, based on time billed to each client. The
following items will be reimbursed:
a. Airfare: Coach or economy rate will be paid. Airline vouchers must be
submitted for reimbursement.
b. Hotels: Moderately priced hotels will be reimbursed, and if available,
hotels providing discounts should be requested.
c. Meals: Charges must be reasonable
d. Rental Cars: Intermediate class cars will be reimbursed. Rental cars
must be refueled prior to returning to the rental agency. Insurance
coverage is not payable.
e. Personal Items: Toiletries, laundry service, in-room movies and other
personal services will not be paid.
C. STAFFING
1. Attorney assignment: With the approval of the Litigation Manager, the lead
counsel within the firm who will be accountable for the conduct of the
engagement and directly involved in the representation should be designated. In
general, the Authority maintains a “one lawyer-one file” policy. However, the
Authority realizes that on more sophisticated exposures there may be
circumstances where “one lawyer-one file” is not a sufficient response. Pre-
approved, qualified partners, associates and paralegals with relevant experience
may be used when the goals of the case management plan necessarily require
the use of additional professional resources. However, the use of additional
professional legal resources must be approved in advance in writing by the
Litigation Manager, preferably when the initial case strategy is formulated. The
work of others on the case that are not on the “team” shall not be billed without
prior approval by the Litigation Manager. Billing rates shall be agreed to in
advance for each attorney on the team. Assignments will be made to attorneys
with the appropriate level of expertise. Requests not to assign a specific attorney
will be honored.
2. Attorney billable hours: Only those tasks performed by an attorney will be
billed at attorney rates. All work will be performed at the appropriate level.
Improper staffing assignments are not payable.
3. Multiple staff: More than one attorney will not be paid for doing any task,
including appearances at court, depositions, trials, and reviewing and analyzing
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documentation and legal research. Exceptions must be approved in advance in
writing.
4. Internal conferencing: Time for internal conferences, emails, telephone calls or
other communications among members of the team or support staff will not be
paid, unless approved in advance.
5. Change in attorney assignment: If changes are made to the attorneys on the
team, the time required for new attorneys to become familiar with a matter due to
the reassignment of work will not be paid, unless the change is at our request.
6. Paralegal: Paralegals should be used for those aspects of a lawsuit, such as
page/line deposition summaries and medical records summaries, which do not
have to be performed by an attorney. Assignment to a paralegal should not
result in duplicative reworking by an attorney. Paralegals will not be paid for
performing clerical work.
7. Appropriate Staffing: Clerical work performed by fee generating personnel or
paralegal work performed by attorneys will not be paid.
D. RESEARCH
1. Routine research: Routine or elementary legal research, including issues
considered to be common knowledge among reasonably experienced counsel,
will not be paid.
2. Updating work product: Prior research completed for other matters or files will
not be paid. Only that portion of the actual time spent on research that updates
the work product will be paid.
3. Authorization of research: Research more than five hours must be approved
in advance.
4. LEXIS/WESTLAW or other on-line services: Only the actual cost of
computerized legal research will be paid.
E. BILLABLE EXPENSES
1. Photocopying: Reimbursement will be at actual cost not to exceed 10 cents per
page. Discretion should be used in the number of photocopies made. An outside
copy service should be used whenever cost-effective. Substantial copying
projects should be competitively bid. Bills must provide the number of copies,
per page rate and total amount.
2. Certified/Registered mail: Charges will be billed at actual cost and should be
used with discretion.
3. Long Distance Telephone: The actual cost of long-distance calls will be paid.
Local calls will not be reimbursed.
F. OVERHEAD EXPENSES NOT BILLABLE
The following are examples of expenses that are considered overhead and included in
the attorney’s hourly billing rates. A separate charge for these items is not billable:
1. Non-attorney/Non-paralegal staff: Work performed by support staff, including
administrative staff, library staff and file clerks. Exceptions must be authorized in
advance.
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2. Clerical work: All clerical work, including clerical work performed by fee
generating personnel.
3. Word Processing
4. Preparation of bill: Preparation, review and resolving billing questions.
5. Internal delivery/courier: All correspondence should be delivered electronically,
unless directed otherwise by a Member Agency. Exceptions must be approved
in advance and less costly than outside services.
6. Summer Associates/Summer Interns
7. Trial preparation when trial is not imminent
8. Page/line summaries of depositions: With prior approval, summaries will only
be paid if trial or use is imminent.
9. Correcting work: Proofreading, editing, and correcting substandard work
product.
10. Organizing files
11. Opening files: The administrative process involved with opening or closing files.
12. Training and education
13. Staff supervision
14. Document stamping
15. Arranging travel accommodations
16. Staff overtime charges
17. Local telephone charges
18. Ordinary postage
19. Publications and books
20. Office supplies
21. Software
22. Rental equipment
23. Conference rooms
24. Refreshments and entertainment
G. EXCEPTIONS
Any exceptions to this Policy must be approved in advance in writing by the Litigation Manager.
Member Agencies may also have additional requirements that will be attached to this Policy.
Amended and Approved by the Board of Directors on June 29, 2020
Repeals April 30, 2018 Liability Program Defense Counsel Policy.
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EXHIBIT 3
CALIFORNIA INSURANCE POOL AUTHORITY
INSURANCE REQUIREMENTS
CIPA reserves the right to modify these requirements, including limits, based on the nature of the
risk, prior experience, insurer, coverage, or other special circumstances. If the existing policies
do not meet the insurance requirements set forth herein, Consultant agrees to amend,
supplement or endorse the policies to do so.
Without limiting the indemnity provisions of this Agreement, Consultant shall procure and
maintain in full force and effect during the term of this Agreement, the following policies of
insurance.
1. Minimum Scope and Limit of Insurance
Coverage shall be at least as broad as:
A. Commercial General Liability (CGL) which affords coverage at least as broad as
Insurance Services Office “occurrence” form CA 00 01, including products and completed
operations, property damage, bodily injury, and personal & advertising injury with limits
no less than $1,000,000 per occurrence. If a general aggregate limit applies, either the
general aggregate limit shall apply separately to this project/location or the general
aggregate limit shall be twice the required occurrence limit.
B. Automobile Liability with coverage at least as broad as Insurance Services Office Form
CA 00 01 covering “Any Auto” (Code 1) or if no owned autos, coverage for hired autos
(Code8) and non-owned autos (Code 9) with limit no less than $1,000,000 each accident
for bodily injury and property damage.
C. Workers’ Compensation as required by the State of California with statutory limits, and
Employer’s Liability Insurance with a limit of not less than $1,000,000 per accident for
bodily injury and each employee for disease.
D. Professional Liability with limit of not less than $2,000,000 each claim and $3,000,000
aggregate. Covered professional services shall specifically include all work to be
performed under the Agreement and delete any exclusion that may potentially delete
coverage for the work to be performed.
E. Cyber Privacy Liability in an amount not less than $2,000,000 per claim and annual
aggregate, covering (1) all acts, errors, omissions, negligence, infringement of intellectual
property; (2) network security and privacy risks, including but not limited to unauthorized
access, failure of security, breach of privacy perils, wrongful disclosure, collection, or
negligence in the handling of confidential information, privacy perils, including coverage
for related regulatory defense and penalties; (3) data breach expenses payable whether
incurred by CIPA, Member Agencies or Consultant, including but not limited to consumer
notification, whether or not required by law, computer forensic investigations, public
relations and crisis management firm fees, credit file or identity monitoring or remediation
services in the performance of services for City or on behalf of City hereunder.
The policy shall contain an affirmative coverage grant for bodily injury and property
damage emanating from the failure of the technology services or an error or omission in
the content/information provided.
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If a sub-limit applies to any elements of coverage, the certificate of insurance evidencing
the coverage above must specify the coverage section and the amount of the sub-limit.
F. Crime Bond in amount not less than $2,000,000 to include at a minimum employee
theft, forgery or alteration, computer fraud and funds transfer fraud.
2. Endorsements
Insurance policies shall not comply if they include any limiting provision or endorsement. The
insurance policies shall contain, or be endorsed to contain, the following provisions:
A. Commercial General Liability
(1) Additional Insured: California Insurance Pool Authority and Member Agencies,
elected officials, officers, employees, volunteers, boards, agents and representatives
shall be additional insureds with regard to liability and defense of suits or claims
arising out of the work or operations performed by or on behalf of Consultant
including materials, parts or equipment furnished in connection with such work or
operations.
Additional Insured Endorsements shall not:
a. Exclude “Contractual Liability”
b. Be limited to “Ongoing Operations”
c. Restrict coverage to the “sole” liability of Consultant
d. Exclude “Third-Party-Over Actions”
e. Contain any other exclusion contrary to the Agreement
Additional Insured Endorsements shall be at least as broad as ISO Form(s) CG 20
10 11 85; or CG 20 10 and CG 20 37.
(2) Primary Insurance: This insurance shall be primary and any other insurance
whether primary, excess, umbrella or contingent insurance, including deductible, or
self-insurance available to the insureds added by endorsement shall be in excess of
and shall not contribute with this insurance. Coverage shall be at least as broad as
ISO CG 20 01 04 13.
B. Auto Liability
(1) Additional Insured: California Insurance Pool Authority and Member Agencies,
elected officials, officers, employees, volunteers, boards, agents and representatives
shall be additional insureds with regard to liability and defense of suits or claims
arising out of the work or operations performed by or on behalf of Consultant.
(2) Primary Insurance: This insurance shall be primary and any other insurance
whether primary, excess, umbrella or contingent insurance, including deductible, or
self-insurance available to the insureds added by endorsement shall be in excess of
and shall not contribute with this insurance.
C. Workers’ Compensation
(1) Waiver of Subrogation: A waiver of subrogation stating that the insurer waives all
rights of subrogation against the indemnified parties.
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3. Insurance Obligations
The insurance obligations under this Agreement shall be: (1) all the insurance coverage and/or
limits carried by or available to Consultant; or (2) the minimum insurance coverage requirements
and/or limits shown in this Agreement; whichever is greater. Any insurance proceeds more than
or broader than the minimum required coverage and/or minimum required limits, which are
applicable to a given loss, shall be available to CIPA and Member Agencies. No representation is
made that the minimum insurance requirements of this Agreement are sufficient to cover the
obligations of Consultant under this Agreement.
4. Notice of Cancellation
Required insurance policies shall not be cancelled or the coverage reduced until a thirty (30) day
written notice of cancellation has been served upon CIPA, except ten (10) days shall be allowed
for non-payment of premium.
5. Waiver of Subrogation
Required insurance coverages shall not prohibit Consultant from waiving the right of subrogation
prior to a loss. Consultant shall waive all rights of subrogation against the indemnified parties and
policies shall contain or be endorsed to contain such a provision. This provision applies
regardless of whether CIPA has received a waiver of subrogation endorsement from the insurer.
6. Evidence of Insurance
All policies, endorsements, certificates, and/or binders shall be subject to approval by the CIPA
as to form and content. These requirements are subject to amendment or waiver only if so,
approved in writing by the CIPA. CIPA reserves the right to require complete, certified copies of
all required insurance policies, including endorsements required by these specifications, at any
time.
The certificates and endorsements for each insurance policy shall be signed by a person
authorized by that insurer to bind coverage on its behalf. At least fifteen (15) days prior to the
expiration of any such policy, evidence of insurance showing that such insurance coverage has
been renewed or extended shall be filed with the CIPA If such coverage is cancelled or reduced,
Consultant shall, within ten (10) days after receipt of written notice of such cancellation or
reduction of coverage, file with CIPA evidence of insurance showing that the required insurance
has been reinstated or has been provided through another insurance company or companies.
7. Deductible or Self-Insured Retention
Any deductible or self-insured retention must be approved in writing by CIPA and shall protect the
indemnified parties in the same manner and to the same extent as they would have been
protected had the policy or policies not containing a deductible or self-insured retention. CIPA
may require Consultant to purchase coverage with a lower retention or provide proof of ability to
pay losses and related investigations, claim administration and defense expenses within the
retention. The policy language shall provide, or be endorsed to provide, that the self-insured
retention may be satisfied by either Consultant, CIPA or Member Agency.
8. Contractual Liability
The coverage provided shall apply to the obligations assumed by Consultant under the indemnity
provisions of this Agreement.
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9. Failure to Maintain Coverage
Consultant agrees to suspend and cease all operations hereunder during such period as the
required insurance coverage is not in effect and evidence of insurance has not been furnished to
CIPA. CIPA shall have the right to withhold any payment due until Consultant has fully complied
with the insurance provisions of this Agreement.
If Consultant’s operations are suspended for failure to maintain required insurance coverage,
Consultant shall not be entitled to an extension of time for completion of the work because of
production lost during suspension.
10. Acceptability of Insurers
Each such policy shall be from a company or companies with a current A.M. Best’s rating of no
less than A:VII and authorized to do business in the State of California, or otherwise allowed to
place insurance through surplus line brokers under applicable provisions of the California
Insurance Code or any federal law. Any other rating must be approved in writing by CIPA.
11. Claims Made Policies
If coverage is written on a claims-made basis, the retroactive date on such insurance and all
subsequent insurance shall coincide or precede the effective date of the initial Consultant’s
Agreement with CIPA and continuous coverage shall be maintained, or an extended reporting
period shall be exercised for a period of at least five (5) years from termination or expiration of
this Agreement.
12. Excess Umbrella Liability Policies
If any excess or umbrella liability policies are used to meet the limits of liability required by this
Agreement, then said policies shall be “following form” of the underlying policy coverage, terms,
conditions, and provisions and shall meet all the insurance requirements stated in this
Agreement, including, but not limited to the additional insured, primary & non-contributory and
waiver of subrogation insurance requirements stated herein. No insurance policies or self-
insurance maintained by the City, whether primary, reinsurance or excess, and which also apply
to a loss covered hereunder, shall be called upon to contribute to a loss until Consultant’s primary
and excess/umbrella liability policies are exhausted.
13. Insurance for Subcontractors
No subcontractors shall be used unless authorized by CIPA. If authorized, Consultant shall be
responsible for causing Subcontractors to purchase the same types and limits of insurance in
compliance with the terms of this Agreement, including adding CIPA and Member Agencies as
Additional Insureds, providing Primary and Non-Contributory coverage and Waiver of Subrogation
to the Subcontractor’s policies. The Commercial General Liability Additional Insured
Endorsement shall be on a form at least as broad as CG 20 38 04 13.