Resolution 86-18387 P • %
RESOLUTION NO. 86-18387
A RESOLUTION OF THE CITY COMMISSION OF THE
CITY OF MIAMI BEACH, FLORIDA, VESTING IN THE
CITY MANAGER OF MIAMI BEACH, FLORIDA AUTHORITY
TO SETTLE AUTOMOBILE AND GENERAL LIABILITY
CLAIMS FROM $50,000.00 TO $100 ,000.00 FILED
AGAINST THE CITY OF MIAMI BEACH SELF INSURANCE
FUND FOR THE PERIOD FROM THE PASSAGE OF THIS
RESOLUTION ENDING SIX MONTHS THEREAFTER.
WHEREAS, pursuant to Section 13 (j) of the Miami Beach
City Charter , the City Manager is authorized to perform duties
prescribed by, the City Commission via Resolution; and
WHEREAS, as of December 11, 1985, the City of Miami
Beach became fully self insured in the area of automobile and
general liability; and
WHEREAS, review of these insurance claims shall now be
handled in-house as specifically outlined in exhibit "A" attached
hereto; and
WHEREAS, for purposes of ensuring expedition of case
settlements, the City Manager is the appropriate individual to
authorize claims between $50 ,000 .00 and $100 ,000.00 against the
City of Miami Beach Self Insurance Fund.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF
THE CITY OF MIAMI BEACH, FLORIDA that:
1. The City Commission finds, determines and declares that
the matters set out in the foregoing recitals are true and correct
and they are hereby incorporated as part of this resolution.
2. The City Manager of the City of Miami Beach is vested
with the authority to authorize settlements for insurance claims
in the area of automobile and general liability between $50 ,000. 00
and $100 ,000.00 filed against the City of Miami Beach Self
Insurance Fund for the period from the passage of this resolution
ending six months thereafter.
PASSED and ADOPTED this. 19th day of February ,
1986.
Ori
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ATTEST:
FOAM APPROVED
CITY CLERK LEGAL DEPT.
JKO/rg By �� = ? /�'`
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Date / rpr,,
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PROCEDURES FOR THE ADMINISTRATION OF
' THE- CITY OF MIAMI BEACH '
SELF-INSURANCE FUND -
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Establishment of Self-Insurance Program
The City Commission approved the establishment of a. self-insurance program for
auto and general liability at the 11/20/85 meeting. The City became fully self-
insured in this area on 12/11/85. A ,Self-Insurance Fund was established by
the Finance Department. The Fund is a separate, interest bearing account to be
used only for the payment of liability claims, legal and adjusting expenses, and
expenses related solely to this program. The Fund's initial appropriation came
from the amount budgeted for the liability premium for this fiscal year ($800,000) .
Successive year's deposits will be based on a review of the reserves necessary
' to cover anticipated losses. Funds in excess of open case reserves will remain
in the Fund to be used asa reserve for unexpected or catastrophic losses.
Accident Reporting Procedure
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All accident reports are to be forwarded to the Insurance & Safety Division.
All departments are to follow a standard claims reporting procedure as established
by the Risk Manager as follows:
General Liability
This is any claim for damages resulting in bodily injury or property damage
that is the result of an accident other than an automobile accident. The most
frequent are slip and fall accidents.
If an alleged accident occurs on City property and is reported to a department
or division head or any member of his staff, be it verbal , written or witnessed,
it is necessary to complete the report (NOTE: if reported by correspondence,
forward the correspondence with a memo regarding •any information you have)
entitled: .
"Report of General Liability Accident"
(Other than Automobile)
Be certain the report contains the following:
Name of injured party
Address
Phone
Age
Social Security #
Employer/occupation
Description of injuries
Description of accident and location
Witnesses
Be sure to state the alleged cause and specific location. Inspect the scene
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and comment on' the conditions. Be sure to note any defect or hazard (i .e. wet
floor, foreign object on floor, poor lighting, uneven pavement, etc. ) . Also,
state if area was not defective (clean, dry, etc. ) .
This initial report is extremely important, especially regarding the condition
of the scene of the accident. Forward this report to the Insurance Division
within 24 hours. Make no statement to the injured party accepting responsibility
for the accident. Do not authorize medical treatment or. payment of bills.
Simply advise the party that your report will be sent to the Insurance Division
and they. will be contacted.
. IMPORTANT: If you or a member of your staff are served a Summons and Complaint
or any other legal notice, make sure this is hand delivered to the Legal Department
within 24 hours.
If you have any questions regarding this reporting procedure contact the Insurance
and Safety Division 673-7014.
Automobile Accidents
In the event of an automobile accident involving a City vehicle, please have
the driver complete the City of Miami Beach Vehicle Accident Report. At the
time of the accident, the driver must notify the appropriate police department
so a report can be made by them. Also, all accidents involving a City vehicle
must be investigated by the Miami Beach Accident Investigation Unit.
,Damage to all vehicles are to be reported to Mechanical Maintenance. Forward
the Vehicle Accident Report to the Insurance and Safety Division within 24 hours.
After receipt and initial review of the report by the Insurance and Safety Division,
the claims are then forwarded to the claims service administration company for
investigation . All departments are to provide any necessary information or
reports as requested by the claims administrator. All departments will be
notified of the company's name and the individual (s) thatwill be handling
our cases. .
Hazard Notices
After a review of the accident reports by the Risk Manager, a notice will be
sent to the appropriate department if a hazard that needs correction exists.
The appropriate department will report back to the Risk Manager as to the action
taken to correct the hazard for the prevention of future accidents at that
location.
Claims Administration
This City has entered into a contract with Johns Eastern Co. , Inc. in Miami to
provide claims administration. Johns Eastern will perform the investigation and
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adjusting functions previously provided by our insurance carrier' s claims. department.
They will be under the direction of the Risk Manager and report directly to the
City regarding the status of all cases against the City. The duties and responsi-
bilities of the claims administrator will be as follows:
1. Review all first notices of claim reports received from the City (this
will consist of loss reports, claim letters, suits, or claims phoned in
by the City) .
2. Conduct a complete investigation of the accident, as deemed necessary.
3. Investigations are to include, but not necessarily be limited to, the following:
A. Contact the claimant or the claimant's attorney within 48 hours of the
time the accident report is received.
B. Obtain statements from the claimant, witnesses and the City personnel
(if necessary) .
C. Do a complete scene investigation consisting of photos and diagrams.
D. Obtain the police and/or fire rescue report.
E. Obtain and review all medical reports and bills submitted by the claimant
or their attorney.
F. Obtain and review all estimates and appraisals for property damage
claims.
G. Establish appropriate reserves on all claims.
H. Submit a report to the City's Risk Manager within 30 days of receipt of
the claim, summarizing:
a. date/time/location of loss
b. claimant, information
c. description of accident
d. injuries or damages
e. witnesses' version
f. liability situation
g. evaluation of claim (i .e. amount of recommended settlement, denial ,
reserves, attorney demand)
If a settlement recommendation cannot be made at this initial report
(due to lack of medical information) , they will so indicate.
However, remainder of investigation should be .completed.
I . Submit a status report every 90 days thereafter to the Risk Manager.
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4. The claims. administrator has authority to settle cases on behalf of. the City
up to $2500 per claim.
5. For any settlement in excess of $2500, the claims administrator must receive
authorization from the City's Risk Manager. The request for this authorization
must be presented in writing, including a copy of the file and the adjuster's
evaluation and recommendation. , After authorization is granted, the claims
administrator will settle the claim and obtain the appropriate release.
6. The City will assign• the legal defense of any claim that goes into suit,
and the City will be responsible for the payment of all legal fees. The
claim administrator will assist our attorneys with any additional investigation
• asdeemed necessary by the City.
7. Forward a copy of any file in suit to the City' s Risk Manager.
8. The claims administrator after approval of the City, can assign the necessary
auto appraiser for property damage claims. These expenses will be paid by
the City.
9. Any other claim expense must be approved by the City prior to being incurred.
However, expenses for normal claim activities, such as photographs, tapes,
supplies, etc. are the responsibility of the claims administrator.
10. All claim files are the property of the City of Miami Beach. The City has
the right to inspect any and all files whenever we deem necessary. All
claims received by the administrator during the contract period will be
handled to conclusion.
In addition to providing claims adjusting services, Johns Eastern will provide
computerized information on our claims experience, with monthly claim reports
summarizing:
number of claims
amounts paid
amounts reserved
case status
The company will also provide loss prevention services to reduce our claims in
both number and cost.
Cases in Suit or requiring Legal Defense
Upon receipt of suit papers on a given case, the City Attorney will be notified
so the proper legal defense of the City can begin. The City Attorney will determine
who will handle the defense. If outside counsel is employed, the City Attorney
will monitor the case and the amount of legal expenses incurred. The defense
attorney will report to the City Attorney and Risk Manager on the status of all
cases handled and provide, when appropriate, his/her recommendation regarding
settlement or defense of a claim and the anticipated cost of this legal defense.
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Claim Settlement Authority
Johns Eastern Co. , the City claim administrator, has been granted authority to .
settle claims on our behalf up to $2,500 per claim. It is necessary they be
granted this limit of authority to be able to settle smaller claims on short
notice as a means of preventing these cases from increasing in severity.
For all cases that Johns Eastern evaluates as having a settlement value in excess
of $2,500, Johns Eastern will forward to the Risk Manager a copy of their file
along with a report summarizing the facts, liability and damages, along with their
evaluation and recommendation.
• The Risk Manager will then review this report along with any reports from the
City' s defense attorney (if the case is in suit) . The Risk Manager will have
authority to settle claims up to a limit of $10,000, if a settlement of the
particular claim is in the best interests of the City, considering the given
circumstances.
The authority for the settlement of claims against the City of Miami Beach' s
Self-Insurance Fund is as follows:
SETTLEMENT RANGE AUTHORITY IS GRANTED BY:
$ 0 - 2,500 Granted to claim administrator.
0 - 10,000 Risk Manager, after case review.
10,000 - 25,000 Risk Manager with concurrence of the City Attorney or his
designee
25,000 - .50,000 Risk Manager with concurrence of the City Attorney or his
designee and the Assistant City Manager
50,000 -100,000 City Manager upon recommendation of the Risk Manager,
City Attorney and Assistant City Manager
Above 100,000 Any settlement above this amount is a waiver of sovereign
immunity and should only be authorized by the City
Commission.
Risk Manager' s Report
The Risk Manager will report monthly to the City Commission on the status of the
City' s Self-Insurance Fund. This report will include a summary of total claims
to date, payments made, reserve amounts and fund balance.
ORIGINAL
RESOLUTION NO. 86-18387
(Vesting in the City Manager of Miami Beach.
Florida authority to settle automobile and
General liability claims from $50,000.00
to $100,000.00 filed against the City of
Miami Beach Self Insurance Fund for the
period from the passage of this Resolution
ending six months thereafter)