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Sec#ion I: Services SFM Risk agrees to perform the folfowing services: F"rrst Reports. 5FM Risk will review all Firsi Reports of lnjury upan receipt and establish a file for each reported cfaim. SFM Risk wilf promptfy investigate the corrjpensability of a claim, including ihe relevant €acts surrounding the occurrence, the claimant's pre- existing medical history, and potential third-party liabiiity for cantribution, indemnity, subrogation, or special compensation fund reimbursement. When, in the judgment of SFM Risk, the locatian of an injury, or the nature af the circumstances of the incident giving rise to a claim or potential clai.m make it ad�isable to �ngage an independent investigation firin, SFM Risk will arrange far such investigatipn, but only upo� priar approval by Employer. The Err�player will be respansible for ihe cost of an independent investigation. 2. �{eservinq. SFM Risk will establish timely and. reasonable reserves for each claim, and will. prompt�y revESe such raserves fo reflect changes in the case's status. 3. Denial of LiabilitvlPa.vment of Claims. SFM Risk will promptly deny liability of non-meritorious claims and promptly pay workers' compensation benefits for compensable claims, as required by law, making all necessary adminisirative filings. SFM Risk will make every effort fo promptl.y cainmence benefits or promptly deny a daim; however; SFM Risk will not be respansi6ie #or late payment or denial where such late payment or denial is attributable to late reparting or other acts by the Employer. SFfVI Risk may refer contesteci cases for legal defense ta the outsid� legal co�nsel of Employer's choosing. SFM Risk will consult with outside legal counsel and arrange far representation af the Employer's interests at claims conferences and heari.ngs. 4. Settlement. 5FM Risk may at#empt to settle a contested claim on behalf of the Employer. Any compromised settlements wilf be negotiated and based on 5FM Risk's e.�aluation of the Employer's liability expasure. 5ettlements may be consummated anly with prior approval of the Employer. Uport settlement af any claim, 5FM Risk will document the basis of the settlement and the amount paid. SFM Risk will prepa�e or request #he prepara#ion af all settlement agreements, farms, filings, and other dacuments necessary to effectuate settlement o€ the claim. 5. Adiustment a�d Resolution o€ Claims. SFM will use its best claims judgment to faci�itatelmanitor appropriate rnedical and rehal�ilitation ser�ices far the earliest passible retu:rn to work. Adjusting activities include but are not limited to: Page 2 a. Maintaining coniact with Employer, claimant, medical pravider(s), and rehabilitation providers; b. Obtaining independen# medical exams or functional capacity e�aluations where there are questians of disability, causal relationship, appropriate treatmen3, ar where reports from treating providers are noE provided; c. Returning. the claimant to work as soon as medically feasible, whether to the former position ar to modifiedllig.ht-duty consistent with medical restrictians; and d. Arranging for any vocational rehabiliiation, job placem�nt, or retraining as appropriate or required by law. 6. Reimbursement, Co.ntribution, Indemnity and Sul�raqatian. SFM Risk will seek reimbursement or contribution �or benefits paid to claimants an behalf of the Emplayer from other workers' compensation insurers, the Workers' Compensation Reinsurance Association, or from other responsible third parties. 7. Loss Reports: SFNt Risk will provide monthly andlor quarterly clairn lass reports to the Em�loyer. 8. Reportinqs and Filinc,�s. SFM Risk will file or provide the necessary information to the Employer far filing, all claim related reports required by the De.partment af Labor and Industry, Departmsnt of Cammerce, MWCIA, WCRA, and other regulatory organizations. SFM Risk will be responsible ta provide infarmation only far periods covered by this Agreement: 9. M�d'ica1lDisat�ilitv. Manapem:ent Services. SFM Risk retains physicians licensed in the Siate of Minnesata to consul# with SFM Risk and/or the Employer regarding medical causation issues significant to the determination of compensabi.lity an.d the propriety of diagnosis; treatmen#, and claimed disability. 10. Nledical Billin Review Services. SFM Risk will review medical, haspital, chirapractic, physical therapy,. pharmacy, an.d rehabilit�tion billings on Employer's claims in order ta: a. Determine appropriate bilfed amounis after applicatian a� ihe f�inneso3a Workers' Campensation Fee Sch�dule, if applicable. b. Identify noncompliance with prevailing billing practices and guidelines as prescribed by the State of Minnesota. c. Id:entify treatments for a I.onger d�ration, greater frequency ar higher service levef t�an is typical of ather claimants with the same diagnosis. ��C The Work Comp Experts Risk Solutions