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2009_0112_Packet
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2009_0112_Packet
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Section III: -- Claim Definitions <br />+ N�w Claims are claims #hat are originafly reported to <br />SFM Risk during the current contract period. <br />• Existinq Claims are claims that were originally <br />reported to and opened by Employer's previous <br />claim administrator. <br />• Incident Only Claims are claims for which no <br />payments are made. SFM Risk provides data entry <br />services anly indicafing pertinent in€ormation from <br />the First Repart of Injury. <br />• f.ndemnitv Clairrrs {Lost Time Claims) are claims on <br />which indemnity benefits are payable (or patentiaily <br />payable or claimed ta be payable}, <br />• Medical Only Clairns are clairns on which medical <br />expenses are payable (or potentially payable ar <br />claimed to be payable) but no indemnity benefits are <br />payable (or potentially payable or claimed to be <br />payable). <br />• Reopened Claims are claims that have been opened <br />by or handled by SFM Risk or a previous <br />administrator, then subsequently closed, and are <br />reopened twelve months ar more after tl�e last date <br />the file was opened or reopened. <br />• Subsequent Year refers to a subsequ.ent year <br />charge, which attaches to ciaims originally opened <br />by SFM Risk or a previous clairns administrator and <br />still apen on the anniversary of the cEairn's referral to <br />SFM Risk. <br />• With Tail provides an additional 12 monih handling <br />perfod in the event of non-renewal. <br />Section IV — Bankinct <br />Employer and SFM Risk a�ree to the following banking <br />procedures: <br />Banking Procedures. SFM Risk will issue payments for <br />claims it administers an checks printed and provided by <br />SFM Risk but drawn against ihe Employer's account at a <br />bank designatEd by Employ�r. Einployer agrees to <br />mainfain su�ficient funds in its account to cover payments. <br />SFM Risk will n.otify Employer in writing wi#h a list of <br />itemized checks drawn against the account For daim or <br />expense paymenis on a weekly dasis, at which time <br />Employer agrees to replenish the account funds. <br />Page 4 <br />�� J <br />The Work Comp Experts <br />Risk Solutior�s <br />
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