AGREEMENT between BROWARD COUNTY and Cummings ...

Exhibit 2
Page 124 of 379
CLAIM REPORTING PROCEDURES
Contractors and Subcontractors must designate a representative at the Project Site(s) to
take injured employees to the medical treatment center (clinic) and to report the claim. This
individual is to remain with the injured employee at the medical treatment center while
he/she is being treated. The treating physician should provide a written description of
whether or not the injured employee can return to work, a list of restrictions if any, and the
estimated length of time the injured worker must be on modified duty. The Owner supports
transitional modified work to keep injured workers gainfully employed during recovery.
Copies of the treating physician’s written description should be returned to the employee for
his/her Employer, the OCIP Safety Manager, General Contractor’s Safety Manager and
OCIP Administrator. A post accident drug test will be included in the treatment regimen as
indicated in the Program Safety Standards.
A detailed Broward County Loss Notice form (Exhibit 4, Section 8) must be completed
along with the FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF
WORKERS' COMPENSATION FIRST REPORT OF INJURY OR ILLNESS form
(Form DFS-F2-DWC-1 (08/2004) (Exhibit 3, Section 8) and turned into the OCIP
Safety Manager, OCIP Administrator, and General Contractor’s Safety Manager within
twenty-four (24) hours of the accident/incident.
Each Contractor and Subcontractor with employees injured at a Project Site(s) will be
required to attend claims meetings and participate in the management of claims for their
employees. Injured employees will cooperate with the OCIP Insurer and comply with the
treatment regimen prescribed by the primary care physician.
When additional information is requested by the insurance carrier or the employer needs to
talk to the adjuster:
Report all Liability claims
to the OCIP Safety Manager
& Administrator and the
General Contractor’s Safety
Manager.
Liability Claims
Incidents or accidents at, or around the Project Site(s) or a designated off-Site(s) location
that has been added to the OCIP (see definition of Project Site(s) on page 2) resulting in
damage to the property of others (other than your own property, rented or leased property,
or your own Work product), or personal injury or death to a member of the public, must be
reported immediately to the designated claims and safety representatives and OCIP
Administrator. (See Section 2 for contact information). Contractors and Subcontractors
must designate a representative at the Project Site(s) to report the claim.
A detailed Broward County Loss Notice form (Exhibit 4, Section 8) must be completed
and turned into the OCIP Safety Manager, OCIP Administrator, and General
Contractor’s Safety Manager within twenty-four (24) hours of the accident/incident.
This documentation will be forwarded onto the insurance carrier for further handling. A
copy of this documentation should be sent to Sandy Steinlage, Risk Management
Liability Supervisor, at SSteinlage@broward.org Dawn Mehler, Risk Insurance and
Contracts Manager at DMehler@broward.org, and Danielle French, Assistant Director
Risk Management at dfrench@broward.org.
Do not voluntarily admit liability. Contractors and Subcontractors of any tier must cooperate
with the Owner and the OCIP insurer representatives in the accident investigation.
The insurance carrier will investigate, process, and settle each claim. Each Contractor will
Broward County, Florida 23
Owner Controlled Insurance Program
OCIP Manual – 07/01/2010
Rev. 0002