Risk Management Liability Claims Process
An incident occurs where a claimant sustains injury and/or property damage and which they believe resulted from a City activity.
Claimant files a Tort Claim Notice with Risk Management. Claimants are encouraged to contact their own insurer if they need immediate repairs or if their claim has been denied.
A claim file is created, and a Risk Claims Analyst is assigned to the case. The analyst sends an acknowledgment letter to claimant with a claim number and the analyst’s contact information (email and phone number). The claimant is advised to submit supporting documentation of their loss if not already provided. The analyst documents the claimant’s version of the event or activity which occurred, and how it resulted in damages.
On the same day the acknowledgment letter is sent, the analyst sends a copy of the tort claim notice to the City bureau(s) which may be involved, along with a memo requesting all available information related to the incident in question. This information may include police reports, incident reports, photos, statements from bureau employees and supervisors, maintenance records, and work orders.
After receipt of all pertinent information, the analyst reviews the documents and statements to determine if the information is sufficient to determine liability. The review may lead to additional clarifying conversations with both the claimant or bureau representatives and potentially more documents may be requested and submitted.
The analyst reviews all documentation, seeking to answer primary questions:
- Was the City negligent?
- What did the City do wrong, and was that action a direct cause of claimant’s damages?
- Were there other conditions that may have contributed to claimant’s damages?
The analyst makes a liability determination after thorough review of all documents and evidence.
- If there is no liability on the City, the claim is denied.
- If some liability exists for both the City and the claimant, the analyst may begin to negotiate a settlement based on apportionment of fault between the parties.
- If all liability is on the City, the analyst begins settlement discussions with claimant, their attorney (if represented) or with claimant’s insurance carrier.
Claimants receiving a denial may speak further with their assigned analyst or the Claims Manager to better understand the City’s decision.
Appeal of a denial by a claimant is generally through the court system; attorneys are sometimes involved but not required.