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Claims and suits under the policy(ies) will be handled by a Third Party Administrator ("TPA") as approved by Discovery Managers, Ltd.
The Insured shall furnish the following information to Discovery Managers, Ltd., 5 Batterson Park, Farmington, CT 06032, Attn: Claims Department:
I. A quarterly report identifying the claimants or injured parties, the dates and places of injuries or damages, the amounts of Case Reserves, IBNR (if any), Loss Adjustment Expenses (both paid and reserved) and payments of judgements or settlements with respect to all losses which were established, revised or eliminated during the previous quarter. This report must be furnished to the Company on the fifth business day of each quarter.
II. Complete files on all claims reserved for 50% or more of the Retention. This information must be furnished to the Company within 30 calendar days from the date each such reserve is established.
III. Complete files on all claims (including multiple claims) arising out of an occurrence or accident which might require payment in excess of the Retention.
IV. Individual written loss reports of all serious injuries or damages regardless of the gross incurred. Serious injuries or damages include, but are not limited to:
1. Cord Injury - Paraplegia, Quadriplegia;
2. Amputations - Requiring a prosthesis;
3. Brain damage affecting Mentality or Central Nervous System - Such as Permanent Disorientation, Behavior Disorder, Personality Change, Seizures, Motor Deficit, Inability to Speak (Aphasia), Hemiplegia or Unconsciousness (Comatose);
4. Blindness;
5. Burns - Involving over 10% of body with Third Degree or 30% with Second Degree;
6. Multiple Fractures - Involving more than one member or non-union;
7. Fracture of both heel bones (Fractured or Bilateral OS Calcis);
8. Nerve damage causing paralysis and loss of sensation in arm and hand (Brachial Plexus Nerve Damage);
9. Massive internal injuries affecting body organs;
10. Injury to nerve at base of spinal canal (Cauda Equina) or any other back injury resulting in incontinence of bowel and/or bladder;
11. Fatalities;
12. Single accidents involving multiple claimants;
13. Any claim or lawsuit not specified above that presents an unusual exposure to the coverage. Examples include: sexual molestation, AIDS, rape, class actions, environmental exposure and bad faith allegations; or
14. Any other serious injury or damage which may involve the Company's liability.
This report must be furnished within 30 days from the date a claim associated with any such injury is first made. This report must contain at minimum, the facts surrounding the claim, a description of damages or injuries, suggested reserves and recommendations for future handling. Subsequent updates should be provided as material developments occur, the evaluation changes, or upon the request of Discovery Managers, Ltd.
V. Other loss information or reports as indicated in a separate letter from the Claims Department of Discovery Managers, Ltd.
Click Here to report a claim via e-mail.
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