GENERAL LIABILITY The JIF will pay for bodily injury and property damage liability claims arising out of municipal activities in accordance with the coverage described in the Plan of Risk Management and Coverage Documents provided by the Fund. Types of losses to be reported on this form: Trip/slip--falls (anywhere). Highway accidents not involving an insured vehicle (i.e., pothole claims, motor vehicle accidents due to weather or alleged road conditions). Improper signage/obstruction of view allegations. Police liability, false arrest, assault, etc. Police liability due to bodily injury or property damage allegedly caused by police activities. Sewer back-ups which cause damage to other than municipal owned property. The purpose of this manual is to highlight the major coverages, limits, sub-limits, and extensions as afforded through the Joint Insurance Fund. This manual is not a policy of insurance and in no way modifies, restricts, expands or in any way changes the coverages afforded through the JIF. For actual coverage determination, reference must be made to applicable coverage documents. D:\Docstoc\Working\pdf\d879cd3a-5d7e-41b0-b519-b6b6a13e2b72.doc GENERAL LIABILITY – Reporting Instructions GENERAL LIABILITY REPORTING INSTRUCTIONS (INCLUDING POLICE PROFESSIONAL LIABILITY) 1. You will receive some type of notice of claim from either the claimant or his/her attorney. In some instances, the injured party will report the claim by telephone, which obviously will not contain sufficient information to meet New Jersey State Statute (See Section 9, Tort Claims Notice Procedures). However, you may take the information from the injured party and utilize the ACORD General Liability Loss Notice (sample attached) in reporting the claim to our office. Although the ACORD General Liability Loss Notice does not contain a sufficient amount of information to adhere to New Jersey Statute, we will obtain additional information once we have received the claim from you. The information, however, should contain the following: A. Name of injured party or party by whom damages are claimed. B. Address and telephone number of above party. C. Social Security Number, if possible. D. Date, time, and place of accident. E. Brief facts about the accident. F. Extent of injuries. 2. Once you have obtained the above information, please complete the Claim Transmittal Form (sample attached). You will note that the Transmittal Form includes information as to the type of claim, which department was involved, the name of the claimant, the date of loss and the date you are transmitting the information to us. Also indicate whether this is a new claim or additional information on an existing claim being forwarded to us. 3. Once we have received this information, we will assign an adjuster and an Acknowledgment Letter will be sent back to you. The Acknowledgment will identify the adjuster assigned and our claim number, which you will use when transmitting additional documents or information to us (see attached sample). 4. It is important that you forward any official reports that your police, fire or other departments may have completed with reference to the incident. Do not hold up the claim until the official reports are completed by the individual department, but forward them to us once they are completed and received in your office. Refer all correspondence, telephone calls and inquires from claimants and their attorneys to a Scibal Associates claims adjuster for handling. GENERAL LIABILITY – Helpful Hints HELPFUL HINTS These are some helpful hints that will assist you in processing your General Liability claims. Be sure to keep a copy of all information sent to Scibal. If attorney letter is first notice of claim you receive follow the Tort Claims Notice Procedures in Section IX . Then fill in the ACORD form with as much information as you know about the loss. Attach a copy of the attorney letter to the ACORD Notice and immediately fax or mail to Scibal. GENERAL LIABILITY – Common Errors COMMON ERRORS These are some common errors made when reporting General Liability losses. No date of loss on the forms. Using the wrong form. Leaving blank the information on the contact person or putting the incorrect person's name in that blank. No description of the loss. Leaving the address and phone number of the claimant blank. Leaving the injuries or damage information blank. GENERAL LIABILITY – Sample Claim Transmittal Form CLAIM TRANSMITTAL FORM TO: Scibal Associates, Inc. P.O. Box 500 Somers Point, NJ 08244-0500 PHONE: 609-653-8400 FAX: 609-926-9270 FROM: Claims Coordinator Borough of Sunnytowne PHONE: 609-555-1234 FAX: 609-555-5678 TODAY’S DATE: 6/30/02 This is a: New Claim Additional Information on Existing Claim Claim Number, if known Date of Loss: 6/22/02 Claimant Name: Borough of Sunnytowne Claim Type: Auto Liability Auto Physical Damage General Liability Property Workers’ Compensation Department: NCCI Code: Street Maintenance 5509 Water Department 7520 Electric Department 7539 Sewage Disposal 7580 Paid Fire Department 7711 Paid First Sid/Rescue Squad 7715 Police 7720 Crossing Guards 7727 Off Duty Police 7728 Clerical 8810 Library 8838 Buildings Department 9015 Lifeguards 9053 Parks Department 9102 Street Cleaning 9402 Garbage Collection 9403 Municipal Employees NOC 9410 Volunteer First Aid/Rescue Squad 9420 Volunteer Firefighter 9430 Always complete this form whenever transmitting claim information to Scibal Associates GENERAL LIABILITY – Sample Claim Transmittal Form CLAIM TRANSMITTAL FORM TO: Scibal Associates, Inc. P.O. Box 500 Somers Point, NJ 08244-0500 PHONE: 609-653-8400 FAX: 609-926-9270 FROM: Claims Coordinator Borough of Sunnytowne PHONE: 609-555-1234 FAX: 609-555-5678 TODAY’S DATE: 8/3/02 This is a: New Claim Additional Information on Existing Claim Claim Number, if known Date of Loss: 7/1/02 Claimant Name: Borough of Sunnytowne Claim Type: Auto Liability Auto Physical Damage General Liability Property Workers’ Compensation Department: NCCI Code: Street Maintenance 5509 Water Department 7520 Electric Department 7539 Sewage Disposal 7580 Paid Fire Department 7711 Paid First Sid/Rescue Squad 7715 Police 7720 Crossing Guards 7727 Off Duty Police 7728 Clerical 8810 Library 8838 Buildings Department 9015 Lifeguards 9053 Parks Department 9102 Street Cleaning 9402 Garbage Collection 9403 Municipal Employees NOC 9410 Volunteer First Aid/Rescue Squad 9420 Volunteer Firefighter 9430 Always complete this form whenever transmitting claim information to Scibal Associates GENERAL LIABILITY JOHN J. JUSTICE, JR. COUNSELOR AT LAW A PROFESSIONAL CORPORATION 666 COUTHOUSE ROW SUNNYTOWNE, NJ 08000 TELEPHONE: (609) 555-1234 FACSIMILE: (609 555-4321 July 30, 2002 Borough of Sunnytowne Certified - Return Receipt Requested 123 State Street Sunnytowne, NJ 08000 Attention: Borough Clerk Re: Betty Smith v. Borough of Sunnytowne Date of Loss: July 1, 2002 Place of Accident: Sunnytowne Borough - Municipal Boardwalk Dear Sir/Madame: Please be advised that as a result of the above stated accident, my client has suffered damages. These damages arise as a result of negligent maintenance of the Municipal Boardwalk. Kindly forward this letter to your liability insurance carriers and have them contact me immediately. If you are not insured, you or your attorney should contact this office regarding resolution of this matter. Very truly yours, John J. Justice, Jr. JJJ/dew GENERAL LIABILITY HIGHWAY ACCIDENT INVESTIGATIONS Even the best designed roads cannot prevent all accidents. Human error inevitably leads to accidents, especially when automobile traffic is concerned. Your municipality should have an established protocol when a serious automobile accident takes place on roadways and streets for which you are responsible. A separate standard accident investigation protocol should be used when the accident involves one of your vehicles. This accident investigation protocol should include the following for any automobile accident involving an intersectional collision or serious injuries: Have a police accident investigator take pictures not just of the accident scene, but wide-angle pictures of the approaches to the intersection, from a minimum of a block away from each direction. Try to show in the picture what the drivers saw as they approached. If available to your community, use a hi-lift or cherry picker to take bird’s eye views of complex intersections or accident scenes. Have a checklist for the police investigator to follow in taking the pictures. All pictures should be taken within the context of the scene, at the time of the accident. Conditions of guardrails, cycles of the traffic signals, lines of sight, condition of signage and landscaping features should be on the checklist. Identify all witnesses and obtain detailed statements as soon as possible. If any witness indicates that a road defect was involved, secure your own records on such items as traffic counts, traffic surveys, trouble calls, repair orders and other internal information that will help establish the true condition of the road at the time of the accident. Notify your claim or insurance investigator as soon as possible if any accident caused death, head injuries, loss of use of any limb or bodily function or other serious bodily injury. Develop a way to maintain your records accurately for an appropriate period. New Jersey has guidelines dictating how long you must maintain records. Review these guidelines with your legal counsel to ensure that your record- keeping procedures are adequate. Any records that are, or might be, involved in litigation should be maintained until the case has exhausted all of its appeals. Cases involving minors should be held until the minors reach their age of majority (18), plus the statute of limitations period (2 years) once they reach their age of majority. GENERAL LIABILITY – Accident Investigations INCIDENT INVESTIGATIONS (Other than Workers Compensation) Accidents don’t just happen; they are caused. After incidents or accidents involving employees, injuries or property damage, someone in authority should investigate to determine what happened. All accidents, including those occurring to volunteers or citizens, should be investigated by the supervisor responsible for the area in which the incident occurred. “Near misses” are accidents also, and even if they do not cause injury or damage, they should be investigated as thoroughly as an accident that results in injury or property damage. We have developed a Supervisor’s Incident Investigation Report form that you can use to investigate accidents. Attach a copy to your Scibal claims transmittal and forward copies to your Safety Coordinator and the JIF Safety Director (Commerce National Risk Control Services). The Incident Investigation Report can be reproduced in your office or additional supplies can be ordered from the Fund Administrator, the Fund Safety Director, or the Claims Administrator. Remember: The purpose of investigating accidents is not to determine who was at fault, but to determine the cause so that similar accidents can be prevented in the future. When an employee is involved in an accident or causes any damage, the supervisor or someone in authority should make a detailed report about the incident and should document what happened. Too often, supervisors and managers focus on a symptom of the problem, such as frequent accidents or employee injuries, when the actual problem may be a failure to perform proper inspections for hazards, supervise employees, provide proper instructions and training, or enforce work rules. Investigations provide: Documentation that can be used in analyzing whether claims are justified. GENERAL LIABILITY – Accident Investigations A basis for understanding what causes an incident--whether or not a loss occurred. Clues to determine what the actual problem is. Formation of actions that can be take to address the problem. Information on incidents and losses that help identify trends and potential losses. After acquiring necessary medical aid for injured persons, supervisors should follow these steps for investigating accidents: If possible, ask the person or persons involved to describe what happened. Do not fix blame or find fault; just get the facts. Survey the accident scene for information. Collect any objects that might have contributed to the accident. Determine if there were any witnesses to the accident and get their accounts of the incident. Take whatever steps are necessary to prevent recurrences until the condition can be permanently corrected. Complete an Incident Investigation Form. If the police were called, attach a copy of the police report to the Incident Investigation Form. This is most common for vehicle accidents. Most accidents occur because of a combination of an unsafe act and an unsafe physical condition. Look for both, and then draw a conclusion as to why the unsafe act was committed or why the condition existed. Once an accident occurs, immediate action must be taken to prevent a recurrence. Indicate what needs to be done and who is going to do it.