Office of Risk Management

1. Office of Risk Management

2. GENERAL LIABILITY CLAIMS KATHLEEN GASSER CLAIMS MANAGER OFFICE OF RISK MANAGEMENT

3. Ann Wax, State Risk Administrator-Claims Kathleen Gasser Claims Manager Frank Foret Claims Supervisor Susan West Claims Manager James Lea Claims Supervisor (225) 219-0012 (225) 342-8433 (225) 342-8463 (225) 342-6031 (225) 342-8399 Who We Are

4. PENNY BUCHANAN BARBARA BURNS JIMMY MARTIN BYNIE WELLS DIANE WILLIAMS TOM BLUFF 225-342-8512 225-342-8516 225-342-6214 225-342-8447 225-219-4428 318-262-2131 CGL ADJUSTERS

5. WHAT DO WE COVER? • The State of Louisiana provides insurance coverage for third party bodily injury and property damage claims for which the agency could be held legally liable.

6. General Liability Claims • Claims alleging damages in tort due to negligence by the state of Louisiana. • The CGL unit handles claims that are not Worker’s Comp, do not involve state owned automobiles, and do not involve damages attributed to the state highways. • Claims range from trip and falls to property damage to wrongful acts, for example.

7. Premises and Operations Completed Operations and Products Liability Elevator and Escalator Watercraft under 26’ Contractual Liability Wrongful Acts Errors and Omissions Professional Liability Public Officials Custodial Garage Keepers Foster Parents Protective Liability Fire Damage Legal Liability Publisher’s Media The General Liability Policy covers:

8. CIVIL RIGHTS CLAIMS • Claims alleging discrimination, harassment and or retaliation are also covered. The General Liability unit handles these claims.

9. Reporting CGL Claims • In writing to: • General Liability Claims • Office of Risk Management • P. O. Box 91106 • Baton Rouge, LA 70821-9106 • If loss is serious in nature, also telephone it in to (225) 219-0168.

10. HOW TO REPORT A CLAIM • For injuries sustained by visitors to your agency, have agency contact complete the CGL claim form found on our website: • www.doa.la.gov/orm

11. ON LINE REPORTING • CGL will be introducing On Line Reporting later this year. We plan to provide a Pilot Program with one or more agencies. • Worker’s Compensation is using On Line Reporting now.

14. When a Loss Occurs • All Property which has been damaged is to be protected against further damage and is to be made available for inspection by a claims adjuster assigned by ORM. • The agency is not to assume any obligation or incur any expenses without the authority of ORM.

15. Where to send report of claim • 1. Mail it to: • Frank Foret, Supervisor • Office of Risk Management • Post Office Box 91106 • Baton Rouge, LA 70821-9106 • 2. Fax it to: • Frank Foret, Supervisor • (225) 342-4470

16. How a claim is processed An Adjuster is assigned.

17. CUSTOMER SERVICE • One adjuster will handle CGL claims for the entire agency in order to provide more effective customer service.

18. The adjusting process: • 1. Investigation • 2. Evaluation • 3. Negotiation • 4. Settlement

19. Investigation of Claim • The adjuster investigates to determine coverage by ORM • Liability and exposure are determined after obtaining the facts of the incident.

20. What is Our Negligence?

21. Limitation of Liability for Public Entities • R.S. 9:2800 • …No person shall have a cause of action based solely upon liability imposed under CC Article 2317 against a public entity for damages caused by the condition of things within its care and custody unless it had actual or constructive notice of the vice or defect, had reasonable opportunity to remedy it and failed to do so.

22. Constructive Notice • The existence of facts which infer actual knowledge • Example: • Defective sidewalk in front of administrative building or • Defective sidewalk somewhere in middle of campus where there are miles of sidewalk.

23. Evaluation of the claim • Do we have liability? • Are we 100% at fault or was there comparative fault by the claimant or fault by another party? • What damages were suffered: • Medicals • Lost wages or lost time • Out of pocket expenses • Property damage

24. Negotiation of Claim • Claims may be filed “Pro Se” by the injured party or by an attorney. • The adjuster will negotiate directly to settle a claim. • When a lawsuit is filed, the adjuster will work with our defense counsel in negotiations.

25. Settlement of a Claim • The adjuster must have settlement authority in order to negotiate and settle a claim. • Requests for settlement authority may be presented to supervisors or to Claims Council depending on the level of authority sought. • A full and final release of all claims and a dismissal of any legal action are obtained in order to settle a claim.

26. CGL FY2006 STATISTICS • Pending as of 6/30/2006: • 1,155 GL • 959 PI • New claims: • 724 GL • 245 PI • Settlements/Judgments: 86 • Paid: $5,976,258.27

27. Frequently Asked Questions ???

28. Do we cover trip and falls? • Were we negligent in maintaining a safe environment? • Take pictures of area of fall. • Note whether claimant was wearing glasses, carrying things, type of shoes worn. • Provide witness information.

29. How You Can Help • Tell us about conditions that contributed to the accident: • Wet floor, any warning signs? • Holes, barriers, irregular surface • Lighting • Weather • Handicap • Eyeglasses • Carrying anything that might obstruct vision

30. Take Photographs of the Scene • Label with name of injured party and date • Take some photos that show location and landmarks

31. Falls that involve a chair? • Only if the agency is negligent in maintaining a chair in a safe condition. • If chair broke, remove it from service, save it and label it with name of person who fell and date of incident. • Note the manufacturer and supplier of chair. • Take pictures • Provide witness names

32. Damage to private cars? • Falling tree branches? Depends on whether it was live or visibly dead. Need photos. • Gate arm? If it malfunctioned. • Vandalism by unknown person? No. • Our mower? Yes if the auto is insured. • Need proof of liability insurance required by LA Law.

33. Loss of personal property • Must determine care, custody and control • If property was left behind and then discovered to be lost, it would be abandonment on the part of the owner, and it would not be negligence on the part of the state.

34. Theft or Burglary of Privately Owned Auto Parked on Agency Grounds. • The state is not the insurer of a privately owned automobile. We act as the gratuitous depository only.

35. Trip and Fall in Elevators • We must determine the Maintenance Co. who services the elevator and review the contract. • Check to see whether a malfunction has been previously reported to the Maintenance Co.

36. Do We Cover Injuries or Damages Caused by Wildlife? • Vehicle traveling on state highway hits a deer • Visitor to state park receives insect bite/snake bite

37. Lawsuits filed against your Agency • Forward all lawsuits, demands, or legal documents pertaining to a claim to ORM immediately for further handling.

38. What if Lawsuit names a State Employee as a Defendant?

39. Louisiana Governmental Claims Act • R.S. 13:5101 et seq. states this applies to any suit in contract or for injury to person or property against the state, a state agency, an officer or employee of the state or a state agency arising out of the discharge of his official duties or within the course and scope of his employment…

40. EMPLOYEE COVERAGE R.S.13:5108.1 • Indemnification of officers and employees of the state; civil rights; representation by the Attorney General. • ORM is the insurer • State employee is the insured • DOJ is defense counsel

41. Named Defendant Must Request Representation by Attorney General • Send a copy of the petition • Send a cover letter to Attorney General Charles C. Foti requesting representation • Provide information regarding service of the petition • Within 10 days of date of service of petition

42. Our Duty to Defend: • The state shall defend and indemnify a covered individual against any claim, demand, suit, complaint or petition seeking damages filed in any court over alleged negligence or other act by the individual, including any demand under any federal statute when the act that forms the basis of the cause of action took place while the individual was engaged in the performance of the duties of the individual’s office or employment with the state.

43. Who is Covered? • R.S.13:5108.1(e) • 1. An official, officer, or employee holding office or employment: • Executive branch • Legislative branch • State Supreme Court, courts of appeal, family, juvenile or judicial district courts • Deep-water ports

46. Claim, demand, suit, complaint or petition seeking damages • Remedy sought determines whether complaint with be handled by ORM. • Suits seeking contractual damages or suits on open accounts are not handled by ORM.

47. Limitations • Suits against the state must be filed in Louisiana state courts • Suits for personal injury to any one person total recoverable exclusive of property damages, medical care, loss of earnings, shall not exceed five hundred thousand dollars.

48. Future Medical Care Fund • In personal injury suits wherein the court awards medical care and benefits subsequent to judgment, this is paid according to R.S. 39:1533.2 • Medical care benefits are paid directly to providers as incurred.

49. Civil Rights Lawsuits

50. Employment Practice Liability • Claims of Improper or Discriminatory: • -Hiring, Firing, Discipline • -Compensation Classification • -Treatment, Training, Opportunities • -Terms and Conditions of Employment