Division of Risk Management

BUREAU OF CLAIMS ADMINISTRATION

 

The Bureau of Claims Administration is responsible for the investigation, and resolution/settlement of claims involving or against state agencies, universities and injured state employees. Coverages provided by the Division include the following types.  The Division also provides management and oversight of lawsuits filed against state agencies and universities.

·        Workers’ Compensation

·        Property

·        Fleet Automobile Liability

·        General Liability

·        Federal Civil Rights/Employment Discrimination and

·        Court Awarded Attorney Fees

Workers’ Compensation  

The Workers Compensation section is responsible for processing and paying workers’ compensation benefits for injured State employees, including Medical, Indemnity and Death Benefits.  Investigations of claims are conducted by staff.  Field investigations, surveillances and investigations of suspected cases of workers' compensation fraud services are performed by contracted vendors and defense of litigated claims is provided by contract law firms.

Medical Case Management:

Since January 1, 1997, the Program has contracted with vendors to provide managed care services.  Medical care is "managed" by medical case managers who are registered nurses, or are supervised by registered nurses, in conjunction with either a medical network or panel of clinicians. 

 State Property Insurance Coverage

This program provides property coverage through the State Risk Management Trust Fund. The division offers coverage for damages to covered property caused by specific insured perils, such as fire, windstorm and lightning.  The self-insurance coverage includes:

·        Buildings,

·        Contents,

·        Loss of rental income when the coverage is required by bonding or revenue certificates or resolution

·        Non-owned State-leased real property can be covered if an approved lease provides and conforms to the coverage under the property policy. 

The program has the responsibility of investigating, evaluating, negotiating, and settling covered property claims.  Investigations are conducted by staff and/or in concert with a contracted adjusting service.

Fleet Automobile Liability

This program provides auto liability insurance through the State Risk Management Trust Fund, for claims arising out of the ownership, maintenance, or use, including loading or unloading, of any:

·        owned,

·        hired or

·        non-owned automobile

used by an employee, agent or volunteer of the State, while acting within the course and scope of their office or employment. 

The program has the responsibility of investigating, evaluating, negotiating, and making appropriate disposition of any auto claims and lawsuits filed against the State. Investigations of claims are conducted by staff and/or in concert with a contracted adjusting service.  Defense of litigated claims is provided by the Attorney General’s Office, contract law firms, or State agency attorneys.

In accordance with Chapter 768.28, Florida Statutes, the limits of liability (under the waiver of sovereign immunity law) for which the State may be sued, are $100,000 per person’s claim, $200,000 for all claims.

As of 7/1/04, Risk Management has offered coverage for property damage to state vehicles sustained when these vehicles are being used in approved off-duty use by a law enforcement officer. Risk Management establishes a premium each year for this coverage and there is a $500 deductible per incident if the law enforcement officer is determined to be at fault.

General Liability Coverage

This program provides general liability claims coverage through the State Risk Management Trust Fund. The state is liable for damages for injury, death, or loss of property caused by the negligence of its employees, agents or volunteers while acting within the course and scope of their employment or responsibilities.  The self-insurance coverage includes:

·        Premises and operations,

·        Personal injury, and

·        Professional liability.

The program has the responsibility of investigating, evaluating, negotiating, defending and making appropriate disposition of claims/lawsuits filed against the State because of a negligent act or omission.  Investigations of claims are conducted by staff and/or in concert with a contracted adjusting service.  Defense of litigated claims is provided by the Attorney General’s Office, contract law firms, or State agency attorneys.

In accordance with Chapter 768.28, Florida Statutes, the limits of liability (under the waiver of sovereign immunity law) are $100,000 per person’s claim, $200,000 per occurrence for all claims.

Federal Civil Rights/Employment

This program provides federal civil rights and employment discrimination claims coverage through the State Risk Management Trust Fund. 

This coverage includes:

·        Federal civil rights actions filed under 42 U.S.C 1983 (and other similar federal statutes),

·        Plaintiff attorney fees/awards (where so provided by the covered federal statutes),

·        Employment discrimination actions filed under 42 U.S.C 2000e, Title VII of the 1964 Civil Rights Act, as amended by the Civil Rights Act of 1991, and

·        The Florida Civil Rights Act of 1992, and other similar employment discrimination acts and statutes. 

The program has the responsibility for investigating, evaluating, negotiating (settling), defending and making appropriate disposition of any covered action filed against State agencies, their employees, agents, or volunteers. Investigations of claims are conducted by staff and/or in concert with contracted adjusting service.  Defense of litigated claims is provided by the Attorney General’s Office, contract law firms, or State agency attorneys.

There is no monetary liability caps associated with federal civil rights actions.  Title VII has a $300,000 cap for compensatory damages while The Florida Civil Rights Act of 1992 has a $100,000 cap.  In addition to these amounts, front and back pay (past and future salary amounts determined to be due from a State agency), and plaintiff attorney fees for which a State agency becomes liable, can be paid under Title VII and The Florida Civil Rights Act of 1992 cases.

Court Awarded Attorney Fees

This program provides court awarded attorney fees coverage through the State Risk Management Trust Fund. 

This coverage pays on behalf of the state, court awarded attorney fees and costs in other proceedings (for which coverage is not afforded under s. 284.30, Florida Statues), in which the State is not a prevailing party.  Risk Management has the right to participate in the defense of any suit or appeal with respect to the payment of attorney fees.