Oklahoma Administrative Code › Title 260 - Office of Management and Enterprise Services › Chapter 70 - Risk Management Program › Subchapter 5 - Casualty or Liability Claims Management, Payment and Reports › Section 260:70-5-1 - Claims management

Current through Vol. 41, No. 20, July 1, 2024
(a)
Settlement and payment of claims.
(1)
General.
While the Risk
				Management Department will explore alternatives, most claims may be paid from
				the state's respective risk pools and not from commercial insurance. This
				requires that procedures be established to administer and settle claims. Where
				the Risk Management Department has approved the acquisition of a policy or
				contract of liability insurance, the terms of which make it applicable to any
				liability incident, the Administrator shall, upon receiving notice of any
				liability incident or claim from an agency or other covered entity, ascertain
				the existence and applicability of such insurance, and, within a reasonable
				time thereafter, notify the insurer of the incident or claim, as may be
				required by the applicable policy or contract of insurance. The terms and
				conditions of the contract or policy shall govern the rights and obligations of
				the state, agency or other covered entity and the insurer with respect to the
				investigation, settlement, payment and defense of claims or suits against the
				state, an agency, and other covered entity or any of their employees.
(A) With respect to claims subject to a
				contract or policy of liability insurance the following shall apply:
(i) A State agency, or any other covered
				entity, and its authorized attorney shall cooperate with any and all requests
				for information made by the Risk Administrator, or his/her representative or
				the insurer, or risk denial of coverage.
(ii) In the case of any possible settlement,
				regardless of the deductible or self-insured retention level claim, a state
				agency or any other covered entity and its attorney, shall notify the Risk
				Administrator or his/her representative prior to a settlement offer being
				made.
(iii) If any State agency, or
				any other covered entity, or its attorney fails to reasonably cooperate with
				Risk Management or the insurer, or fails to notify the Risk Administrator or
				his representative, prior to a settlement offer being made on any claim subject
				to a contract or policy of liability insurance, the Risk Administrator may
				refuse to pay the claim.
(iv)
				Settlement of claims subject to a commercial contract of policy of liability
				insurance shall also be subject to the liquidity of any accounts created for
				the self-insured retention pool established for that particular liability
				insurance policy or contract.
(v)
				Any litigation concerning the Comprehensive Professional Risk Management
				Program of the Office of Management and Enterprise Services shall be handled by
				the Attorney General of the State of Oklahoma. [74 O.S., Section 61.4]
				Accordingly, settlements of matters in litigation shall not be settled without
				consultation with the Office of Attorney General and the Risk
				Administrator.
(vi) Private counsel
				hired by Risk Management or by any state agency are subject to and must also
				comply with the rules and regulations of Risk Management with respect to claims
				subject to a contract or policy of liability insurance.