Liability Claim Decisions

When a member reports a liability claim to the Trust, 信托必须确定会员是否对被索赔的损害承担法律责任. 在一般情况下, for a member to be liable for someone else’s damage, the following three conditions must be met:

1. The member must have been negligent.
2. The damages must have been caused by the member’s negligence.
3. It isn’t an area where the member is immune from liability.

如果不是由成员的疏忽造成的，责任申索通常会被拒绝. 有, 然而, 在某些情况下，索赔拒绝不明确，可能会考虑其他索赔解决方案. In some situations, it may seem easier to make a payment to the damaged p艺术y, even 虽然 legally the member isn’t liable for that payment. 的信任, 虽然, 不能这样做，因为信托用于支付索赔的资金是公共资金，是所有信托成员的共同财产. 信托基金有责任确保这些资金只在法定欠款时支付. To do otherwise would be an unauthorized use of public funds (明尼苏达州. 常量. 艺术. X, § 1).

Resolving liability claims

在评估责任索赔时，通常会涉及到大量的判断, 成员可能不同意或对信托的评估和结论有疑问. 如果有事实或信息你的理赔员不知道或问题，他们没有调查, 成员应该总是把这些问题带到他们指定的调解员那里. If questions persist, 联系理算员的主管或信托的索赔经理Darin Richardson drichardson@pudukottaicitymatrimony.com or (651) 281-1283. 他们将审查索赔要求，以确保得出正确的结论.

Member’s authority to make final settlement decisions

信托基金拥有代表会员解决承保责任索赔的法律权力. 然而, because the Trust is a cooperative organization, 它努力让成员了解案件的发展情况，以及是否正在考虑和解或拒绝索赔. 的信任 always welcomes members’ comments, 建议, 以及关于如何处理索赔以及是否应考虑和解或是否应拒绝索赔的意见.

有时, 出现信托基金认为应解决责任索赔的情况, but the member strongly disagrees. 信托责任保险的“同意和解”条款通常适用于这些情况. 根据这些规定，成员国有权在拟议的和解方案最终确定之前对其进行审查，并就是否提供和解方案做出最终决定. 然而, 同意和解条款不适用于信托基金土地使用或特殊风险诉讼承保范围下处理的索赔, wherein decisions are made mutually between the Trust and the member.

Procedures to make final settlement decisions

行使信托责任保险协议中所载的同意和解条款的权利, 会员须遵守信托责任保障文件所列明的程序，并留意所涉及的财务风险. Under these procedural requirements, the member:

• Must provide notice to the Trust before settlement. 行使对责任索赔的审查、批准或不批准和解的权利, 该成员必须在信托提出和解或作出和解前通知信托. 对于会员希望行使其同意和解权利的每一项具体索赔，必须发出通知. 该成员还必须指定一名个人，该个人有权代表该成员批准或不批准拟议的和解, and it must include the name, address, and phone number of that individual. Unless and until the member gives notice, the Trust has the authority to settle the claim if appropriate.
• Must review settlement and be aware of deadlines to settle. 当该成员通知信托，未经其许可不得解决案件时, 信托基金将联系会员指定的个人，告知他们关于该索赔的任何拟议解决方案的条款和条件. 该成员有14天的时间来否决或批准拟议的解决方案(在某些情况下), this period can be extended or shortened if agreed to by both p艺术ies). 如果该成员未在14天内通知信托其不同意和解, the member is deemed to have consented to the settlement, 信托基金有权在适当情况下进行和解.
• 必须意识到选择否决拟议的和解方案的三个财务风险.
  • 第一个, if a member disapproves a proposed settlement, 有一种风险是，案件的成本最终可能会超过拟议的和解金额. 如果索赔的损害赔偿和辩护费用的最终总费用大于拟议的和解加上截至该日已发生的辩护费用, the member is responsible for the difference.
  • 第二个, 如果该成员拒绝同意拟议的解决方案，导致进一步索赔损害赔偿或采取行动寻求对信托的处罚, the member must defend and indemnify the Trust for that claim, defend itself against any such claims or actions, 并负责对会员的任何损害赔偿或处罚.
  • 第三, 在涉及医疗保险而成员不同意和解的情况下, 成员必须与信托合作，以确保医疗保险的经济利益得到保护, as required by federal regulations. 会员不同意解决必须捍卫和赔偿信托医疗保险索赔的结果.
• May veto settlement after exercising consent-to-settle rights. 成员行使同意和解权后否决和解提议的, there are two ways to proceed:
  • 信托可以向会员支付的款项等于拟议的结算金额减去任何适用的免赔额. 在这一点上，它成为成员的责任，以保护自己和任何其他承保方.
  • 的信任 can continue defending and managing the claim, but if costs turn out greater than what it could have been settled for, the member must reimburse the Trust for the excess cost.