Moore v. Norouzi

807 A.2d 632, 371 Md. 154, 2002 Md. LEXIS 777
CourtCourt of Appeals of Maryland
DecidedSeptember 25, 2002
Docket126 & 127, Sept. Term, 2000
StatusPublished
Cited by48 cases

This text of 807 A.2d 632 (Moore v. Norouzi) is published on Counsel Stack Legal Research, covering Court of Appeals of Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Moore v. Norouzi, 807 A.2d 632, 371 Md. 154, 2002 Md. LEXIS 777 (Md. 2002).

Opinion

BELL, Chief Judge.

In these consolidated appeals, we have been asked to address whether: by notice to a third party claims administrator acting on behalf of a local government, the petitioners, Robert Moore (“Moore”) and Stuart C. Mendelson (“Mendelson”) 1 actually complied with the notice requirement of the Local Government Tort Claims Act (“LGTCA”), Md.Code (1974, 1998 Repl.Vol., 2000 Cum.Supp.) § 5-304 of the Courts and Judicial Proceedings Article; 2 such notice constitutes substantial compliance with the notice requirement; 3 the court, because good cause was shown and the local government defendant were not prejudiced, could entertain the action in any event. 4 The Circuit Court for Montgomery County resolved each of these issues against the petitioners and entered judg *159 ment in favor of Montgomery County, one of the respondents. We shall reverse.

I.

In both of these cases, the petitioners were injured in an accident, in which an employee of Montgomery County was involved and, according to the petitioners, that employee’s negligence caused. In both, Trigon Administrators, Inc. (hereinafter “Trigon”) provided claims administration services for the Montgomery County Self-Insurance Program, which provides coverage for “Workers’ Compensation, Commercial General Liability, including Public Officials and Public Protective Liability, Business Automobile, Automobile Physical Damage, Real and Personal Property and miscellaneous property.” In neither did the petitioners send any notice to the County Executive and there is nothing in the record to indicate that the County Executive was provided with any written notification from any other source.

Trigon acts pursuant to a contract solicited by the Montgomery County Government, Department of Finance, Division of Risk Management. 5 In furtherance of the County’s goals of, among others, “bringing the claims management/risk management information system ... in-house to the Division of Risk Management,” thus providing a fully automated system that is integrated with the County’s existing accounting and other information systems and can be used by the third party claims administrator to enter claims data, print checks and run experience reports, Trigon is charged, under that contract, with achieving currency between the data it uses or maintains and the Division of Risk Management’s information system. It is permitted to do so in either of two ways: using on-line access to the County risk management information *160 system or providing on-line access to Risk Management to its risk management information system.

The provisions of Trigon’s contract with the County with regard to claims handling in general are extensive and comprehensive. In addition to other provisions requiring periodic reviews, evaluations and reports, some of the contents of which are also prescribed, the contract requires the claims administrator, at a minimum, to:

“a. Date-stamp all correspondence on the day it is received.
“b. Create a claim file folder, with a file number and a record of the name of the adjuster assigned to handle the claim....
“c. Set reserve amounts for each claim.
“d. Enter the claim information on the computer database within five days of receipt of the claim. All information captured on claim report forms submitted by participating agencies must be available on the database....
“e. Contact the claimant within one working day of notification of bodily injury claims ... and within three working days for property claims. Contact must be made in person or by telephone.... Personal contact will be made on any claim involving ... when the total reserve is over $10,000.00,
“f. Maintain an orderly claim file. Correspondence must be placed in the file in chronological order on a brad or another means of affixing documents to the file.”
❖ * * * * *
“j. Each file will contain a form developed by the contractor that will clearly state the results of the investigation of the claim and an explanation of the decision of liability/com-pensability/denial.
“1. When requested or required, recorded statements will be transcribed.
*161 “m. Each foldered claim file will be reviewed at least every 45 days. Documentation of the review is preferred to be made on the computerized claims data management system. Documentation to be recorded will include appropriate comments on information received, file direction by the adjusters, and the disposition plans.
“o. A supervisor or manager will review each open fold-ered claim at least quarterly. Documentation of the review is preferred to be made on the computerized claims data management system. Documentation to be recorded will include recommendations of future handling of the file.
“r. A typed captioned report will be completed on each file with combined reserves of $25,000.00 or more. The captioned report must be completed and submitted to the Division of Risk Management within 60 days of the posting of the reserves.
“s. Final reserves must be computed and posted on the file within 180 days of the date the claim is received.... ”

The contract also prescribes the duties of the claims administrator with respect to specific claims. As to workers’ compensation claims, it is required to “perform all duties required of the employer under the Maryland Workers’ Compensation Act.” Its responsibilities with regard to Commercial General Liability are to “record, investigate, tabulate, adjust, appraise, and, where appropriate, make payments for all claims which require defense or indemnification under the Montgomery County Self-Insurance Program.” In addition, it must:

“Cooperate with and assist the Office of the County Attorney, or other designated counsel, in the defense of claims and in subrogation recovery. Such assistance will include, but not be limited to, making a full investigation, including contacting the claimant, taking statements from the claimant, identifying and taking statements from all witnesses, obtaining all bills, taking relevant photographs, completing interrogatories, taking recorded statements, providing for *162 Independent Medical Examinations, preparing status updates, and attending and/or assisting at trials and/or hearings. Once a lawsuit is filed and the claim is transferred to the Office of the County Attorney, or other designated counsel, the above assistance will continue.”

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Bluebook (online)
807 A.2d 632, 371 Md. 154, 2002 Md. LEXIS 777, Counsel Stack Legal Research, https://law.counselstack.com/opinion/moore-v-norouzi-md-2002.