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HomeMy WebLinkAbout04 CONSIDERATION OF CLAIM NO. 10-01, LATE PRESENTATIONAgenda Item 4 ~ Reviewed: ~....:~ AGENDA REPORT City Manager r i -~,,a~'`~ Finance Director N A MEETING DATE: APRIL 6, 2010 TO: WILLIAM A. HUSTON, CITY MANAGER FROM: KRISTI RECCHIA, DIRECTOR OF HUMAN RESOURCES SUBJECT: CONSIDERATION OF APPLICATION FOR LEAVE TO PRESENT LATE CLAIM OF ALLIANCE UNITED INSURANCE/JULIO C. CHAVEZ, CLAIM NO. 10-01 SUMMARY: The Claimant submitted a claim to the City on February 5, 2010 for auto property damage that occurred on June 12, 2009. On June 12, 2009 a City employee was involved in an auto accident that resulted in damage to the vehicle of Julio C. Chavez (insured by Alliance United Insurance). The original claim submitted on February 5, 2010 was presented beyond the applicable six-month statute of limitations, and as such was returned to the claimant as untimely. The claimant has now filed an application for leave to present late claim. RECOMMENDATION: That the City Council deny the Application for Leave to Present Late Claim Number 10-01, Alliant United Insurance/ Julio C. Chavez, and direct Staff to send notice thereof to the Claimant. FISCAL IMPACT: None. DFSCUSSION: Despite a traffic collision report that clearly identifies the at-fault party, and a timely claim filed by their insured, Alliant United Insurance failed to file a claim against the City within the six-month statute of limitations. Additionally, on December 14, 2009 (already beyond the six-month statute), the subrogation manager from Alliant United Insurance contacted the City to inquire about a claim form. Claim forms were emailed to Alliant United Insurance, along with a link to the City's website where a claim form can be found, on December 14, 2009 and January 12, 2010. The claimant has not presented any valid explanation in support of their request for leave to present a late claim. Staff is recommending denial of the application for leave to present late claim. P~~~~ ~(i~~ ~ Kristi Recchia Director of Human Resources ATTACHMENTS: Copy of Claim No. 10-01 Application for Leave to Present Late Claim ~, , (. CLAIM AGAINST THE CITY OF TUSTIN (For Damages to Person or Personal Pro . erg. -~ ~.~T'~1 IT~ ter' R ived Via: Time Sta p: U.S. Mail p l}s ^ Inter-Office Mail ~4~~ F~B _5 ^ Over the Counter Claim No: 19 ~ ~ I PLEASE NOTE: A. Read entire claim before filing. B. Be sure your claim is against the City of Tustin, not another public entity. C. Claims for death, injury to person or to personal property must be filed no later than 6 months after the occurrence (Government Code § 911.2). D. Claims for damages to real property must be filed no later than one year after the occurrence (Government Code § 911.2). E. If additional space is needed to provide your information, please attach sheets, identifying the paragraph(s) being answered. F. A claim must be presented, as prescribed by the Government Code of the State of Califomia, by the claimant or a person acting on his/her behalf and shall provide the information shown below and must be signed by the claimant or a person on his behalf (Government Code § 910.2). G. This form is for the convenience of those desiring to present claims against the city. Claimant is advised to consult a private attorney if legal advice is desired. No employee of the City may give legal advice to any claimant relating to private claims. H. Completed claims must be mailed or delivered to the City of Tustin, City Clerk's Office, 300 Centennial Way, Tustin, California 92780. Name and Post Office address of the Claimant: Name of Claimant: A (r(~! ~J (.~~" (~N t 7 t~ ...~,5 ~2sf~-'C~ /¢ S Sc//~R.4C~~ [2F ~t/G~ D.C . .Home Address: ~. r7 , /,~ v X Cc1'~'Z- Cy~yv- Z Home Telephone: Work Telephone• ~S1 S Ug .-S"g ~3 ~°X T ~ I ~ S 2. Post Office address to which the person presenting the claim desires notices to be sent: (If different from above) Name of Addressee: `~A'~'~L;~' ~- ~' /~.~~+/E" Telephone: Post Office Address: 3. The date, place and other circumstances of the occurrence or transaction from which the claim arises. Date of Occurrence: jp ~ ~ Z ! ~C7 ©~ Time of Occurrence: ~Q/p)( S~p~ Location: ~~O~lr ~q,! ~ a' w~-L.-JUtJT-A-Urv' 7"U S7'-I,v ~~ Circumstances giving rise to this claim: ~ C f `P-t V~`~ ~ r ~ ~~ ~P~i~f_~.-~7.~1 g ~/ tit,% _ S ~. t /< i~v 6- Uv /L ~~S u z is .~ S t/E H f ~ t..-E . E-Yl. ~~ ~b G E' 14a'z.T L( /~-b I L. t T- ~-1 ! S G(..t.="`~'4~C.-- Cc~'f . 4. General description of the indebtedness, obligation, injury, damage or loss incurred so far as you now know. t~2yP~~-~ ~~ f4f~~' r7.~ o u~L "~c c..,2C~J..~ t/~-1"7y ~ C ~ Page 1 of 4 j£ i ~' 5. The name or names of the public employee or employees causing the injury, damage, or loss, if known. ~~S otil ~ r GI~IA-~-L.. ~ ~ ~ 6. If amount claimed totals less than $10,000: Provide the amount claimed if it totals less than ten thousand dollars ($10,000) as of the date of your claim, including the estimated amount of any related potential future injury, damage, or loss, insofar as it may be known as of the date of your claim, together with the basis of computation of the amount claimed (include copies of all bills, invoices, estimates, etc.) Amount Claimed and basis for computation: g-tJ~' ~i4-t ~ S'~/LU~~~}2T~ ~~~'~ 6~ ~__ ~ ~ ~ 8 ~ ' ~ ~ ~J n- ~S Pf}- ! ~ dj~` SU O - `~ E:, ~~~ / 13c,.~" `7b~{~, -- 14-~bvr~, D (__.~'~-''11~-'1~~~ Ct~4! ~-~~'~ ~~S .~ 2. sg ~v if amount claimed exceeds $10,000: Ifi the amount claimed exceeds ten thousand dollars ($10,000), do not provide a dollar amount in the claim. However, your claim must indicate whether it would be a limited civil case. A limited civil case is one where the recovery sought, exclusive of attorney fees, interest and court costs, does not exceed $25,000. An unlimited civil case is one in which the recovery sought is more than $25,000. (See CCP § 86.) 7 ^ Limited Civil Case / " ~ ~ ^ Unlimited Civil Case You are required to provide the information requested above in order to comply with Government Code §910. Additionally, in order to conduct a timely investigation and possible resolution of your claim, the City of Tustin requests that you answer the following questions. Name, address and telephone number of any witnesses to the occurrence or transaction from which the claim arises: _ U /~( L 8. If the claim involves medical treatment for a claimed injury, please provide the name, address and telephone number of any doctors or hospitals providing treatment: If applicable, please attach any medical bills or reports or similar documents supporting your claim. 9. If the claim relates to an automobile accident: Claimant(s) Auto Ins. Co. Address: . ,~_ /.~. (x (/~ /'7~~ ~S Telephone~S~ -- ~~i ~FZ . iii S Insurance Policy No.: ~ 1 L ~bZ`E ~ 3~ Insurance Broker/Agent: f~~'7' ~,(.Ui/~ ,~.,,5 Telephone "7 /~ ~~ ~ ---~ Z c7f~ Address: . o, Q.pfC 7~~' 8 ~g ~ ~! N~ , Ga~- g ?_ (o // 9 Claimant's Veh. Lic. No.: `Z.~~s- 1 ~~j Vehicle Make/Year: ~=o2n 200 7 Claimant's Drivers Lic. No.: ~ (0 3~7 ~ Z,, Expiration: ~,i,iK'L,~„~ If applicable, please attach any repair bills, estimates or similar documents supporting your claim. Page 2 of 4 ~_ READ CAREFULLY For all accident claims, place on following diagram name of streets, including North, East, South, and West; indicate place of accident by "X" and by showing house numbers or distances to street comers. If City/Agency Vehicle was involved, designate by letter "A" location of City/Agency Vehicle when you first saw it, and by "B" location of yourself or your vehicle when you first saw ~ V~ ~ e~ , CURB r ~ ~ ~~ CURB Warning: Presentation of a false claim is a felony (Penal Code §72). Pursuant to CCP §1038, the City/Agency may seek to recover all costs of defense in the event an action is filed which is later determined not to have been brought in good faith and with reasonable cause. Signature: ~/~~~'t~+EL7~'~L~y ~ S~'~6~~ Date: ~ -- 3 °-`z o~0 SvC~~G~4r-ra~v ~rv~4-E~~ i'¢'v.Z~ City/Agency Vehicle; location of City/Agency vehicle at time of accident by "A-1" and location of yourself or your vehicle at the time of the accident by "B-1"and the point of impact by "X." NOTE: If diagrams below do not fit the situation, attach hereto a proper diagram signed by claimant. N~ w -~- ~ Page 3 of 4 t Alliance United Insurance Company P.O. Box 6942 Ventura CA 93006-6942 Phone: (800) 508-5833 Fax: (805) 650-8994 March 2, 2010 City Of Tustin Attn: Ms. Lori Thompson 300 Centennial Way Tustin, CA 92780 RE: Our Insured: Claim Number: Date of Loss: Your Insured: Your Claim Number: Dear Ms. Thompson: Julio C. Chavez G 114792 06/12/2009 City Vehicle /Driver 10-01 RECENED MAR 0 3 2010 Htl1~ ~OC~CE~ Jason M. Muro Previously we sent you a subrogation demand. You in turn informed our office that the claim was not submitted within the prescribed six (6) month widow as required by law. We are submitting this request for "Leave to Present a Late Claim" And respectfully ask the City of Tustin to grant our request and honor the claim. The police report indicates clear liability on the part of the city vehicle, and also due to the fact that our insured is non-at fault victim in this loss. Enclosed please find the original supporting documentation sent to your office on February 3rd 2010 along with your full claim form including page 4 of 4 which is a request to accept our late claim. Should you have any questions you may reach the undersigned at the number listed below. _....----~ Si St3brogation Manager (800) 508-5833 Ext. 6115 Enclosure: Estimate, Check Copies, Police Report, City Claim Form, and Photographs For your protection California law requires the following to appear on this form: Any person who knowingly presents a false or fraudulent claim for the payment of any loss is guilty of a crime and may be subject to fines and confinement in state prison pursuant to Paragraph 1879.2 of the Insurance Code. False representation made on any form signed by the insured subjects the insured to a penalty of perjury pursuant to Paragraph 1871.3 of the Insurance Code. SUB 06 0803 ~; 4 IF LATE CLAIM: COMPLETE ITEMS 1- 9 AND THIS APPLICATION. SIGN BOTH FORMS. APPLICATION FOR LEAVE TO PRESENT A LATE CLAIM TO THE CITY OF TUSTIN The undersigned hereby applies for leave to present a late claim to the City of Tustin. This application is being made within a reasonable time, not exceeding one (1) year, after the accrual of the cause of action. Under some circumstances, Leave to present a late claim will be granted (Government Code § 911.6). The reason for delay in presenting the claim is: CcJ ~ ~--I ~- f~ ~ 55 c...c='" 5 w ~ ~rz--t D l~.'T~- ~.v iii ~ 7~r ~ C u~4-i w, ~yrL~ S `arc-- Cc.'iv1 Cti~- i ,ter , ~ M A , L -7-nx~-~vs,~.c ~sSir.~y ~ ~ GL-14l ~1 iZ~ rti-+u Gas ~f' s~~T' 7wt c.~ 1~ r~'T Na?` r~ C>~vC~J. DU ~ Tb 7vt E ~-GT `~~ ~ocri ~` f°~.~f'y~-7- S~ow~S 0.742., 1..1~~-~3! L!'Tzl Or-~ 7~~ ~~'~" ~~' ~~Lt VE'~~~ o~ 7Wc ~~~ca2-T ~~ ~-So~ ~(. M U,2c~ ", ~~ Az,So ~~~ ~r ~I'~7` a rJi~- -1r~s~~t- Q~ ~ /~c cows ~ Ab~n... d v2 ~~~ v~S r ']'© ~ N~,2._ E L-~-,w, ~.r\, Imo ~ ~A-r `T 1~ , 3 ~~ -2v1 n ~` Date Sinna~r Revised 12/2004 of Claimant Page 4 of 4