HomeMy WebLinkAboutUpdate Documents - BOCC (002)WCRGGrant
County Loss
Run Policy 2020-2021 as of 8/4/25
Policy
PolicyYear
Member
Coverage Effective
Claim Number
Date
'Pol icySetEffective Date: 2020
2020-2021
Grant
County
General 112/11/2020
Liability
W1 236
Employee
....................
2020-2021
Grant
Benefits 11112/11/2020
W1219
;County
Liability -
Primary
Wrongful
2020-2021
Grant
County
Acts - 12/11/2020
W1225
Primary
Ilk' 2020-2021
Grant
General 12/1/2020
W1 621
County
Liability
2020-2021
Grant
Wrongful
Acts 12/11/2020
W 12 14
County
-
I
Primary
.i
Grant
Physical
2020-2021
CountyDamage
- 112/11/2020
W1250
Collision
2020-2021
Grant
County
Auto 12/11/2020
Liability
W1251
2020-2021
Grant
General 12/1/2020
W1 322
County
Liability
2020-2021
Grant
General 12/11/2020
W1228
County
Liability
2020-2021
Grant
Auto 112/11/2020
W1 262
County
Liability
2020-2021
Grant
'Physical
,Damage- 12/1/2020
W1222
County
Collision
Grant
1Wrongful
2020-2021
CountyActs
- 12/1/2020
W1 229
Primary
2020-2021
?Grant
Physical
Damage 12/1/2020
W1257
County
-
Collision
Event Date Date of
Date
Event
Claimant
Status
Paid Deductible Reserve Paid + Reserve
Paid + Accident Adjuster
Claim
Closed
Description
Name
Collected Balance Less Deductible Reserve Location
;Rock off
McConih
7/6/2021 7/21/2021
9/28/2021
mower hit
Don Terrell
C
$483
$483
$0
$0
$483 e Rd &
Bill Correll
claimant's
�`vehicle
D.5 NE
.
...... .... . . . . ........
. ......
. ......
. .........
Kumau
�12/31/2018 6/15/2021
7/11/2023
Life Insurance Dawn
C
$27,593
$10,000
$0
$17,593
$27,593
McWilliam
Issue
Prince
H5 Data
1 /1 /2019 6/30/2021
4/27/2022
\,Complaint for
'\\,Refund of
Centers-
C
$0
$0
$0
$0
$0
Kumau
,McWilliam
Property Tax
Quincy,
\,LLC
s
\\`2235
Snow plow
damaged
'Melody
Steve
2/1/2021 4/9/2024
5/22/2024
\\,Garry
Jeffries
C
$0
$0
$0
$0
$0i\ Lane NE,
Whetstone
Moses
p seals
chiimant
. . . .......
. .. ... . Lake
Disbursement City of
Kumau
10/14/2020 5/25/2021
1/31/2022
interest due
Moses
C
$0
$0
$0
$0
$0
McWilliam
of Lake
Ba St
8/9/2021 8/9/2021
2/11/2022
IV rear -ended
1 Grant
',"County
C
$0
$0
$0
$0
$0 SW&
\\,\\Bill Correll
0V
2ndAve
.. .. a. . . .........
Basin St
8/9/2021 8/9/2021
12/20/2022
,,IV rear -ended
0V
1`Gerald
C
$13,115
$10,000
$0
$3,115
$13,115 SW &
,Brian
Jordan
McClain
..... .....
2nd Ave
11/25/2021 11/25/2021
Failure to
?Follow GCC
Carla Gray
L
$1,638,534
$10,000 $216,466
1
$1,845,000 $1,855,000
Kumau
McWilliam
','\\\'9. 0 7. 0 10
- — - - - - -
— .-------------_ - -
s
6/28/2021 7/6/2021
7/13/2021
'Gravel hit
claim ant's
Hunter
C
$0
$0
$0
$0
WRd 3 NE
Kelly
\�Ogle
Owens
. .. . . .......... ....
vehicle
` .... .... . .. ................
\1 . . . ......
...... ....
,\Rock thrown
\,Wilson
911/2021 9/11/20211
3/15/2022
i by IV hit
Fred
Meise
C
$5,587
$5,587
$0
$0
$5,587 Creek
iChelsea
Chase
claimant's
Loop
windshield
... ...... . . ... ... . ......
. ..... . ..... . .. . ...... . . . ...... .
St
Grant
;Basin
1, SW &
David
6/21/2021
6/21/2021
1/19/2022
OV hit IV
` County
C
$0
$0
$0
$0
$ 0 1 Oth Ave
Kosa
W
Grant
Andrea
8/1/2019 7/6/2021
5/22/2024
Discrimination
Darci
C
$72,360
$10,000
$0
$62,360
$72,360 County
ITsivgadelli
issue
I�Armstrong
Fairgroun
\ds
s
620S.
8/18/2021 8/18/2021
12/20/2021
IV struck
Grant
C
$2,140
$2,140
$0
$0
'Pioneer
$2,140\Way,
lChelsea
building
County
\ Chase
IMoses
;Lake
F Hot water 20072 a
I Grant General € Carrie � &
2020-2021 12/1/2020 W1242 7/9/2021 7/21/2021 8/3/2021 heater C $0 $0� $0 $0 $0 Linden lKelly 1
County Liability I Lnenicka Rd NW, iOwens
damage
Soapa
Grant F I Bridge Grant i !Rd M SE David
2020-2021 Property 12/1/2020 W1327 10/21/2021 �10121/2021 12/6/2022 C $0 $0 $0 $0i $0 & Rd 5 I 1
County damage County SE =Kosa
Rock chipped Grand '
Grant Auto Mike 'Chelsea
2020-2021 County Liability 12/1/2020 W1268 9/29/2021 9/29/2021 12/22/2021 claimant's Shear C $757 $757� $0 $0 $757Coulee, =Chase
windshield_m 'WA ? i
Client hit lip
Grant General I ! Playgrou Brad
I 2020-2021 12/1/2020 W1310 11/17/2021 11/17/2021 7/26/2022 on playground Unknown C $0 $0� $0 $0 $0 1 er
s
F d-Guidin
2 County Liability equip ng
Estate of
( Grant General 1 Patrick €lk
2020-2021 12/1/2020 �W1567 7/26/2021 11/29/2023 3/25/2024 Drowning Danika L $29,932 $10,000 $30,068 $50,000 $60,000$
County Liability IBoruff i
Ross i s . f
p. -.� , .m . ,..._w.� ._, �...., �,.,....� _..._......_...--w_...,..........�......................_.................,................... _ .__...,.........., _............
_,....... __.... _.
}}j �. _
_ .,,�.,, _..Y.... ,,,i., ,..#
t Claimant I Rd 4 NE I
Grant General 5/31/2021 12/16/2021 8/6/2024 inured due to Virgil C $7,848,865 $10,0001 $0 Patrick
2020-2021 12/1/2020 W1296 � $7,838 865� $7 848 865& Rd E
County Liability dangerous Redwine NE Boruff I
€ road !
r F
g � s
-_.._._._--...._
._._..._ Claimant r
3 Rd j s
Grant General injured due to Tera I !Patrick r
2020-2021 12/1/2020 W1297 �5/31/2021 12/1612021 11/16/2022 C $0 $0 $0 $01 $01& Rd E €
I
County Liability i dangerous Redwine I NE Boruff
road
e
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i..,..._._...............,_......_.�..__..,.��,�.._.....��....�.�..�.._.._.�..,.�...._�...._....�.�.w,._.._.____ ..�._..-,.-.�....�.___�.�........,._.......�..._.__�.-...�.,_..�.�,.___�_..�._..__..__ �.�.. .......�_....�_.'.....�_._...��.�.�....�..,��_�._..�....-.�...._,.�m��.__�,.�._......_..__.�,...,�.M.....�.....,.,�._.�..W_.__.�.�......�.......,..w..-�.,_.,�..,-..,...�..._._.._..__.._ � � iWheeler
Grant I
� Grant <
2020-2021 I Damage- 12/1/2020 W1171 1/14/2021 1/14/2021 L3111/2021 OV hit IV C $11 $0 $0 $11= $11 Rd & Hwy Bill Correll
County
-..�.,......__......._..._..�.�.....Collision ��County
�#_ _ _ .._...... _. _... .. _i ...1..7
.._....... ____.
Physical .._.__...._.._.___ ._ .. ...._.._.__.._______...�.__.
i
Grant IDavid
Grant Damage -
2020-2021 12/1/2020 W1277 11/3/2021 11/3/2021 2/9/2022 IV hit deer County C $0 $0� $0 $Oi $011-90 'Kosa z
County Comprehe Y
F
t
z
Veh# 7139
nsive
P 4
t
_.._...._..__...._.,._........
__
Phy sical � Damage to IV � �
Grant Damage - Grant l Chelsea i
2020-2021 12/1/2020 W1281 11/15/2021 11/15/2021 4/5/2022 from C $0 $0 $0 $01 $01 Chase
County Comprehe County x
transporting
nsive�
I Wrongful - F Estate of � �S_. >Kumau
F � � '
I Grant Records = F '
2020-2021 Acts - 12/1/2020 �W1193 19/18/2015 �3/29/2021 2/8/2022 Jessica C $0� $0 $0 $0 $01 tMcWilliam €
County I request s
Pnma
! - _ ._ _ _.µ. Alvarado.��__...__...._.__._._.._....._...._.. ___......_._ ......... __.r....
Grant Physical _ Grant ' _ Grape
2020-2021 Damage - �12/1/2020 W1186 �1/26/2021 1/26/2021 10/13/2021 rOVhitIV County C $11 $0 $0� $111 $111Di=Bill Correll Y
I County ty rive
1........,.___.......__.,..._.._- - w_...___ ...��__� �.�.._ __..-.... Collision
.._._..._.._. ._.�._.._._..___-__....__.._.._..._-..__.. _.__..__.� �_�_._._ �_� .�____-._..___-____._....._.w...._..._-_......_._._.._....___. _....._____ ._.__._._. ? .._._ ...__.._.__............_.._ ...___.._.._.._ _...___...__... F
Under- �.... i
s
Insured
Grant Jaret F Grape David
2020-2021 and 12/1/2020 W1187 1/26/2021 1/26/2021 8/29/2023 OV hit IV F 'C $14,000 $01 $0 $14,000€ $14,000
County Fulbright t Drive ' Kosa
Uninsured
Motorist$ I - __.,�..._,_,_._.. �,.....-........� . °._....._...._.....___........_._..._.,..._....._..._........_....__._........_.__,_..__ _.._.-_ ..._ _...__
I Under
Insured
2020-2021 Grant land 12/1/2020 �W1200 1/26/2021 4/16/2021 10/13/2021 OV hit IV Grant C $2,343 $100 $0 $2,243' $2,343 Grape
3Bill Correll
t County County 3
_.
Uninsured �w
IMotorist ._,m..___,_.� ._ ,� ..m. w �... _w _.w,.��.,w _....m._M_...,.,�m_ �_.., .p-..._ .� �. w..,_ �� ._..,__._-..._ �._.....,_®......_....._.._........_...__._....,..._.._....i...._...._._....__.........._.__.._....#......_._ __.....-.. __ i _-.._....�._... z