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Home My WebLink About Item No. 9AGENDA COVER SHEET MEETING OF City Council E-1 Redevelopment Agency Other DEPARTMENT: ` , -14 1 CONSENT: APPEAL BUSINESS: E-1 RESOLUTION: ORDINANCES PUBLIC HEARING ATTACHMENTS: Report emailed to Clerk ....... ... .... ....... 0 ....... a ......... a ...................... ........i FOLLOW UP DIRECTION: CITY OF LADE L LSII`IOlZE � DREAM EXTREME- REPORT TO CITY COUNCIL TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL AND SUCCESSOR AGENCY FROM: GRANT M. YATES CITY MANAGER DATE: MARCH 12, 2013 SUBJECT: REJECTION OF CLAIMS Recommendation Direct the City Clerk to notify claimants Thomas Ciccarelli and Kaylie Ciccarelli that their respective claims submitted to the City Clerk's office on February 11, 2013 and identified as Claim 2013 -003 and 2013 -004, respectively, are rejected. Background On February 11, 2013, the City Clerk's office received two claims for damage or injury related to the death of Fatima Ciccarelli on August 9, 2012. The claimants are Fatima's husband, Thomas Ciccarelli, and her child, Kaylie Ciccarelli. Mrs. Ciccarelli's untimely death is part of a well - publicized controversy in the City of Wildomar in which the members of the Autumnwood development claim that they have been exposed to multiple hazardous substances in the soil and their homes that have resulted in serious injury or, in the case of Fatima Ciccarelli, death The Ciccarelli's' claims were initially referred to the City's carrier, the California Joint Powers Insurance Authority through its claims administrator, Carl Warren & Company. On February 21, 2013, the City Clerk received notification from Carl Warren that the Ciccarelli's wrongful death claims were not covered under the City's policy which excludes claims related to injuries caused by the long -term exposure to hazardous materials. Accordingly, the City Attorney's office was contacted to review the claims and advise the City Council. AGENDA ITEM NO. 9 Page I of 1 Rejection of Claims March 12, 2013 Page 2 Discussion As noted above, the Autumnwood development lies well outside the boundaries of the City of Lake Elsinore (adjacent to Palomar Street south of Central Street in the City of Wildomar). At this point, the City Attorney's office is not aware of any facts suggesting that the City engaged in any activities transporting soil or materials to the Autumnwood development nor did the City of Lake Elsinore exercise any land use or inspection activities with respect to that development. The claim itself also provides no factual information supporting a connection between the death of Fatima Ciccarelli and any actions by the City of Lake Elsinore. Accordingly, the City Attorney's office recommends that the City Council reject the claims tendered by Thomas and Kaylie Ciccarelli and that the City Clerk notify their attorney of the rejection as required under the Tort Claims Act. Following notification of the City's rejection, the claimants have six (6) months to file a lawsuit should they choose to go forward with an action against the City. Fiscal Impact None. Prepared by: Virginia Bloom City Clerk OWI-•. —^ Barbara Leibold City Attorney Approved by: Grant M Yates City Manager ly Attachments: Claims Page 2 of I 1 SILVERTHORNE F10111 Ian Silverthorne, Attorney acyardiny our alenl: Thomas and Kaylie Ciccarelli III Corporate Drive, Sultc 260 Lades Ranch, CA 92694 Incident Date: 8/9/2012 LETTER OF REPRESENTATION: THIS LETTER CONCERNS ATTORNEY REPRESENTATIOk_OF.THE ABOVE NAMED PERSON AND IS MEANT 70 ADDRESS ANY PEOPLE. ORGANIZATIONS. COMPANIES.OR ENT/TIES_REGARDING THIS REPRESENTATION, City Clerk's Office sentvia: Certified Mail City of Lake Elsinore 130 South Main St. Lake Elsinore, CA 92530 February 8, 2013 Dear City Clerk's Office, City of Lake Elsinore, Please be advised that this office represents Thomas and Kaylie Ciccarelli for injuries sustained on the above date. A general description of the injury or damages suffered by the claimants includes but is not limited to wrongful death and loss of consortium due to the death of Fatima as Thomas' wife and Kalie's mother. This letter along with the attached claim forms is sent in compliance with California Government Code Section 910 requirements 910(a) — (f). This letter is to provide a general description of the injury or harm that was incurred by Thomas and Kaylie Ciccarelli and a description of the circumstances giving rise to this claim as requested in the City of Lake Elsinore claim form provided with this letter. This letter is not intended to give a complete and total description of any and all injuries sustained by Thomas and Kaylie Ciccarelli, as these circumstances are unknown at this time and pending investigation. This letter is intended to preserve Thomas and Kaylie Ciccarelli's right to pursue a claim against the City of Lake Elsinore as required by statute. Thomas and Kaylie Ciccarelli both suffered the loss of Fatima Ciccarelli on August 9'n, 2012. The right to pursue a claim against the City of Lake Elsinore is being maintained due to the possibility that Fatima Ciccarelli's death was caused all or in part by negligence by the City of Lake Elsinore or any of its agents. The cause of Fatima's death is being investigated and the cause of death may be related to toxic exposure or another type of poisoning. The City of Lake Elsinore may have had a duty to inspect or otherwise prevent the spread of toxins from the soil at Fatima Ciccarelli's house, or otherwise committed negligence in the exercise of the duties of a city that led to Fatima's death including but not limited to a duty to warn the Ciccarelli family of the danger present in their neighborhood, their home, or any materials or soils used in its construction. The �you, ��(an Silverthorne, Attorney -at -Law RECEIVED Email: tan @silverthorneattorneys corn Phone: (949) 234 -6034 FEB i Z 2013 CITY CLERi<S OF �-I ag� of 11 CITY OF LAKE ELSINORE City Clerk's Office 130 South Main Street Lake Elsinore, California 92530 (951) 674 -3124 ext. 262 (951) 245 -5322 fax Time/Da c edA, FEB 112013 CITY CLERKS OFFICE FILING A CLAIM FOR DAMAGES WITH THE CITY OF LAKE ELSINORE Dear Claimant: The requirements and procedure for recovering damages from the City of Lake Elsinore are outlined in the California Government Code, commencing with §900. Subject to a few exceptions, you are required to file a timely claim with the CITY CLERK. In most cases, as further discussed below, to be timely, the claim must be filed within six (6) months of the date of accrual. For your convenience, the City of Lake Elsinore provides a claim form you may elect to use to assist you in presenting your claim for consideration. Instructions for use of the claim form are outlined below. INSTRUCTIONS FOR COMPLETING THE CLAIM FORM Please type or print, using black or blue ink, all of the information requested on the Claim Form. 1. Claimant, Notification and General Information — In the top section of the claim form, state full legal name, address and date of birth of the claimant. Also provide the name and mailing address where claims information should be sent if other than the claimant. Provide the telephone number where additional information may be obtained. 2. Date of Accident — It is critical that you provide the date of the accident or event that caused the damage for which you seek compensation. Failure to provide this information will cause your claim to be returned as insufficient. 3. Place of Accident -- Describe the location of the accident or event with sufficient particularity to be able to identify the location on a map and visit the scene. Be sure to indicate if it is within the City. 4, Property Damage — if the claim seeks recovery of property damage, describe the nature and extent of the damage and the method used to calculate the claimed amount. If someone else owns the property, provide their name, address and telephone number. Attach copies of any repair bills and damage estimates that support your claim. In case of lost property, evidence of ownership and replacement costs are helpful. 5. Personal Injury — If the claim seeks recovery for personal injury or wrongful death, describe the nature and extent of the injuries, medical treatment received, and any other information relevant to assist in consideration of your claim. 6. Liability — Describe how the event occurred and the facts and circumstances of why you believe the City of Lake Elsinore is liable for your damage. 7. Amount of Claim — State the total amount you are claiming as a result of the alleged damage /injury. Indicate if the costs or damage is continuing, and describe the basis for this assertion. if the total amount is unspecific or exceeds $10,000, designate the appropriate court jurisdiction for the claim. If available, attach copies of all bills, payment receipts, and cost estimate(s). Provide an itemized and total of all damages. Attach at least two (2) estimates of repairs for damages to your property. 8. Witnesses — Provide the names and contact information of any witnesses to the accident, including City employees involved in the incident. Page 4 of 11 9. Signature —Government Code §910.2 provides: "The Claim shall be signed by the Claimant or by some person on his /her behalf." 10. Additional Space Needed — If additional space is needed feel free to attach additional pages. The date of the incident must be provided on the claim form. Pursuant to Government Code §911.2, claims relating to causes of action for personal injury, wrongful death, property damage, and crop damage must be presented to the City no later than six (6) months after the incident date. Government Code §911.4 provides for an Application for Leave to Present a Late Claim for these types of claims presented beyond the six months, and within one year. Once you have completed the claim form, mail or deliver it with all supporting documents to the: CITY CLERK CITY OF LAKE ELSINORE 130 SO, MAIN ST. LAKE ELSINORE, CA 92530 A clear postmark date on an envelope or the received stamp by the City Clerk's Office for claims made by personal service will be deemed the date of presentation to the City. WHAT HAPPENS NEXT? Your claim will be reviewed and investigated by the City's Insurance Carrier. You should hear back on the status of your claim within 30 days of the presentation of your claim. Medicare recipients seeking compensation for personal injuries or medical expenses may be required to provide their Medicare Identification Number pursuant to 42 USC §1395y. Claims submitted to the City of Lake Elsinore are public records, and must be disclosed upon request. Page 5 of 11 City of Lake Elsinore Claim for Damage or Injury Use Black or Blue Ink Type Attach Additional ages if Necessary Form City Clerk City of Lake Elsinore 130 South Main Street Lake Elsinore, California 92530 CLAIMANT FULL NAME CRIMINAL PENALTY FOR CLAIMANT ADDRESS (Required) / PRESENTING FRAUDULENT CLAIM FOREGOING IS CORRECT AND THAT THE AMOt1NT OF THIS CLAIM COVERS ONLY DAMAGES AND OR MAKING FALSE STATEMENTS PERSON TO BE NOTIFIED OF ANY ACTION TAKEN ON CLAIM Eve erson who, with Intent to NOTIFICATION ADDRESS (IF DIFFERENT THAN ABOVE) -4 �GD q�.n fc T...�, X ✓ a`l't l� payment any false or fraudulent I '� SIGNATURE OF CLAIMANT DATE claim against the City Is guilty of a felony. (See California Penal Code §TI) CLAIMANT DATE OF BIRTH MEDICARE BENEFICIARY PHONE NUMBER(S) �✓ ;_..� ❑ Yes R_ No - J ( / G l/%� C i� v�-t ; -(OPTIONAL) DATE OF ACCIDE T ACCIDENT TIME AM IPM EMAIL ADORES PLACE OP ACCIDENT(COMPLETE ADDRESS AND DESCRIPTION TO LOCATE ON A MAP/ OR VISIT THE SCENE): 7 3L> 14aM u. /�Vi � U'r / �0 STATE THE NATURE AND EXTENT OF CLAIMANT'S INJURY WHICH FUKMS IHe nnow yr V t/ y 7 _4 (^/ r i r c: ✓ �� r ti S �(� 7 C .� G .. �'� v wr ` < i� o� LIABILITY INDICATE HOW THE ACCIDENT HAPP-ENED,, WHY YOU FEEL THE CITY IS LIABLE AND NAME OF INVOLVED CITY EMPLOYEE(S): SCE J 'J /G / / NAME (S) I ADDRESS(ES): CRIMINAL PENALTY FOR I DECALRE UNDER THE PENALTIES OF PURJURY OF THE STATE OF CALIFORNIA THAT THE PRESENTING FRAUDULENT CLAIM FOREGOING IS CORRECT AND THAT THE AMOt1NT OF THIS CLAIM COVERS ONLY DAMAGES AND OR MAKING FALSE STATEMENTS INJURIES CAUSED BY THE A_QCIDENT'DE-$EluBED HEREIN, �-- - -- Eve erson who, with Intent to defraud, presents forallowance or X ✓ a`l't l� payment any false or fraudulent I '� SIGNATURE OF CLAIMANT DATE claim against the City Is guilty of a felony. (See California Penal Code §TI) Page 6 of 11 NOTICE TO CLAIMANT In order for your claim to receive proper consideration you are requested to supply the information called for on this application form. All material fads should be slated on this form, as it will be the basis of further action upon your daim. The instructions set forth should be read carefully before the form is completed. INSTRUCTIONS Claims must be signed by the property owner, injured party, or the person representing the claim. Unsigned claim forms Cannot be honored. See Government Code §910.2, the amount claimed must be sustained by competent evidence before a claim can be paid. Whether allached to the claim form, or submitted subsequently, evidence supporting the amount claimed may include: (a) In support of a claim for the personal injury or death, the claimant should submit documentation evidencing the injuries sustained, treatment rendered, the period of hospitalization, future treatment, the degrees of permanent disability, the prognosis, and evidence of medical bills received and paid. it is recommended that such medical evidence NOT be attached to the claim form, but that such substantiation of damages be provided upon request. The Claim Form and attachments thereto is a public record and subject to public inspection. (b) In support of claims for damage to property which has been or can be economically repaired, submit at least two itemized signed repair estimates or statements of damage by reliable, disinterested persons, or if payment has been made, the itemized signed receipts evidencing payment. (c) In support of claim for lost property or property that cannot be economically repaired, submit documentation of the original cost of the property, the date of purchase, and the value of the property before and after the accident. The statements demonstrating the value of the property should be disinterested competent persons, preferably reputable dealers, persons familiar with the type of property, by two or more competitive bidders, or advertisements for the same or similar property. The completed Claim Forth must be mailed or delivered to the City Clerk at the address on the prior page. Questions or requests for further information should be directed to the City Clerk's Office at (951) 674 -3124. 11 \Vii \4v „v,�v •�rvr••�r.•.� In order that claims may be properly adjusted by the City or your insurance company, it is essential that the claimant provide the following information regarding any insurance coverage available for the loss or injury. DO YOU CARRY AUTO COLLISION COVERAGE? IF NES' GNE NAME ANU ADDRESS OF INSURANCE COMPANY AND POLICY NUMBER: ❑ Yes ❑ No HAVE YOU FILED A CLAIM WITH YOUR IF "YES' WHAT IS YOUR DEDUCTA6LE? INSURANCE COMPANY CLAIM NO.? INSURANCE CARRIER IN THIS INSTANCE? ❑ Yes ❑ No IF A CLAIM HAS BEEN FILED, WHAT ACTION HAS YOUR INSURER TAKEN, OR WHAT ACTION DOES IT PURPOSE TO TAKE WITH THE REFERENCE TO YOUR CLAIM? DO YOU CARRY PUBLIC LIABILITY AND PROPERTY IF " YES" GIVE NAME OF INSURANCE CARRIER: DAMAGE COVERAGE? NAME OF CLAIMANT: Page 7 of 1 I CITY OF LAKE ELSINORE City Clerk's Office 130 South Main Street Lake Elsinore, California 92530 (951) 674 -3124 ext. 262 (951) 246 -6322 fax Time /Date Received: Wl FEB 112013 CLERKS OFFICE FILING A CLAIM FOR DAMAGES WITH THE CITY OF LAKE ELSINORE Dear Claimant: The requirements and procedure for recovering damages from the City of Lake Elsinore are outlined in the California Government Code, commencing with §900. Subject to a few exceptions, you are required to file a timely claim with the CITY CLERK. In most cases, as further discussed below, to be timely, the claim must be filed within six (6) months of the date of accrual. For your convenience, the City of Lake Elsinore provides a claim form you may elect to use to assist you in presenting your claim for consideration. Instructions for use of the claim form are outlined below. INSTRUCTIONS FOR COMPLETING THE CLAIM FORM Please type or print, using black or blue ink, all of the information requested on the Claim Form. 1. Claimant, Notification and General Information — In the top section of the claim form, state full legal name, address and date of birth of the claimant. Also provide the name and mailing address where claims information should be sent if other than the claimant. Provide the telephone number where additional information may be obtained. 2. Date of Accident — It is critical that you provide the date of the accident or event that caused the damage for which you seek compensation. Failure to provide this information will cause your claim to be returned as insufficient. 3. Place of Accident — Describe the location of the accident or event with sufficient particularity to be able to identify the location on a map and visit the scene. Be sure to indicate if it is within the City. 4. Property Damage — If the claim seeks recovery of property damage, describe the nature and extent of the damage and the method used to calculate the claimed amount. If someone else owns the property, provide their name, address and telephone number. Attach copies of any repair bills and damage estimates that support your claim. In case of lost property, evidence of ownership and replacement costs are helpful. 5. Personal Injury — If the claim seeks recovery for personal injury or wrongful death, describe the nature and extent of the injuries, medical treatment received, and any other information relevant to assist in consideration of your claim. 6. Liability — Describe how the event occurred and the facts and circumstances of why you believe the City of Lake Elsinore is liable for your damage. 7. Amount of Claim — State the total amount you are claiming as a result of the alleged damage /injury. Indicate if the costs or damage is continuing, and describe the basis for this assertion. If the total amount is unspecific or exceeds $10,000, designate the appropriate court jurisdiction for the claim. If available, attach copies of all bills, payment receipts, and cost estimate(s). Provide an itemized and total of all damages. Attach at least two (2) estimates of repairs for damages to your property. 6. Witnesses — Provide the names and contact information of any witnesses to the accident, including City employees involved in the incident. Page 8 of 11 9. Signature —Government Code §910.2 provides: "The Claim shall be signed by the Claimant or by some person on his /her behalf." 1a Additional Space Needed — If additional space is needed feel free to attach additional pages. The date of the incident must be provided on the claim form. Pursuant to Government Code §911.2, claims relating to causes of action for personal injury, wrongful death, property damage, and crop damage must be presented to the City no later than six (6) months after the incident date. Government Code §911.4 provides for an Application for Leave to Present a Late Claim for these types of claims presented beyond the six months, and within one year. Once you have completed the claim form, mail or deliver it with all supporting documents to the: CITY CLERK CITY OF LAKE ELSINORE 130 SO. MAIN ST. LAKE ELSINORE, CA 92530 A clear postmark date on an envelope or the received stamp by the City Clerk's Office for claims made by personal service will be deemed the date of presentation to the City. WHAT HAPPENS NEXT? Your claim will be reviewed and investigated by the City's Insurance Carrier. You should hear back on the status of your claim within 30 days of the presentation of your claim. Medicare recipients seeking compensation for personal injuries or medical expenses may be required to provide their Medicare Identification Number pursuant to 42 USC §1395y. Claims submitted to the City of Lake Elsinore are public records, and must be disclosed upon request. Page 9 of I 1 City of Lake Elsinore Claim for Damage or Injury Use Black or Blue Ink Type Attach Additional Pages if Necessary Form City Clerk City of lake Elsinore 130 South Main Street Lake Elsinore, California 92530 V LMIIYIf1r� r 1 r�V 1 u Ivy, v. CLAIMANT FULL NAME CLAIMANT ADDRESSfRequlretl) -CLAIMANT . ADDREs I DECALRE UNDER THE PENALTIES OF PURJURY OF THE STATE OF CALIFORNIA THAT THE NT OF THIS CLAIM COVERS ONLY DAMAGES AND PRESENTING FRAUDULENT CLAIM OR MAKING FALSE STATEMENTS PERSON TO BE NOTIFIED OF ACTION TAKEN ON CLAIM NOTIFICATION ADDRESS (IF —DIFFERENT THAN ABOVE) �/( lV /• FAG. ^4.�! 1 //`f l/( j �! ��.G _ %, /Z X1 v ^'l 7 6'7 CLAIM OF BIRTH MEDICARE BENEFICIARY PHONE NUMBER(S) �'J•l _ C rJ'w,. ' ^ -r ❑ Yes ❑ No DATE OF ACCIDENT ACCIDENTTIME AM I PM EMAIL ADORES (OPTIONAL) PLA E OF q CIDENT (COMPLETE ADDRESS AND DESCRIPTION TO LOCATE ON A MAP f OR VISIT THE SCENE): Gam. , A ? .s STATE THE NATURE ND EXTENT 0 LAIMANT'S INJURY WHICH FORMS THE BASIS OF THIS CLAIM: f -- NAME (S)1 ADDRESS(ES): CRIMINAL PENALTY FOR I DECALRE UNDER THE PENALTIES OF PURJURY OF THE STATE OF CALIFORNIA THAT THE NT OF THIS CLAIM COVERS ONLY DAMAGES AND PRESENTING FRAUDULENT CLAIM OR MAKING FALSE STATEMENTS FOREGOING IS CORRECT AND dT- EHE.AM INJURIES CAUSED B ('T CCIDENT DESCRIB D EH REIN. / Every person who, with Intent to / 7 ? G defraud, presents for allowance or // -'� °` X payment any false or fraudulent _— J SIGNATURE OF CLAIMANT D TE claim against the City Is guilty of a felony. (See California Penal Code Page 10 of 11 NOTICE TO CLAIMANT In order for your claim to receive proper consideration you are requested to supply the information called for on this application form. All material fads should be stated on this form, as it will be the basis of further action upon your claim. The instructions set forth should be read carefully before the form is completed. INSTRUCTIONS Claims must be signed by the property owner, Injured party, or the person representing the claim. Unsigned claim forms cannot be honored. See Government Code §910.2, the amount claimed must be sustained by competent evidence before a claim can be paid. Whether attached to the claim form, or submitted subsequently, evidence supporting the amount claimed may include: (a) In support of a claim for the personal injury or death, the claimant should submit documentation evidencing the injuries sustained, treatment rendered, the period of hospitalization, future treatment, the degrees of permanent disability, the prognosis, and evidence of medical bills received and paid. it Is recommended that such medical evidence NOT be attached to the claim form, but that such substantiation of damages be provided upon request. The Claim Form and attachments thereto is a public record and subject to public inspection. (b) In support of claims for damage to property which has been or can be economically repaired, submit at least two itemized signed repair estimates or statements of damage by reliable, disinterested persons, or if payment has been made, the itemized signed receipts evidencing payment. (c) In support of claim for lost property or property that cannot be economically repaired, submit documentation of the original cost of the property, the date of purchase, and the value of the property before and after the accident. The statements demonstrating the value of the property should be disinterested competent persons, preferably reputable dealers, persons familiar with the type of property, by two or more competitive bidders, or advertisements for the same or similar property. The completed Claim Form must be malled or delivered to the City Clerk at the address on the prior page. Questions or requests for further information should be directed to the City Clerk's Office at (951) 674.3124. nvo r rxuvrwnv In order that claims may be properly adjusted by file City or your insurance company, it is essential that the claimant provide the following information regarding any insurance coverage available for the loss or injury . 00 YOU CARRY AUTO COLLISION COVERAGE? IF'YES' GIVE NAME AND ADDRESS OF INSURANCE COMPANYAND POLICY NUMBER: ❑ Yes ❑ No HAVE YOU FILED A CLAIM WITH YOUR IF "YES" WHAT IS YOUR DBDUCTABLE? INSURANCE COMPANY CLAIM No.? INSURANCE CARRIER IN THIS INSTANCE? ❑ Yes ❑ No IF A CLAIM HAS BEEN FILED, WHAT ACTION HAS YOUR INSURER TAKEN, OR WHAT ACTION DOES IT PURPOSE TO TAKE WITH THE REFERENCE TO YOUR CLAIM? DO YOU CARRY PUBLIC LIgBILI7Y AND PROPERTY IF "YES" GIVE NAME OF INSURANCE CARRIER: DAMAGE COVERAGE? NAME /OF CLAIMANT: tc-, Page I I of I I