Gallagher Bassett Services Reviews (%countItem)
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Address: 2850 Golf Rd, Rolling Meadows, Illinois, United States, 60008-4050
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I spoke to Claire at *** because my chiropractor told me they were not paying on my bills. Claire at *** said that Gallagher Bassett Services, a 3rd party payor for ***, submitted claims to them #*** on May 24, 2018 regarding an incident at the *** Hardware Store on May 4, 2013. I spoke to ***'s Recovery Dept. They told me that Gallagher Bassett Services needs to advise them this matter is closed, and that I should call them. I stopped by *** and they advised me to call Gallagher direct. No help to me. I called Gallagher and spoke to Monica Irwin, who I was advised was handling this matter. She was very rude and told me that my file had been transferred to Paul ***, she refused to give me any information, but said they were having a lot of problems with claims for ***. Referred me to Paul ***, Claim Supervisor (Tel: ). I called and left him a couple messages and specifically told him I was only available from 9am to 1pm at that number. He would always call me back in the afternoon and leave a voicemail at work. When I finally reached him on Friday, September 7, 2018, at 10:00am, he was quite rude to me. as well. He refused to give me any information regarding the incident. He claimed that I should remember what happened on 5/4/13. Said he couldn't verify it was me, even though I gave him the claim number. Not willing to help me at all. He only said the incident was closed, but *** said it was still open and that they were still reporting the incident to them as of May 24, 2018.
Ms. file has been reviewed. The *** required coding was updated on 09/12/2018. It takes 10 days for this data transmission to be received by *** and reflected in their system. Ms. current doctor will be able to resubmit the billing for the current treatment after 09/22/2018.
This claim has not been coded as a car accident in our system, and all activity and notes in our file confirm that this accident did not involve a motor vehicle. The last payments made on this file were in July, 2013, and were paid directly to Ms. physician at the time of the May, 2013 incident. This file has been closed in our system since 07/24/2013 with no additional activity until Ms. call on 09/05/2018. The statute of limitations has run on this claim, and the coding entered for *** reflects that tolling of the statute.
There have been no attempts to bill *** for any services related to this claim, and no activity of any kind on this claim in over six years.
With the updated data coding done on 09/12/2018 to send that information to *** in the format needed for their system, this should resolve Ms. current billing issues for her current non-incident related treatment by 09/22/2018.
On July 11, 2018, my husband was injured in an work related accident at a company insured by Gallagher Bassett. The company reported the accident within a few hours of it happening. He was treated in the ER and referred to an orthopedic specialist since the bone in the end of the finger was broken. At the appointment, we refused to give our personal insurance information to the practice and they contacted GB .The adjuster assigned to this case appears to have contacted us only after medical staff contacted them to make sure they were going to get paid. We (both of us on the line) followed up with a phone interview to the adjuster. At that time the doctor had prescribed being off for 6 weeks. The adjuster only asked when the next appointment was. It appears that since the next appointment was within the minimum 7 day waiting period. The adjuster assumed we would be back in touch with her. Approximately 10 days later, my husband received a form letter giving her contact information. He asserted his rights by going online to the VA webfile site instead of. On August 8th, he realized that he was not getting paid by this company and contacted his employer. All paperwork and progress had been filed with them. The adjuster had not followed up on any level. Emails and phone calls went unanswered and he did not receive an award notification until 6 weeks from the initial contact. He has received a partial payment but not information about bills paid or when he can expect his next payment although countless attempts to contact this company have been made. Letters dated a week after the envelops have been postmarked, incorrect information and failure for the adjuster to act in a professional manner are commonplace. He finally asked the doctor to ok his going back to work with restrictions because had to have some kind of income. He has 7 days pay coming to him and medical bills that will continue to need to be paid. Poor company training seems a factor.
We have received the above complaint. Contact has been made with Mr. on 09/05/2018 to address the additional claim for benefits, and a check has been issued on 09/05/2018. Additional information and clarification on the awards and benefits on Mr Lewis' claim have been shared with him via telephone and via e-mail for his records. A timeframe and a future date to share information has also been established for both parties.
Back 2 years ago, I worked for a company called Addison Group, contracted out to a company called Diversified. Unfortunately Diversified had Gallagher Bassett as their workmans comp provider. I was actually injured twice on the job, and had to deal with Gallagher Bassett on multiple occasions. It was a pain to try to get a hold of anyone at Gallagher Bassett, because they would not answer back calls or emails, for periods of months. It ended up getting so bad that the medical places I had to go to ended up contacting credit agencies, and I had to end up paying thousands of dollars out of pocket. I still have not received that money back, and do not think I ever will. I am in so much debt, and do not have a job right now that can help me out much. Warning: Do not work for the company called Addison Group or Diversified...and make sure your workmans comp is not under Gallagher Bassett.
Hello,
Let me first say, I always see the positive potential in every situation, but this has been the most horrible experience ever, *** and *** have treated me so poorly while dealing with my WC claim. I was hurt while sitting in my car, attending a business meeting for work, when someone slammed in the back of me, I immediately had head injuries, concussion, and neck and back sprain. My employer was so helpful and submitted a WC claim, the same day. No one from this company, called to request my statement of what happened. I received a letter in the mail, indicating this was an acknowledgement letter. I emailed and called my claims Rep *** several times, I called at least 20 times and even press 0 for an operator which no one ever picked up. Now my doctor office/hospital showed all of my injuries even with me being unresponsive due to concussion, and after requesting a manager call, Laura/Laurie, was beyond nasty and rude to me. This is my first experience ever, where someone has treated me so unfair. I have now hired an attorney. Worse company ever.
I was in *** west orange, nj on 2-28-18 when an employee ran a shopping cart into the back of my ankle. the assistant store manager took my information and stated their insurance company will contact me. approximately 2 weeks later a representative called me and I was at work and couldnt answer the phone she left a message her name is kate from gallagher basset phone #609-***-*** and my contact # ***. I returned the call and left the messaage. she called once more, when I was at work and again I left a message. I have constantly called and continue to get her voice mail which states "she is out of the office because of the weather and she is working remote so leave a message" , I leave messages and she doesn't return the calls. I feel she is putting me off to waste time so this insurance company doesn't have to respond or entertain my injury. I also call the main number 609-***-*** and get the same message. I looked at their complaint review and this appears to be normal business practice for this business.
Gallagher Bassett has reviewed the file in question and provided a timeline of events below.
3/5/18 Ms. loss was received by Gallagher Bassett electronically.
3/5/18 Phone call to Ms.. No answer; left detailed message with Resolution Manager contact information
3/6/18 Phone call to Ms.. No answer; left detailed message with Resolution Manager contact information
3/6/18 Contact letter sent to Ms. to the address provided at the time of the loss and with detailed contact information
3/6/18 File put on 30 day diary to follow up on contact status with Ms..
4/2/18 Phone call received from Ms. – claim resolved for client gift card for *** of West Orange, NJ
As noted in the above timeline, if phone calls were placed to the office there did not appear to be any indication that a voicemail message was left.
The paperwork for the agreed settlement was mailed on 4/3/2018 to Ms. address.
Jan 1 2017 I was injured on the property of the *** lounge in Austell GA in which Gallagher Bassett represents. The director Mr. then proceeded to contact Mr. Ray *** director of the *** lounge the day after the incident accured and finally had to seek legal action after all calls and visits to the location were ignored. I then reached out to Gallagher Bassett on several occasions with email and phone calls for over a year that was also ignored as the company decided to stall and prolong my claim with fraudulent tactics they commonly used on victims when they don't want to settle disputes. I have been passed to several claim adjusters which were Cynthia ***,Carol *** , and now Henry *** who is the Senior Resolution Manager at the location *** S Meyers Rd, Oakbrook Terrace, IL 60181. Henry has ignored every form of communication for over 5 months and I have spoken to managers for each claim adjuster that has been assigned to my case. I am seeking resolution and fair compensation for my injuries in which I have provided more than enough proof of for this claim. I am filing a complaint on the Gallagher Bassett company due to there unfair and unethical tactics against injured claims including providing false and misleading information during this investigation,engaging in pressure tactics, delaying medical evidents and documentation in my case and the list goes on.
This injury was not reported to Gallagher Bassett until 03/03/2017. At the time it was reported, Ms. was represented by an attorney and we received the letter of representation. Gallagher Bassett maintained contact regularly with Ms.’s attorney until 09/21/2017, when her attorney’s office advised that they no longer represented her for injury. Gallagher Bassett then maintained communication with Ms. via phone and via e-mail on a monthly basis to advise her that the investigation was ongoing and what was needed from her to complete the investigation. The item that was most needed to make a full determination was the medical treatment that Ms. advised she had sought. The medical providers were slow to respond to our requests, and when the records were received, they did not clearly identify a causal connection between Ms.’s alleged incident and her treatment. Ms. was advised via e-mail and phone of these findings and assisted on securing the needed medical information. The medical information needed was not received until March, 2018, at which time a review of that information was made. Based on the liability assessment, as well as the submitted investigation material, an offer was extended to her telephonically and via e-mail on 3/14/2018. Negotiations have been continuing directly with Ms. with additional correspondence taking place on 3/23/2018, 3/30/2018 as well as most recently on 4/4/2018.
My supervisor filed a worker compensation claim through my place of employment on 3/5/18 for an injury I sustained on 3/2/18 while on duty. My employer's (*** Hospital) Employee Health Department (EHD) contacted me on 3/5 to inform me that I would receive further instruction from the workers compensation representative from Gallagher Bassett Services (GBS). On 3/6, I took x-rays at the office of my physician, which confirmed that I had suffered a small avulsion fracture on the tip of lateral malleolus (left ankle). On 3/7, I received the first call from Austin *** of GBS, and he recorded my telling of how my injury was sustained. During this call, I asked Mr. if I could follow the advice of my physician and schedule an appointment with an Orthopedist; he told me no. I indicated that given my condition, if I did not receive instruction from Mr. by the next day I would contact my lawyer. Mr. then told me that he would do further investigation and then would recommend 3 Orthopedists for me to contact. On 3/8, Mr. contacted EHD and instructed them to relay the message to me to go to urgent care. I did so and received a temporary soft cast and was urged to seek the care of an Orthopedist immediately. I called EHD and Mr. at ~3pm on 3/8 to relay this information, and again requested Mr. provide me with a referral for an Orthopedist. Mr. then claimed that he did not receive relevant documents from my physician. This prompted back and forth conversations between myself, my physician's office, and Mr.. My physician's office sent the relevant documents to Mr. on 3/8 and again on 3/9, at which time Mr. indicated the fax machine was "not at his current location" and he didn't know when he would be able to retrieve the documents. Mr. contacted me on 3/12 to tell me my claim had been denied. I have been in limbo for 5 days, not able to walk, due to Mr. negligence.
Gallagher Bassett received Ms.’s worker’s compensation claim on 03/05/2018. In the State of Virginia, per the statute, we have 21 days to make a decision on whether a claim is accepted or denied. For that reason, Mr. contacted Ms. on 03/06/2018 to begin his claim investigation. At the time of the initial call, Mr. did advise Ms. he would need some items to make that compensability decision, which included her statement and her medical records for the treatment received prior to the claim being reported to Gallagher Bassett. He secured her statement, and on 03/07/2018, made an additional call to Ms. to confirm the information on the initial treating physician as there was some clarification needed on where she sought treatment in order to request the records. The request for the records was made on 03/07/2018.
On 03/08/2018, Mr. was notified by Ms.’s employer that she had requested a visit with Urgent Care, at which time, authorization for the one time visit was provided. Upon the completion of that treatment, Ms. requested approval for an orthopedist. Ms. was notified that because the investigation into her file was not complete, approval for that visit could not come from Gallagher Bassett until a compensability decision was made.
Gallagher Bassett received Ms.’s initial medical records on 03/09/2018. Based on having all the information at hand, a compensability decision was made and issued on 03/12/2018, and Ms. was advised that her claim was being denied and that a denial letter was being issued.
Mr. kept Ms., as well as an individual who reported to be her husband, as well as a woman who reported to be her daughter, apprised of all steps and what was needed for him to make a decision. He advised why Gallagher Bassett could not approve the required treatment, but did not say she could not seek care. A decision was made on the claim well within the 21 days allowed per the statute, and was done with the understanding that Ms. needed to have an answer to make the best decisions she could in regards to her care.
Nancy *** is the claim adjuster for my workers compensation claim. I have tried to reach her and left many messages with her, her assistant and her office. I have not heard back from anyone for four weeks now. I am in dyer need of medical attention due to my work related injury and have been ignored and delayed many times throughout the year that my claim has been prolonged. Please help.
Please find the enclosed timeline on this claim, showing there have been no delays in treatment or response based on the Statutory Requirements of California, where this claim is handled. Also of note, Ms. reviewed her phone logs and showed no missed calls or messages on her voicemail from Mr. in the last four weeks. If there are specific dates and times where messages were left, if those can be provided, further research can be done. Ms. spoke with Mr. on 02/20/18, when he called her line directly, and she provided him an update on his file.
File was reported to employer on 04/05/2017.
File reported by employer to GB on 04/05/2017
Claim delayed due to questions surrounding coverage of personal medical bills for pre-existing issues, prior to employment
Delay notice issued 04/19/2017
Industrial Clinic note from Sacramento Occupational Medical dated 4/27/2017 indicates condition is non-industrial
Denial of claim issued on 6/12/2017 via notice issuance.
Claimant requested a State Panel Qualified Medical Examination (PQME) in May 2017
State PQME evaluation on 08/28/2017
PQME requested diagnostic testing in October 2017 before he can render a final determination
Claimant contacted resolution manager to discuss PQME report on 10/24/2017. A follow up appointment was to be scheduled in 2-4 months pending test results
Resolution Manager contacted PQME office on 1/17/2018. Confirmed diagnostic testing was done and a supplemental report was requested.
PQME supplemental report was sent on 01/29/2018 and received on 02/06/18. The report is incomplete and needs clarification.
Claimant called Resolution Manager on 02/21/2018 where the report issues were discussed along with the next steps
Complaint: ***
I am rejecting this response because:
The claim adjuster states that further clarification needs to be made as to whether the injury is work related however the qualified medical examiner clearly stated in the supplemental report that the injury is beyond a doubt work related. The response also states that further steps were shared with me on 02/21/2018 which is tomorrow, that has hot happened as that day has hot existed yet. I was told I would be contacted later today but have very little confidence in that as apparently there is no record of the multiple calls and voicemails I have left throughout the Gallagher basset services offices. I am also filing a report with the workers compensation commissioner as to the lack of communication that I have endured during the last 10 months that my claim has been prolonged with Gallagher basset services while I've been in need of prompt medical attention.
Sincerely,
David
In response to Mr. reply, the 02/21/2018 date was a typo. Ms. spoke with *** on 02/20/2018 to advise of the report issues and next steps.
Ms. contacted Mr. again on 02/22/2018 to advise that he had been set up with a hand specialist on 03/23/2018. At that time, he had no further questions.
I had to deal with Joshua *. who is a claims adjuster? He was no help at all. He seemed disinterested and rude when talking to him on the phone about a claim I filed. It took over 5 months to finally get a response from them and to no surprise, it was a denial.
Yes, I am angry that they denied my claim, but I am more upset that it took so long and he made me jump thru hoops to get him the information that he could have simply gotten on his own. I would have been so much happier if he had just denied the claim early on instead of dragging it out for months. Every time I spoke to him he would say things like, "yeah I don't think they will cover this"....My blood just boils just thinking about him and his methods. I am so glad this was just a small claim, but now I know how this company functions. Drag things out and then deny it.
I was injured at work for over a year now, this company refuses to approve any MRI requests made by my doctors. I have a pinch nerve in my lower back and as a last resort, I've decided to go through with surgery. My dr sent several requests for a MRI but have all been denied. My initial MRI was over a year ago! My dr needs something more current before he can perform surgery. I've spoke with the lady handling my claim and she says that she's just following "protocol". (whatever that crap is). I am in so much discomfort, I can't stand or sit for more than 10-20 mins because of the pain in my lower back. All I'm asking for is an approval for a MRI and surgery so I can get back to work.
Ms. doctor's request for an MRI was received on 04/21/17 and submitted to Utilization Review the same day. Utilization review non certified the MRI. It was resubmitted again on 09/07/17 to Utilization Review and again it was non certified on 09/13/17. On 09/18/17 there was a review and no ***nge in determination was made after a peer to peer review was completed. Only Utilization Review can Modify or Deny medical treatment in California, which is what was done in this case. Ms. and her physician have the option to file for an IMR review. The documentation was provided to the treating physician with the Non Certification notice.