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Gallagher Bassett / workman's comp

1 KY, United States Review updated:

I sustained a work related injury to my left knee. I have had problems with Gallagher Bassett since day 1. I have had difficulty with my doctor's appointments and payments. My worst problem has been with receiving workman's comp payments. It has taken weeks to get a payment after seeing my doctor. The longest time it took to get a payment was for 6 weeks. I have had problems with them returning a phone call. I have had to talk to my adjuster's supervisor at least 4 times to date. I was told that the adjuster had up to 24 hours to return calls. It had been over a week. I contacted the KY ombudsman, her calls were not returned either. I haven't received payment since before Christmas. I took a desk job that pays $15 less on the hour, last week, just so I don't lose my house. I have submitted info to the Better Business Bureau, but that doesn't help me.
Just wanted to let you know, you're not the only ones getting screwed by Gallaher Bassett.

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  • Ni
      29th of Jan, 2009
    0 Votes

    i also have been dealing with them and from day one i had had late checks and had to call them continuesly and the lady cindy has been rude and theyll even hang up on you how can we put a stop to this once and for all i will get a lawyer on this asap but i need to do something to them in mean time i will be contacting the ri courts to see what can be done to them !!!

  • Re
      6th of Feb, 2009
    -1 Votes

    I have been dealing with them since Oct.08 and in the beginning it took almost 3-4 weeks to get my first check. Then the check were pretty routine, but there are times when it is 2 weeks before I see a check. They approve my care but it usually takes me calling over and over and badgering the case worker to contact the doctor, Physical Therapy, or other types of medical procedures. The case worker also encourages me to call her over and over because she "forgets and is so busy", her words. Right now I have talked to her and her supervisor everyday this week re: late check and approval for an epidural and I still don't have a check for last week or this week. I am at the point where I am thinking about getting an attorney. If it weren't for my parents I would be homeless and without food at this point. I am so disgusted with all of it. I am in pain all the time and I am sick of this!

  • Br
      21st of Feb, 2009
    +3 Votes

    here is how I deal with GB---just "carpet bomb" them with emails. If you go onto Google and search 'Branch Matrix' it pops right up. CC as many VP's and Area VP's as you see. Also the branch manager is always at extension 201.

    Some important people to copy on your email can also be found by searching "executives" at the Arthur J Gallagher Co (Itasca IL) and copy them too.

    For the BEST afffect send the email to your adjuster and BLIND CARBON COPY everyone else.

  • Ne
      11th of Apr, 2009
    0 Votes

    I understand dealing with insurance of any sort is confusing and frustrating, but the claimants posting comments really do not have a fair understanding of the process or the other side.

    As for checks there are a number of reasons a checks can be delayed. First place to look at the jurisdiction and determine what the laws are. The Better Business Bureau doesn't regulate the insurance companies or TPA's.

    One reason payments and treatment are delayed is due to the slow response from the medical providers. The injured worker has the option to select the medical provider of their choice (absent a MPN but even in a MPN has the opportunity to select a provider within the network). That responsibility must be shared by the injured worker or injured worker's attorney.

    The doctors must provide medical updates before payment is issued. The injured worker selects the medical provider and the medical provider is supposed to be the advocate for the injured worker. However, many MD's dictate the visits and send it out to be transcribed. Often this takes 1-3 weeks for the physician to provide this to the claims adjuster. In these instances payments are delayed. This is the same with treatment requests, the treater tells the injured worker in the office but after the injured worker leaves the report is dictated, then sent to transcription, then back tot he office, then given back to the physician to proof before it is sent out to the insurance carrier. With this being said payments, treatment, return to work, etc delays are not always the adjusters fault.

    There are many times the doctor is called and called but the front office staff are non responsive. There are 200 claims that each adjuster is responsible for which includes getting medical updates, speaking with injured workers, being yelled at by attorney's, dealing with the customers, and the carrier. There are constant audits conducted by the carrier, various state offices, and the clients. I am sure anyone in any industry or field can relate to an overwhelming amount of work and little time. Most employers regardless of which side your on are concerned with making money on the back of the employees.

    Getting an attorney is a means to reduce your frustration as you will no longer be able to correspond with the carrier. But there is a cost, people do not get rich or significant amounts of money from claims. Anyone with that belief is mistaken. The law is the law is the law, with or without an attorney the money is the same. The difference is like ordering a pizza, someone can bring the same pizza to you or you can pick it up. The difference is the amount you pay.

    As far as emailing VP's, the adjusters, branch managers, supervisors, etc are paid by the client (i.e. McDonald's, UPS, etc) and these entities have a different set of priorities...the bottom line. The carrier is responsible to following the law and servicing the customers. A few emails isn't going to get a claim paid that should not be paid. It may assist in getting a phone call sooner.

  • Si
      17th of Apr, 2009
    -1 Votes

    You don't need to have a fair understanding of the process or of the other side in order to expect some decent customer service and maybe a touch of human decency. It's not that tough to return a phone call and take 30 seconds to explain that your check is going to be late again because the medical providers were slow to respond. I can understand how things may take awhile when you require paperwork from various sources, but please tell me why before I got a lawyer my checks were always late, if I got them at all, and in the wrong amounts, and then when I got so frustrated I couldn't take it anymore and hired a lawyer...POOF! Like magic, now all of a sudden the checks come on time and in the correct amount. Wow, it's strange how just hiring a lawyer can make all those other "excuses" go away. Seriously, don't try to blame others for your lack of customer service, human decency, and your ability to do your job.

    So yeah, the law is the law, but apparently GB doesn't feel the need to follow the law for their customers until they are threatened with legal or monetary consequences from a lawyer.

    Even after I hired a lawyer, Gallagher Bassett still denied me the second surgery I needed in order to (hopefully) fix my injury. So I got the surgery and paid for it myself and now to add salt to the wound they are telling me that the adjuster misread my wage statements in the beginning- months and months ago, so they think they had been overpaying me the whole time, so not only do they want the overpayment money back, but they want to file a charge against me because I "should have known" that I was getting too much money. Um, so let me get this straight... the adjuster screwed up his job and claims they gave me too much money (they didn't), they wouldn't cover my 2nd surgery, they paid me partial disability when I was in a cast and crutches (should have been paid full disability), and this is my fault, because apparently between 2 surgeries, lots of pain pills to ease the excrustiating pain, and trying not to go bankrupt because I have to cover my own surgery costs, apparently I should have been reading (and understanding) all the intricacies of workers comp laws, and double checking the job of the adjuster to make sure they were giving me the exact right amount. Sorry, but if anyone has ever tried to read a law explaining how you figure out your payments (especially when you have 2 jobs), then you'd understand it is totally unreasonable to expect a layman to be able to (and to have to) calculate the payments. If that's not the adjuster's job, then what is???

    It's like me walking into McDonalds and asking for a cheeseburger and then they give me a quarter pounder because the guy behind the counter is too lazy or stupid to check his work, and after I eat it they charge me with theft because I "should have known" that a quarter pounder weighs 4.6 ounces, where a cheeseburger weighs 3.7 ounces and they want the .9 ounces of meat back and to throw me in jail for knowingly taking the burger I wasn't supposed to get. Seriously, WTF is wrong with these people? I understand that they are a business trying to make money, but to blatantly screw with people's lives like this is just not cool.

    I'm not trying to get rich, and anyone who thinks they could get a huge chunk of change from workers comp is fooling themselves. What I do want is this: payment for the 2nd surgery they refused to cover, payment for full disability for the time I was immobile and spent my days screaming and crying in pain because they sawed a chunk of leg bone off and screwed it in at a different location in order to fix the problem, them to stop blaming me for their mistakes and to stop treating me like a criminal because THEY screwed up their own job, and an apology from them for making the past 2 plus years a living hell. And I want other people to stop trying to make excuses for their disgusting behavior.

  • Fe
      2nd of Jun, 2009
    Best Best Advice +4 Votes

    Gallagher Bassett is one of the most deceptive insurance providers I been in contact with up to date. They promise and yet they fail to provide. I have some of the very same complaints about stalled payments for weeks at a time. They also tried to manipulate me into returning to work and I had an injury that required surgery. They used non-payment to try and starve my family and I. I wonder why do we pay for insurance or work for companies that are going to work you like a slave and then when you injure yourself doing your job they want to treat you like a criminal. Gallagher Bassett and my employer Pepsi americas were in a conspiracy to throw me under the bus after I injured myself rendering service and following company and the insurance policies to the letter. I wish it were some way they could feel the pain, embarassment, shame and financial difficulties of those that they so frivolously represent.

  • So
      10th of Oct, 2009
    +2 Votes

    MY time with gallagher basset has been a total nightmare.I have herniated disc in lower back reqiuring surgery and bulging discs in my my cervical and thoriac spine as well as 2 torn rotator cuffs from boxes falling on me at work, I have not been paid ttd since may 19, 2009.HAD 4 MRI'S AND ONE EPIDURAL with 4 shots, PT(2), Accupunture, Cortisone shts to both shoulders.I have been off work since Marcg 16th, 2009.I have attorney, and they are getting a expediated hearing, hopefully.Been requesting bi-latteral shoulder surgery in June 2.2009.I filed my second complaint with Workman comp audit control as well as a copy to the adjuster.HEREs a copy of the text of the complaint. My workman's comp diary October 6th 2009

    1.Date of injury was 3/14/2009.The boxes we use for catering fell on me from about 4-5 ft off a shelf on my back while I was looking in another box bent over looking for chicken tins to restock the carver station. There is a video of the incident. There are several camera's throughout the store and where the accident happened there is a camera first payment was 10 days late. 14 days after my injury was sent without my apartment # and was sent back and received by the adjuster's office on the 9th of April and sent to me after a call from my attorney by the 11th.My payments were delayed again APR 28 until the 11th but was not issued until the 15th with me and my lawyer at the time making phone calls to the adjuster extra day were paid but once again delayed. The reason given is they(my employer) were looking for modified duty for me and haven't heard from my store manager. Now I'm not being paid and it has been 4 months as of October 6th of this year. claim was accepted and yet I still face numerous denials for treatments and have been off work since march 16th until the present with the worst example being that a upper GI was scheduled as a follow up for to a appointment that was scheduled by a nurse case manager "L", that worked for Coventry workers comp services, who scheduled the a appointment for me at Samson Clinic, Santa Barbara because she could not find one that accepted workman's comp closer. I went to the first visit with transportation was provided by the nurse case manager and authorized by the adjuster. While I was still was at the clinic everything to my knowledge was approved for the GI that was requested. The day before at 3:36 pm the transportation was not authorized, the nurse called me and the transportation as well. I had to postpone the appointment with no time to replace that ride as it was close to 4:00 pm. I would like to state that in my opinion this was done at the very last moment as I made the appointment for the transportation the same day of th first visit so ample time was given for the adjuster's denial, was done with malice and could harm my health. Another example my shoulder surgery was requested in June 2 2009. as of October 6th 2009 still denied with physical therapy or not all conservative treatments were used. this is not true, by the time I even had a nurse case manager I had already had, physical therapy (5 out of 6 sessions) even before i had the first MRI and each time I complained of worsen pain in neck and burning in my shoulders. I had cortisone shot in both shoulders, which made things worse, I'm taking my medications with little to no relief and in June Dr. P stated my shoulders would not improve without the surgery I need in both shoulders which each one takes 6 months of rehab thats a year at the least to just get my shoulders back to some type of functioning capacity. This is shoulders alone. I feel their lethargic way of handling my case has made things worse I have gone back to PT (I have had at least one trip to the Er and cannot finish after 4 visits as well chiropractic 4 visits as well.

    4.My TTD payments have been cut off since May 17 which I was not notified by mail because mysteriously all the notices were sent to a address that has no association with my case ever. As well as the reason for this is that modified work was available for me since may 19th 2009.which not only did my Dr. Did not want me to return and wrote to this fact on may 29, 2009.Also another Dr also said I was temporarily totally disabled at least until 7/15/ of this date no payments are being made to me. and I cannot return to work with the injuries I have

    5.The adjuster has also repeatedly denied my pain psychological consult with Dr. E to help me learn to deal with a non medication way to deal with the pain I suffer and because I have a previous condition. i think that is bias in every way. I was able to make it to work every day and was a manager in their store and was able to be a fully functioning person and now because I have a previous condition I'm denied treatments that could possibly help me and not even a part of my claim so I should be treated as any other injured worker. Once again I must state because of all this ongoing stress of pain and not be treated fairly in my opinion is taking a toll on my previous condition. I would like to know who did it benefit to send me back to pt again and it showed no signs of helping, made things worse. Not me and only slowed down any progress that could have got me back to work. The Mir's showed I have significant damage and my claim was accepted. first epidural was approved September 23 2009 after at least 2 months of waiting for a approval.

    6.Went to see Dr. V on Oct 8, 2009 and he requested aquatic therapy for my back as well as adding ms con tin .I went to get the script filled and the was told that my card had expired (this with the fact I was not sent a current one and me still having a open w/c comp case) and told pharmacist they would try to get it extended all that with me being without my medication possible until Mon and not sure if they can do it period I would take this as a denial.

    7.Also as of the 8th of October no word on my shoulder surgery. My appointment with Dr. P was on the 29th of September and the nurse case manager did speak with dr. P .this would be the 3rd request if not more made for this surgery as I remain in this pain. I would like to file a complaint against the insurance adjuster. My Dr has told me that I will not get better without this surgery on June 2, 2009.all that the adjuster would agree to is my back to physical therapy again after the first round hurt me and made thing worse.

  • Ja
      14th of Dec, 2009
    +2 Votes

    i agree highly i susbtained an injury to my head and no one seems to want to help me i cant even see the doctor without their approval so i have yet to see any medical attention i want something done

  • Jo
      18th of Jan, 2010
    0 Votes

    I know what your saying i've been dealing with GB since OCT 2003 for back problems and now two surgeries and plenty of rehab later i'm still having problems with them especially when it comes to them paying for travel payment i deal with a Ms B out of Birmingham AL . I do have a lawyer and even then they (gallagher bassett) drag it out until you get a court date and then they do something at the last moment then you have to start all over again good luck to everybody. p.s maybe if everybody starts sending complaints to the CEO of GB it might help it couldn't hurt.

  • Mo
      25th of Jan, 2010
    0 Votes

    Your Going to need A compensation attorney, To deal with them. I have one, and have not had to many problems. Keep good records. Register all your mail to them. Get receipts.Make copy's of everything... If you have a attorney. Foward all med & travel expence receipts, and any correspondance to Gallagher Bassett. threw your attorney's office...They will foward it to G. B. I think with the attorney letter head. It gets there attention...Hope this helps some of you..

  • Lo
      28th of Jan, 2010
    0 Votes

    I to have been injured on the job, back in March, 2009, and nevered healed. So again I reopened my claim and added another injury, do to on the job, and this time I haven't been paid for any thing. I have been off of work since December 11, 2009 and haven't had a pay check from them at all. My attorny told me that they were sending out a check. That was a week ago, and still haven't gotten paid. How are people to that are not able to work, that are injured on the job, live without money. We can't go back to work because We are not fixed, hell can't even afford to go to the doctures, because they refuse to pay you for your injury on the job. What ever happened to it's the LAW, they have to pay you if your Doc says you can't work, or they put you on light duty, and your place of employment doesn't have light duty. You know if this were me, I would be slapped with a big fat fine, if I didn't pay for an injured worker, in the 14 days, BY LAW. Something needs to be done about GALLAGHER BASSETT. and again I do have an attorney, and nothiing is being done.

  • Ma
      28th of Jan, 2010
    +3 Votes

    Gallagher Bassett seems to have a policy or corporate mandate to use every deceptive tactic and excuse possible to delay payment. It can only be a concerted effort on their part to starve out all of us that have had the misfortune to become sick or injured at our place of employment.

    Even after they are presented with qualified medical diagnoses of condition they still delay payment or even worse promise payment they never intend to deliver. This company is in need of some serious regulation. As the pain and suffering of injured workers and their families continues on an almost universal basis for those that have the misfortune of dealing with this company.

    I have heard comments from adjusters that they are swamped with cases and complaints from lawyers and managers. Well at least you have the option of getting another job. If you are off work and disabled you are at the mercy of these heartless ###. Even with competant legal representation it will be an arduous uphill battle to get this company to do anything for the sick or injured worker.

    It makes me sick that we can dedicate our entire lives to our careers and the companies that employ us. And then when fate steps in and we are hurt or become sick in the course of our employment. We have to deal with a corporate monster whose only goal is to minimize risk and financial exposure.

    Before I became ill at work I believed that this great nation we live in could do better by its working middle class. That have proven themselves to be the backbone and engine that runs this whole great country of ours. But in reality your only value comes in your ability to keep money flowing into the pockets of the richest Americans.

  • Re
      24th of Feb, 2010
    0 Votes

    Not that it helps anything but I am so happy that I am not the only one dealing with these people. I have never had to deal with such an awful company. My husband works for Pepsi and was hurt on the job and they refuse to do anything they say they are going to do. We have bills that are in collection because the adjuster does not do her job... ever!!! I am dealing with a lady named Donna, who is one of the rudest people I have ever dealt with. I call her every week and she always says she is taking care of it but still the hospitals have never received payment from her. My husband has been back to work for 4 months and has not seen a doctor since and they still have not paid the bills. She does not deserve her job and I would do anything to find a way to stop the way this company does business and treats people.

    We should have never got the bills in the first place but we did and after I faxed the bills four times to her at her request she then says she can not take the bills from me they have to come directly from the hospital so I give the hospital her information and they have sent them, faxed them, called her and still nothing. Every week I call and check to see if she has decided to do anything and she talks to me awful and of course it is the same thing each week... nothing is done!

    While my husband was going through treatment she was the prime reason things took forever. When the doctors faxed stuff to her for her approval it would take her 3 weeks to do anything with it. She told my husbands boss it was his fault that he was not doing what he was suppose to, which I seen first hand that was not the truth. He could call her everyday and a week and a half later she would return his calls. I want somthing done and if anyone has any suggestions on what to do please let me know.

    Are we going to have to get a lawyer to deal with this company?

  • Wa
      5th of Mar, 2010
    0 Votes

    I agree. Gallagher Bassett Services, the companies that hire them and the bogus doctors they use need to read the new RICO laws dealing with workers compensation or they will be at the heart of the next lawsuit!!

  • Su
      19th of Mar, 2010
    +1 Votes

    I agree. The most unserious company... Yes... you should to get a lawyer to deal with this company. They like to take money, but not to give service...I had to hire a lawyer to get my rights. I am still on lawsuit with them...

  • Am
      25th of Mar, 2010
    0 Votes

    I totally agree with you people, I have had all types of problems with GB and fighting with them going on 3 yrs now. I started out with a lawyer and finally won my case, but after the case was won, GB was to pay all of my
    medical bills, and meds till i no longer need them. I totally understand how you people feel about getting approvals on dr visits, or meds, or GB paying for the bills once they have been summited. Most of mine gets denied, and turned over to a collection agency. I have an extensive medicine list (13) different kinds of meds,
    along with 4 dr's and there are times I need to see one of my dr's and can't see them until it is approved, by the time it gets approved, i could die. I have had many adjusters to my case, and every one of them has been really nice, all but one, but the one i have now is really understanding and tells you like it is, he does not suger coat it.
    overall GB is the hardest and unfair company I have ever had to deal with, but stay on their ### and don't give up and make sure you have a good attorney, and you will finally get some results. I know how you people feel
    I just didnt know that there was so many people suffering like I am through the same co. It looks like something could be done with this, they are dealing with people's lives! Any suggestions?

  • Ro
      22nd of Apr, 2010
    0 Votes

    i've got hurt on the job Jan. 27 2010, and it took 7 weeks to send me a check. i got an attorney but obviously these people are not scared of attorneys because i havent received nothing sence. now the dr. has released me, march 30, my job says i have to get the attorney to get in touch with GB before i come back. its been two weeks now and still not working. im very behind on bills and very frustrated.

  • Ro
      22nd of Apr, 2010
    0 Votes

    These people gotta be from another world. They have NO hearts. I pray that they get what they desevre

  • Sc
      30th of Apr, 2010
    0 Votes

    i got injured on 11/13/09. i was told i had a sprained knee and lower back muscles and that i couldnt work and that i needed physical therapy. the entire time i was in therapy and seeing their doctors i said the pain has never gone away. i finally had a ime which lasted like 8 mins and the doctor said nothing was wrong. GB never called me they called my boss saying i could work. i can barely walk or move my back inmost ways. i finally got a lawyer cause the day i was ordered back to work i couldn't even stand or barely walk after an hour. when i got to see the doctors of my choice i was diagnosed with rsd. the orthopedic doctor i picked has sent me to 2 specialists. the spine specialist said that i have rsd as well and that i shouldnt do anything that increases the pain i have. which is pretty much everything. when we went to court to get my benefits reinstatted i didnt even have to testify because the judge said that GB missed the filing deadline and that they couldnt deny any benefits. their lawyer had no clue that the deadline was missed and the company i work for did not give anyone a proper address so the judge didnt like that either. if you get a good lawyer it helps when dealing with these idiots. they are good at screwing themselves over by hiring doctors that rush people in and out, since i now have 2 doctors saying that i have rsd, and the only thing that has worked for me so far is Valium and percocete which means i cant drive or do my job while taking that. hell they even tried to settle right after the first hearing once they saw i cant walk.

  • Lo
      10th of May, 2010
    0 Votes

    I was injured on the job in 2007, so it has been a long fight for me with Gallagher Bassett (GB). they stopped medical services for over 6 months, denied services, had me travel over 2 hours to appointments, and only after arriving I would be told that the visit was not approved. GB took over 4 months to pay my initial checks, then abruptly stopped the checks, hired unscrupulous doctors that lie at the drop of a dime to pad their pockets, falsify medical reports, and then to repeat the entire process by stopping medical services again in May 2010.

    If you are in South Carolina, be careful if they send you to Coulmiba Neuroligical Association, (Dr. Storick). This Dr. is the worst.

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