Gallagher BassettStay away

V
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Verified customer

I too had a workman's comp claim in which my actual doctor and the doctor I was sent to from work both put me on work restrictions after a shoulder injury. GB denied my claim but stated that I could file for an appeal within twenty days. I had it sent in 2 days later. Still to this day have never heard from them whatsoever. They played it off as a shoulder sprain. Well 5 and half months later my shoulder is still not like it used to be. It's got about sixty percent of its strength back. Pretty crappy since I was supposed to start firefighter training in the fall and now because of GB, I may not be able to ever achieve that dream. Thanks alot [censored]s!

Responses

  • 1l
    1ltallen Jul 17, 2011
    This comment was posted by
    a verified customer
    Verified customer

    hi i had and have actually and ongoing case with this insurance company. I hurt my neck at work last fall. They took three months to finally approve PT then sent me to a doctor who didnt even look at the MRI sent by the preovious doctor. The first doctor told me I had an unstable neck from a C 5-6 herniation and put in a referral. The doctor said Oh is Muscular skeletal gt a better attitude go back to work. So I asked for a second opinion. The second surgeon said sure it s surgical she needs it. They denied the claim, They GB sent me to another surgeon for another independant opinion. He agreed with MD 1 and #3 I needed surgery but still GB said no. They then hired a PI to follow me around day and night. However they only submitted film of the one day I had the nerve to actually take medicine so I could function in hopes of getting the MD to change their opinions. However I looked up Florida law and this type of thing is illegal to do pursuant to 440.10 comp regulation. You cannot make statements to pursuage or convince or discolor evidence in hopes of denying a claim. If any of you are still reading this blog please reply here as If I can prove that this is a normal behavior and the normal status of how they handle claims, which it seems from reading here above that it is then this is just their attempt to get out of paying claims . ( a big no no ) I even have a statement from the adjuster in an email saying my doctor directs my care not me. ( aparently she doesnt even follow her own rules as the doctors x 3 say I need surgery and still denying the claim. According the the patients bill of rights ( Federal Law - Which superceeds State stautes), Section iV of the Federal patients bil of righs states ( I have copied it direct from the site) IV. Participation in Treatment Decisions
    Consumers have the right and responsibility to fully participate in all decisions related to their health care. Consumers who are unable to fully participate in treatment decisions have the right to be represented by parents, guardians, family members, or other conservators. ( Quote obtained from http://www.opm.gov/insure/health/reference/billrights.asp ). We need to stop this behavior of insurance companies, while I under stand that there is alot of fraud in these areas, that sould be a risk of doing business, if they dont want the risk they should not sell the insurance. If the company I worked for paid the premiums for coverage it is their job to satisfy the claim. So by trying to not pay the claims made by an employee I think this constitutes some breach of contract. But that would be their fight. I just want this to be over get my surgery and move on with my life. There is a board who investigates these problems in every state. I am curious if anyone has sent a complaint to the state about Gallagher Basset. And if so what were the findings?
    1ltallen

    2 Votes
  • Ti
    Timmerman Sep 20, 2011

    Hello I'm having the same thing happening to me, I've had 2 surgeries on my ankle and still hasn't gotten any better so i went back to the othropedit that done my previous surgeries said i need a third one to fuse my joint and clean catrlige out of my ankle and Gallagher Bassett is refusing to pay and now they sending me to see an independent Dr. on the 28th of this Month for they don't have to pay for anything and my Dr. said that that i need the surgery so what kind of crap is G.B. trying to do? Make people suffer that's not right at all. They should my pain and what i'm going through with my ankle on a daily bases...

    0 Votes

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