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Report: #260033

Complaint Review: Gallagher Bassett Insurance - Clearwater Florida

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  • Reported By: Huntsville Alabama
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  • Gallagher Bassett Insurance 2600 Mccormick Dr Ste 110 Clearwater, Florida U.S.A.

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On 22 January 2007 I was injured while at work as a night maintenance man for Cracker Barrel at approximately 3:30a.m. when a box of platters fell striking me in the left lower quad of my stomach and groin area. I was in extreme pain but managed to complete at least most of my duties that night. Reporting the injury as soon as a manager came in at 6:00a.m. that morning.

A report was taken and then was told to go to the clinic that was near the store. I was checked out by a doctor there who felt that it was only a "soft tissue" injury giving me some prescriptions that I filled told me to take them and return in 3 days giving me a chit for that time off. I did as I was told only to have no change in the pain.

She requested a referral to see another doctor to confirm that there was no hernia. The referral was authorized by a Mr. Richard Hawkins who would be my agent, an appointment set and I went. He checked me physically stating he didn't see any sign of a hernia but that there was tenderness to the area. Gave me prescriptions that were filled by comp. along with another week off from work.

A week later I returned with no change in my status. He stated that I would probably be "sore" for a while but to work with it. I went back to work where I was told that I was still scheduled as to be off for 2 more days to go home relax then come in at that time. I did as I was told, coming in two nights later.

There was additional work that I had to do that night when I returned which only increased the pain that I was having. Lifting several boxes, climbing a ladder several times changing lights, and some additional cooking that needed to be done. By the next morning I was in server pain to the point that I could hardly walk to my car.

When I got in to drive home I was in tears almost having an accident on the way. I made it home taking my pills tried to sleep. Sometime in the course of that day or evening something happened which I'm still not sure what as the next three days are more or less blank in some ways. I woke finding myself on the floor of what I thought was still the same day, only to find out later that it was the following day.

My mind was confused, I was disorientated, and couldn't hold anything in my left hand. My hand, arm, and leg on my left side was hurting with radiating pain in the lower left side of my stomach as well. I went to the emergency room of the hospital where they thought I was either having a stroke or a TIA admitting me on the spot.

In the hospital they began running all kinds of tests on me for Stroke and TIA but found nothing wrong in my brain. It was two days later that I tried to explain about the injury but they didn't seem concerned about it. I was released told to go home with 2 weeks or "home care" to relax and use caution since they had pumped me with a good amount of blood thinners.

I went by work giving them the information then went home still in pain from the original injury. I did nothing but rest for that next two weeks, returning to work I was told that I had to go see a doctor before I could come to work. The general manager asked how I was explained that I was still hurting where the box hit me but that otherwise I was ok. He told me to contact the Insurance company to get in touch with a doctor to be checked out before I could come back.

I called the GB and found out my agent was Mr. Richard Hawkins who said I could go back to the doctor who had seen me before. I told him I would prefer seeing someone else as for one that doctor was too far away and driving caused only more pain and second he didn't seem to do much for me. I was given the Option to pick another doctor which there was one only two miles from where I live. I went there to see him.

This doctor asked if an ultrasound had been done? I replied no, which he said that he wanted to have one done. He put in a referral for one to be done which took a week to be approved then another week to be scheduled. I went then had to wait yet another week for the results to come back to the doctor. Once returned the doctor said that he wanted me to see another doctor that there was no hernia however there could be nerve damage. He put in a referral for that doctor that was approved and scheduled.

I went to see him only to have him look at me stating that there was a good amount of pain to the site area however he wanted to have me take a couple prescriptions and see if they helped. Once again I took meds for another 10 days having a work chit off only to return to the doctor with no improvement. During that time off I contacted a few others I knew where I was given a site location of a medical article that would be of interest about nerves in that area. Having had a hernia repair some 8 years prior they stated that it would be of interest to the doctor as well.

I printed it taking it back with me since there was no improvement. I asked him about the article which he told me he needed time to review and would get back in touch with me.

During this time I was still under his care and not able to return back to work. About a week or so later he contacted me stating that he wanted me to be seen by the Tennessee Pain Center for their opinion prior to scheduling any surgery. That he felt that the article I showed him was very possibly the cause of the pain but wanted them to check me first. I told him that a referral had to be placed with GB to have it done. He said that my referring doctor would do that and that they would be in touch with me.

As of date, 10 July 2007 and the time of this report the following has and has not been accomplished:

1) I am still sitting here with pain to the site area of the accident and has got worse.

2) I am not able to drive more then about 10 miles before I am having shooting pains going through my side, groin, and stomach. I can't walk around a store and go shopping without assistance as I begin to have pains shooting though my side, stomach, and groin.

3) I received one comp check that covered from 1/22/07 to 2/12/07 and nothing since then.

4) None of the doctors, tests, or anything have as of yet been paid. I am now getting bills sent to me with some going to collection agencies and demand of payment or else.

5) I have not got a referral as of yet to the Tennessee Pain Center as requested by the doctor.

6) The agent I had Mr. Richard Hawkins was terminated from GB with a new agent now taking his place Ms. LuElla Rogers who upon talking with her told me that she has nothing on me at all. That no approvals for referrals had ever went through their office, and as far as she was concerned the case was closed. That if there was still something going on that before anything could be approved that I had to go to all the doctors and testing agencies, get all the reports, notes, chits that I gave my work location, and referrals that they are "suppose" to have and mail them to her. That she would then review them and make her decision as to rather or not to approve anything or any kind of compensation. That in her eyes as it stands I have nothing and that I am suppose to be working. I had contacted our Corporate Office for Cracker Barrel that states I am on extended leave due to a work related injury. I was further told that GB has that same information along with copies of the chits.

I retained a lawyer back on 15 May to try and help with this case. They work on a percentage basis, but he told me that there wouldn't be much that could be got other then what I would be due in compensation and the referral authorized. I was told that there was nothing for pain, suffering, or stress that could be got on a workman's comp case. That it wasn't like other types of injuries and only if there was a disability could there possibly be something.

I don't understand it at all! Right now as it stands:
1) I am about to have my car repoed due to non-payment. I am 4 months behind which they are not understanding at all.

2) I have been begging family and friends to help keep my electric on and something to eat.

3) I am not able to do any of the physical activities I normally do such as riding my bike, swimming, driving, taking walks, or tennis.

4) I am not able to enjoy a full physical relationship with my girlfriend causing problems between us. No matter how we have tried there is always pain which causes us to have to stop.

5) I am being hounded by collection agencies, my credit is going down the drain, and my life is falling apart.

I don't understand why a workman's comp claim can't be held responsible for their actions as any other insurance claim would be. To me Gallagher Bassett and its agents are Liars, Sadists, with nothing more of interest to them but to watch people fail. They have no concern of health, family, quality of life, or people's lives other then their own! If there was ever a more WORTHLESS company in the world it is Gallagher Bassett! I would not recommend them to anyone, would never work for another company who used them as a carrier, and would tell anyone who was to be worried, be very worried!

Neil
Huntsville, Alabama
U.S.A.

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This report was posted on Ripoff Report on 07/10/2007 08:25 PM and is a permanent record located here: https://www.ripoffreport.com/reports/gallagher-bassett-insurance/clearwater-florida-33759/gallagher-bassett-insurance-the-rip-off-insurance-company-workmans-comp-ripoff-torture-260033. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year. Ripoff Report has an exclusive license to this report. It may not be copied without the written permission of Ripoff Report. READ: Foreign websites steal our content

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REBUTTALS & REPLIES:
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#6 Consumer Comment

Crack That Barrel/REBUTTAL

AUTHOR: Cherie - (U.S.A.)

POSTED: Saturday, March 28, 2009

Neil,we must compare notes about
Luella Rogers, agent for
Gallagher & Bassett Ins., you know the company that is to help you with the on the job injury, workers comp. Yes, I have been with Cracker


Barrel, server/trainer for 5 plus years,store #138, Slidell, Louisiana. Luella Rogers' never puts anything in writing. My doctor just wrote my attorney a note about this. Luella has cut off all checks and demands the doctors clinic to put everything in writing. She is the Ring Leader that will put you into a very dark place. Featuring no respect and could care less about Cracker Barrel standards. I have a knee injury after slipping in the over flow of water from the ice machine, smashing into a steel back of the house leg of a table. No matting on the floor. This happened on May 9, 2008. I had one operation, yet Luella Rogers decided she no longer had to take any advise from my doctor unless he put it into writing. For 9 months I handled Luella & the circus of Gallagher & Basset by myself, now I have a Attorney. If you wish to file the class action, let me know. Your entire report is true. 100% plus behind you. At this time Luella cut off P.T., refuses to give me the permission for the treatment needed to make me pain free and maybe have the chance to walk with a straight leg. She wants me at work. She continues to pick me apart, one word has 6 meanings. Cracker Barrel is unable for accominadation for the server position due to injury with limintations. My doctor said what I can tolerate. Now they want me to host. Yet, server duties along with host duties cross one another, this is a very busy company, you can see over 600 people a day. For 3 months Luella Rogers has picked apart job essinetinals requirments for the job position. OSHA Standards has code of Federal Regulations required. This may help me with the wet flooring. Cracker Barrel home office workers comp dept. helped me push Luella. Then came the screaming phone calls with threats from Luella, not only to me, along with the entire staff at the doctors. I could go on for days on the way Gallagher & Bassett's prize cookie has treated me. Good Luck My Friend. Please contact me if I can help you in any issue dealing with Luella Rogers, adjuster for Cracker Barrel.~~~Ms. Cherie~~~Covington, Louisiana

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#5 Author of original report

Update 10 March 2009

AUTHOR: Neil - (U.S.A.)

POSTED: Wednesday, March 11, 2009

I was told that we were to have a mediation prior to going to trial however GB decided that their lawyer needed to talk with me. A meeting was set up along with my lawyer and a stenographer who took all the information. At the end I was suppose to be hearing from them. They agreed to set up an appointment for me to see a Doctor. My Dr., recommendations was to be going to a pain center to see a specialist to verify possible nerve damage. GB set me up with an appointment with a Rehab therapist rather then a Specialist. Upon my lawyer's recommendations the appointment was canceled and my lawyer contact their lawyer to inform them that we wanted a specialist not a rehab therapist. As of date I have not seen another doctor however I received a letter dated the 25th of Nov. 2008 from Coventry Worker's Comp Services who I have no idea who they are unless they are a part of GB. I received the letter on the 2nd of Dec. 2008.

The report stated: Procedure/Description date Start 11/26/08 End date 12/31/08 Amount 1 PerDiem. Pain Management Evaluation for lower abdomen.

So far that would sound good except I never had an appoint for that and never saw a doctor. It further states:

Notice of medical necessity. On behalf of Gallagher Bassett, the requested treatment referenced above has been reviewed by Coventry Worker's Comp Services, and has been determined to be medically necessary.

So for still sounds good you would think. Continuing:

This recommendation is not a guarantee that benefits are payable by the claim administrator. If you have any questions about payment please contact the claim administrator (gives her name and number). If you have any questions about this review, please contact (a nurses name at Coventry and her number).

That might have been all good and well however in the top of the letter there is something that contradicts the letter itself. Date of Injury 01/22/2007, Diagnosis Code: 847.2 Lumbar Sprain. How can you get a lumbar sprain out of lower abdominal injury and how do they figure one PerDiem when I've been out of work for over 2 years?

Not only that but this was sent to my Doctor and to me, and not my lawyer. When I contacted him he had no knowledge of it so I faxed it directly over to him and he confirmed receipt. He said he would contact the lawyer and find out what was going on. Since the 2nd of Dec.2008 I have been in constant contact almost weekly to my lawyer's office. In Jan 2009 I found out the one secretary he had was no longer working there but that he had a new one. Spoke with her she was not up to date on the case so I asked to speak to my lawyer. He informed me that he had to bring her up to speed on the cases but that he was trying to still find out for their lawyer what was going on. In Feb. 2009 when I contacted my lawyer I was told that yet another secretary was now handling all the worker's comp cases. I spoke with her which of course she was unfamiliar with the case. I asked for an update on what had been going on, what the status of that letter was and when were we going to have some type of mediation. She had no knowledge but would get back to me. On Monday the 9th of March I contacted my lawyer's office and he was out. Left voice message that I needed him to call me and let me know what was going on. That I was in constant pain, my life has been destroyed, I have no money at all, my sister and family can no longer continue to support me, I can't get a job, can't file for disability, can'f file for SSI, and at a point that I don't know what to do.

As of today the 10th of March 2009 I have still heard nothing back from my lawyer. GB I believe is hoping I will either die or forget the whole thing which I can't do. I live in constant pain some days better then others but constant. My doctor said that there isn't anything he can do for me without their authorization which seems impossible to get. I can't get another lawyer as I am on a contact with this one. I wish there was not only a class action suit against GB but that the President and Congress would step in and investigate the shady practices of this company. The 4th largest in the world and yet one of the worse to deal with. Something little or simple they would deal with but let it be a major event and they will do anything in the world to put you off. The sad part is that the way Worker's comp is written we have no recourse against them I am told.

They have destroyed my credit, taken my car, finances, life, and ruined me but do they care? NO! Being 55 years old I think they are hoping that I will die off rather then have to pay me a dime! I wish that our President would take a good look, read what the people are saying who have been injured, who have been screwed over, who have lost everything because of this insurance service and do something about them. HELP US FIGHT BACK!!! I would be more then happy to go on TV, to help file suit, and to fight them. I am an emotional and physical wreck because of them!!! This web site knows how to contact me. I have documentation to back up everything I have stated and more. I want satisfaction for what has happened but feel as though GB would want me to praise them if only to get the treatment (if that) that I need.

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#4 Consumer Comment

GB Thinks They Are Above the Law

AUTHOR: Enoughalready - (U.S.A.)

POSTED: Saturday, November 29, 2008

On Sept 24, 2007 I reported to my Supervisor that I was having numbness, tingling, shooting pains in my hands and wrists that woke me up at night.
I have worked for my employer for 24 yrs as a sheet metal operator.

I was immediately sent over to Occupational Health at the nearby hospital where the Dr examined me and ordered for me to see a Neurologist for an EMG study on both hands. Neurologist preformed the EMG and his diagnoses was SEVERE Carpel Tunnel in BOTH hands
Went back to see the Dr from Occupational Health who after reading the results brings in an Orthopedist, am told that at this point the Carpel Tunnel is so severe that only surgery will help....surgery is set up. From the time I reported the problem up until the day before surgery is a total of 4 weeks, not bad right?
12 hours before surgery I get a call from GB saying the surgery is off and a few days later a formal letter of denial for Workers Comp.
I also had a part time job of 1 yr, and once GB saw that they now were going to blame the part time job which was laughable because all the doctors I had just seen who were not my doctors all agreed the Carptel Tunnel was a result of my full time job of 24 yrs...lots of repetitive motion, vibration and grinding metals etc.

Since GB denied WC I had to retain an attorney. Attorney advises since GB has denied claim to go through my private Health Insurance and have the surgeries and collect Short Term Disability.
I was out of work a total of 5 months because I had to have one of the surgeries done twice on one hand, first time wasn't successful.
I was only able to collect STD on my full time job and recieved nothing from my part time job...so now I was living on 1/4 of my pay, it was beyond awful.
I didn't think my family and I would make it, it wiped any savings and retirement out we had.

My attorney and an attorney for GB go before a WC Judge.....GB orders me to have an Independent Medical Exam with a doctor the choose, of course.
They (GB) hire the best of the best, an Orthopedic Hand doc in Philly, this guy treats major athletes.
I go to my appointment, an eval and exam is done..
A few weeks later we get notice that the WC Judge has ordered another hearing to be updated on the case.
The day BEFORE the hearing GB faxes my attorney the report of the doc they had sent me to in which their very own doc says he believes the Carpel Tunnel is a result of my first job, agreeing with the other doctors. Not exactly what GB wanted to hear.
So GB and my attorney go before the WC Judge and it is entered that GB will pay all lost wages from BOTH jobs (minus the STD I recieved) and all my medical bills.
They have to reimburse my health insurance company.

The Stipulation Agreement is drawn up, I sign, my attorney signs, GB attorney signs and the WC Judge signs. Great...all settled right?
Pennsylvania WC Law states the Insurance Comapny has 30 days from when the WC Judge signs the Stipulatiion Agreement to cut your Compensation check.
Guess what? It's been way over that and they still have not cut the check, they keep giving the run around " Well it was cut on such and such date and sent out on this date" and we have yet to recieve anything.
So even though they were ordered by a Judge to pay out by a certain date they have yet to do so, as if they are above the law.
I will now ask that a Penality Petition be filed against them.

This whole case was a joke from the word go, it didn't take a rocket scientist to see it was my first job and not my part time job that caused the CTS.
GB wants to break you down so that you'll back down and not persue the claim..it's a game to them
They could care less about you and your family, you're a file # to them and a pain in the butt.
They could care less that you are on the verge of being homeless, can't feed your family, can't even buy the medication you need to function etc.
They could care less that they have stripped you of your dignity when you have to go and ask for someone to help when you've always taken care of yourself and family for 25 plus yrs.

To be honest, and I know WC laws vary from state to state, I don't even know why there is a WC law period, they are for the Employer not the Employee

Hang in there

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#3 Author of original report

Up Date Gallagher Bassett Insurance The RIP OFF Insurance Company Workmans Comp, ripoff, torture, scrooge, liars, Sadists Clearwater Florida

AUTHOR: Neil - (U.S.A.)

POSTED: Monday, August 27, 2007

As of date 8/27/07 I have now been told by my lawyer that GB wants more information. Not only that but as of date they have not yet even gave me any of the comp they owe me.

I have now lost my car which was repoed a few weeks ago due to non-payment. I still have no referral to get the needed evaluation or surgery done, and I am sinking fast. The worst part my mom passed away the end of this past month. I had to beg others around in order to get there for her funeral as I didn't even have the money for that.

GB thinks they are doing me a favor as they have finally sent me a prescription card to be able to get meds filled at no cost while this is going on. Funny thing though, they don't have me on any meds right now because everything that they had gave me didn't work. The doctor told me that they wouldn't prescribe anything further till I was evaluated by the pain treatment center and after the probable surgery that would be needed.

Personally if I ever go to work for another company in my life the first thing I would ask is who their insurance is with and if they said GB I would tell them "Thank you but NO THANK YOU!"

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#2 Consumer Comment

Yeah tell me about it--I'm just living with the pain.

AUTHOR: Nimoeheart - (U.S.A.)

POSTED: Monday, August 27, 2007

I was injured at Starbucks a while back--began developing carpal tunnel in my right wrist. First off, at the store level I had to fight just to be able to report it and see a doctor. Nobody cared and my manager and district manager just kept saying they didn't know where I was supposed to go--I ended up tracking it down myself.

Finally, I got to the doctor and my case was handled by Gallagher Bassett. First off, my claim kept getting handed to someone else and they expected me to keep filling out the same paperwork and retelling them the situation over and over again. So, I just stopped taking their phone calls because either way they had to pay for the doctor.

Ah yes, the doctor...I used to think that people's complaints about doctor's being in someone's pocket (as in owned by a company) was just paranoia. How wrong I was. This guy made it very clear that I would be getting no real care, that I wasn't in pain (though I was, so much so that it would wake me up at night), and that I would go back to work as usual. I ended up quitting my job because my injury was not being taken seriously--probably exactly want they wanted. The last time I saw the doctor, when I realized it was absolutely futile, I told him "it still isn't better. It isn't healed; anytime I use my hand for anything it hurts all the way up my forearm." His response: "So." My response: "Well, you just said you are going to discharge me and close my case. What if it gets worse, or needs surgery or something? What does it mean for my future that it still isn't better?" His response and last words: "It doesn't mean anything."

Obviously my complaint relates to Starbucks as well--they treated me very poorly throughout the whole ordeal. However, I just wanted to respond and let you know I've been there, am still injured, and understand that going to a doctor assigned by Gallagher Bassett does not indicate that you will actually be recieving any medical care/treatment.

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#1 Consumer Comment

I Sympathize with you Neil!!!

AUTHOR: John - (U.S.A.)

POSTED: Monday, July 23, 2007

I am in the same boat in Texas as your are in Alabama. The big difference about Texas is that I can't even find a Lawyer that will help me with my matter. I have tried to resolve things myself. No matter what I information I give GB, they come back wanting more or something totally different. Gallagher Bassett strives on stall and scare tactics towards injured employees. You know you are in trouble when you are invited to an informal meeting between GB, yourself, and the State mediating the whole thing when you find yourself up against a GB attorney instead of an adjuster. GB banks on this intimidation style to scare off the injured employee and make them want to give up. Hang in there Neil....

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