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Complaint / review / scam report
Gallagher Bassett Services in Corona, CA
Complete Mishandling of Workman's Comp Claim Follwoed by Wrongful Denial

Complaint / review text:
So I am a young, physically healthy woman who got sucked into a really stressful job; they are known to take advantage of good workers and as time progressed, new management took over and the environment was so stressful, 10 people quit in 1 month...which left us even more stressed because we had extra work.

I got hired at this company in April of 2013 but I took a promotion to a Claims Representative in February of 2015.

I had never been treated for nor diagnosed with a mental disorder in my entire life; I was only 20 when I took the promotion to Claims.

Within less than a year, I had been severely taken advantage of, verbally abused by managers and even clients, and given extra workload...even work completely out of my job description and being required to do other people's and even manager's workloads because they were slacking off.

I was put on FMLA by my primary care doctor in January of 2016, and again in March of 2016 after a suicide attempt. They had me on all kinds of medications that were messing with my head.

When I have panic attacks, they always stem from work...whether I'm thinking about work, going to work, or especially at work. It actually causes physical pain. I've been to the ER twice for severe shooting chest pains, thinking they were in relation to a heart attack. My pulse will increase drastically, my entire body will quiver, my breathing will become rapid or labored and I will get dizzy/lightheaded.

When I returned to work in April, for awhile the managers had finally started to back off and were allowing me to complete work at my own pace. I was doing a good job and continuously being commended for being the top rep on the floor.

Things took a dramatic turn for the worst starting in July of 2016. New management took over and they began laying people off, one of which was my mother who also worked at the company. Not only did the lay offs cause a massive spike in workload, but they had the nerve to force me to do my mom's job in her place because the department was so behind. 10 people quit within a month; leaving us with more work. I was not only taking care of my own workload, but was doing other people's files as well in addition to performing tasks entirely outside my job description which was distracting me from handling my own files, thus causing me to fall further and further behind. They even started having me do things I didn't want to do; they at first would ask me how I felt about doing certain tasks and I would politely decline, but they would still end up making me do them, anyway.

It eventually got to a point that my meds had stopped working entirely and I was feeling extremely depressed and anxious again. I had a panic attack right at work in front of several witnesses. The VP of Operations saw me collapse and rushed me to his office and had people bring me water.

I refused to leave work and go to the ER because we get penalized every time we leave early or call in sick, and I didn't want to be put on FMLA again because I couldn't afford to take more unpaid time off. The woman who worked in HR at the time but is now retired brought me a workman's comp form and asked me if the job was the cause of my stress. I advised her it ABSOLUTELY was. She had me fill out the form and let me know based on what I was saying, there was no reason the claim should be denied.

I was placed on FMLA two weeks. The claim was submitted to Gallagher Bassett in the beginning of October. My representative Antoinette McCargo never returned my emails nor phone calls; she actually exceeded the 30 day timeframe that insurance companies are REQUIRED to send status updates, and would make me repeat information several times that was already there in writing (I.E. I asked her if she received my MAILED forms, and she asks where I faxed them. I told her again they were MAILED and even capitalized the word "MAILED" and she asks yet again for me to provide the fax number. This was a common thing for her).

I eventually got a denial letter, stating the reason for denial was there was no proof my stress was job-related.

I took it upon myself to order my own records, even going back to January and March. Every single medical record indicated I told the doctors (FOUR different doctors, mind you) that my stress was being caused by job.

I ended up dealing directly with Antoinette McCargo's supervisor Carole Sharp and sent her every medical entry that pertained to this condition, even directing her attention to which pages specifically noted my job as being the source of my condition. They have still remained by their decision to deny me.

This whole process has actually aggravated my symptoms, as you can imagine. It is especially hard for patients with mental disorders to receive benefits because insurance companies just LOVE denying for mental-based illnesses...I should know; I work for an insurance company!

This is a legitimate claim. I would understand if my medical records did not list my job as the source of my stress, but to have it specifically notated on four separate office visits (not to mention having 5 witnesses AT work that witnessed my panic attack which caused me physical harm) is just beyond me.

I would like this settled. Carole Sharp had indicated they may offer me a settlement but of course provided no information as to how one would go about this. I just need the money at this point. This was the whole reason I initially refused medical treatment in October for fear of taking more unpaid time off. The only reason I accepted it was because I was told there was no reason my claim should be denied.

I may just pursue legal action and see if I can also get paid for January and March, since I was not offered workman's comp forms at that time and was not aware I could even claim for workman's comp. I would most definitely also be applying pain and suffering, as the original rep completely mishandled my claim and ignored various emails. She would only respond if I threatened to talk to her supervisor, which is not right.

Not only that, but they're just completely untrained in customer service. Aside from not being able to READ SEVERAL emails all saying the same thing, not once did I ever receive a simple, "I understand what you're saying", "I understand your frustration", or not even, "We apologize we were not able to assist you"...which are just generic, bare-basic simple acknowledgment statements most companies will provide you...even if they don't agree with you, it's a matter of principle.

Contact information:
Author: Ashley Martinez


Offender: Gallagher Bassett Services in Corona, CA

Country: USA   State: California   County: Corona   City: Corona   Zip: 92880
Address: 391 N Main St #301
Phone: 9512790073
Site: https://gallagherbassett.com

Category: Miscellaneous

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