Insurance Services Office
Tristar Risk ManagementThis business is NOT BBB Accredited.
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Complaint Details
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Initial Complaint
01/16/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
I filed a claim with my business insurance carrier Clear Spring which is managed by Tristar Risk Management on November 8, 2022. The claim also went to arbitration with **************** ************* on May 2, 2023 which was decided without representation from our insurance carrier nor Tristar. ************ and Tristar have now taken the position of penalizing us by not paying for the entire claim because of cooperation clause despite us notifying them of our need for help with representation for the arbitration meeting. We now need help now that they have not acted in good faith.Initial Complaint
10/03/2022
- Complaint Type:
- Order Issues
- Status:
- Unanswered
Tristar provides coverage to injured workers. ***************************, was injured on the job and received treatment at our facility on 07/31/2020 and 06/25/2021 . Both treatments were identical and in the first bill, we received fair payment in the amount of *******. But the later date only produced a payment of$ ****** , for the exact sane treatment. We then collected documents supporting fair reimbursement rate and sent Tristar a reconsideration of payment in August of 2021. Since then we have been calling and trying to discuss these terms and I always am directed to a person named *****. ***** is in no way by definition a professional. ***** disregards faxes and phone calls and when actually on the phone, she speaks over the caller, she speaks with condescendence and she does not let the other party talk. She then requests you send the same information, that has already been sent 4 times prior, with proof, again. ***** refuses to do her job and deflects all responsibilities to other departments, but when I reach out to other departments, they all redirect me back to this unprofessional. ***** refuses to give names and contacts of her manager or supervisor. Tristar needs to find some consistency in coverage for their members, and they need to better train the employees they have left on their own. Tristar owes a minimum of ****** to our facility if they were following CMS guidelines, but they truly owe an additional ******* to us to remain consistent and fair inn reimbursement for treatment.
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Customer Complaints Summary
2 total complaints in the last 3 years.
1 complaints closed in the last 12 months.