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Insurance Claims Management

How nice to know there’s a TPA that’s going to lookout for the interests of independent auto glass shops. Wait....... where have I heard that before? Anyone who’s dealt with Paul Gross or HSG knows they’re no better than the other TPAs. Just because they don’t have retail stores doesn’t mean they’re going to help you out. And if they have as much trouble getting major carriers to work with them as HSG did they’re going to be non players.
Hard to beat billing direct and avoiding all TPAs. JMO

Re: Insurance Claims Management

But doing work for nothing will be good for you! Also, don't forget that you doing work for nothing just leads another to do it for less than nothing.

"where providers compete for business based on workmanship, customer service and price".

Translation: PRICE.. PRIce..PRice..Price..price.

I'm going buy me a bigger watermelon truck, and I'll haul more with some luck.
I'll haul some extra and do it for free, cause the TPA's know what's best for me.

Re: Insurance Claims Management

Insurers can't complain when a claim is filed direct in writing via mail, fax or email. Photos can take the place of physical inspections without prejudicing the insurer. If an insurer wants to hire a TPA to save on "administrative" costs they must bear the fees paid to TPA's, not service providers.

If a service provider submits an invoice directly to the insurer, it is the insurer's responsibility to either pay the invoice promptly or see that the TPA does without any delay.

If an invoice isn't paid in full, it is the insurer's burden to prove that the invoice was unreasonable. Unfortunately, the service provider will have to get the balance due from either the insurer or the insured and it may have to go to court to get it.

Mr. Wilson and Mr. Gross most likely have some insider knowledge to have invested so heavily.

Re: Insurance Claims Management

No thanks to anything either one of them have to offer. HSG may be the worst paying network out there. What a joke, looking out for the independents. Make sure to note not to include sales tax on your invoice because it is for "resale" so they can both mark it up AND charge to process the claim. Nice gig if ya can get it.

Will there ever be a fair TPA model developed that doesn't require independents to bend over? I highly doubt it...

Re: Insurance Claims Management

Just say no.

Re: Insurance Claims Management

As if it couldn’t get any worse

Re: Insurance Claims Management

I can't add much that Freddy and $0.02 put up, but one thing.

Didn't anyone notice that Jones Day was representing Riverside in the transaction?

How does professional ethics work when one huge legal beagle represents two large competing network providers or their owners, with no conflict of interest?

How many times has the question of "ownership" being hidden or "laundered" behind equity investors been asked by now?

I do know that state DOIs watch what insurers own, and have admitted that investment of money into private equity investors that may then re-invest that money into other "certain" business entities would effectively launder that ownership from oversight.

Can anyone be naive enough to believe that if an investor hands several hundreds of millions of dollars to a private equity investing firm, that they won't have "some" say in how or where that investment company invests their money?

There's more to this onion, or big ball of string, of course, but that should be enough to make you think about all of the private equity investors that have invested monies into this incredibly lucrative and cash rich auto glass business we're all in, I would think, other than to add that "some" investors may not actually "care" if the glass company they were investing in actually makes a profit, because it's made elsewhere and otherwise.


Re: Insurance Claims Management

So I see you've dealt with Paul Gross LOL!!!!!

Re: Insurance Claims Management

Paul’s last name says it all. HSG lowballing shops and turning around and invoicing insurers at a higher price is nothing short of sleazy.

Re: Insurance Claims Management

Surprise, Surprise...some "extra" information cometh forth in the article in BSB, regarding who's who, and who-we-be-in-this-for-and-what-we'll-be-a-doin'-and-where-work-will-be-a-goin'. (J.N. Phillips Auto Glass, Techna Glass, Windshield Centers and Harmon Auto Glass)

In other words, so many big words, and warm 'n fuzzy descriptions of steering and price control. What they cannot "refer" to themselves, they'll "fix" pricing to "allowed market pricing". Sound familiar? In a way, I suppose you can't blame them for "fighting fire with fire", but then, unlike the movie "War Games" one cannot invoke the solution "The smartest move is NOT to play!". Not without repercussions, of course. Again, sound familiar? Bottom line: to compete, or even have access to the market to try, one must become what one abhors?

All based on ignoring one simple fact: Insurers don't contract for repairs to cars, therefore, TPA's cannot be either, by default, and can't subcontract to anyone else. There is NO such thing as "insurance work".


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