May 4, 2021

Mr. Charles J. Verre

Chief Administration Officer

Worker’s Compensation Section

3300 W. Sahara Ave. Suite 275

Las Vegas, NV 89102

 

 

REF:       Injured Employee:           Kevin Cloney

               Claim Number:                  WC617-A-16640

               Date of Injury:                   September 12, 2019 (600 days since accident)

               Employer:                           Vegas Hot Air sin City Balloon

               Insurer:                               LM Insurance

               Adjuster:                             ASHLEE ISBELL (Adjuster # 3397993)

               Attorney:                            DANIEL SCHWARTZ                        

              

Again, I am forced to appeal to you in reference to the above issue and the lack of enforcement as ordered by Appeals Officer McKay on September 30, 2020 Hearing No: 2005112-TH Appeal No: 2008519-DM to provide “Mr. Cloney (to)receive all apppropriae benefits pursuant to Chapter 616 of the NRS.”

 

To date I have not received any medical or financial benefits from ASHLEE ISBELL. My attorney, JASON WEINSTOCK, has had over six hearings and over twenty hearings pending on the over thirty-six denials over burdening the court system costing Nevada citizens thousands in wasted tax payer dollars.

 

I have attempted to resolve this issue through the Nevada Division of Insurance File a Complaint portal Doi.nv.gov/consumers/File-A-Complaint/ also without success.

 

 

 

 

 

 

Complaint Created Date 01-31-2020

     

                 Status Closed

 

 

 

 

 

Posted By:

Submitter

Posted On:

05-03-2021

599 days since my accident without resolve. UNBELEIEVABLE. Although I notified my personal health insurer, Humanna, about this debacle. They continued to allow me to be treated for injuries that Liberty Mutual has continued to deny. NOW Liberty Mutual claims adjuster ISHLEE ISBELL has contacted my Humanna providers (Drs, PT et al) and notified them it is against Nevada law to treat me. Now I am without pain medications PT, OT and disability income I again turn to the Dept of Insurance for enforcement NRS 616X

 

Posted By:

Submitter

Posted On:

04-07-2021

Workers comp is under the Dept. of Insurance and links me back to this file a complaint link. Attached are letters sent to both of Nevada Senators, Representatives and two letters to the Governor requesting assistance.  Kevin

 

Posted By:

State

Posted On:

04-07-2021

Perchance have you filed a complaint with Worker’s Comp regarding this issue?

Tanishia

 

Posted By:

Submitter

Posted On:

04-01-2021

Yes, I do have an attorney in actuality I have had two JILL KOLOSKE with Nevada Attorney for Injured Workers in which we had two hearings to oppose DANIEL SCHWARTZ, attorney for LIBERTY MUTUAL, blatant disregard of Nevada workers comp laws. Now with JASON WEINSTOCK, who has already had over 6 court appearances with twenty (20) still pending. This makes me wonder if  this is LIBERTY MUTUAL’s ASHLEE ISBELL’s Modus Operandi since becoming an adjuster in 2014. And if she has abused the system against other workers comp victims with less organizational skills and persistence to receive justice and compensation for injuries. This may be justification for auditing and investigating their operation.

 

Posted By:

Submitter

Posted On:

04-01-2021

Thank you.  Appreciate your persistence. As of today my personal insurance billings are over $125,000 and my out of pocket (deductibles and co-pays) are over $14,000. No income ( injured can not receive unemployment) Thank God for family and friends and the selling of my vehicles. Kevin

 

Posted By:

State

Posted On:

04-01-2021

You’re welcome. I can understand your frustration but we have certain protocol to follow regarding regulations. If the Division can prove a violation, of course we can enforce it. But as I said previously, we cannot force a company to pay without solid evidence of a violation. We usually can get the company to reconsider their position before it gets to the point of enforcement.

In your case, my supervisor and I have spent hours discussing your case and reviewing our statutes to try and find a violation. Having an attorney, also, complicates our actions as well since we do not supersede the courts. Most of the delay with this complaint was spent waiting for the hearing(s) to decide if you were approved. The Division cannot supersede that or enforce anything while legal proceedings are pending.

At any rate, if we can find and have subjective evidence of a violation to the NRS you mention in your latest letter, we can definitely enforce and advise them what further action is needed on their behalf (within reason) to resolve your issue. I will update you asap.

Thanks,
Tanishia

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Posted By:

Submitter

Posted On:

03-31-2021

Thank you. I am disappointed in the lack of enforcement action from those enities that have been empowered to protect the employee/victims of incidents in Nevada. Unbelievable.

 

Posted By:

State

Posted On:

03-31-2021

Thank you for the information. I will send your concerns to the company to respond to. Depending on their response, the Division may have follow up questions for them in regard to the delay. I will update you when I receive more information.

Tanishia

 

Posted By:

Submitter

Posted On:

03-26-2021

562 days since the accident without compensation. Yes I have additional anguishes. For review: ‘Posted by State Posted on 10-13-2020 ‘I was advised by their counsel yesterday that your case was approved and they are working out the details of your back pay.’ Never received! Although court ordered and claim accepted LIBERTY MUTUAL’S ASHLEE ISBELL, claims adjuster, has denied ALL treatment and although compelled by a March 3, 2021 Decision and Order for Hearing No. 2106173-RS finally agreed to my receiving an IME determination from Dr. Kaplan. Now on March 19, 2021 ASHLEE ISBELL has denied Dr. Kaplan report and added her notorious ‘deny and defer’ tactic of stating that ISO reports for multiple auto claims (my ex-wife’s), which happen while separated and I was out of state, now need to be addressed. Even though she knows that these occurrences are unrelated to this workers compensation claim. In addition, ASHLEE ISBELL’S recalculation of my disability benefits again has not taken into account that my earned, but not paid, income for two days of work (Sept 9 & 12, 2019 with the 12th being the day of the accident) is still not correct.  It is appalling that ASHLEE ISBELL can, without penalty, continue to defy court orders for compensation and that the requests for enforcement by me from the Nevada Department of Insurance tasked to protect victims of insurance company abuse and of Nevada laws including NRS 616D.120 3(c) which states: ‘Refused to pay or unreasonably delayed payment to a claimant of compensation or other relief found to be due the claimant by a hearing offer, appeals officer, court of competent jurisdiction.’ All of the above unduly burdens the court system and unjustly denies compensation to those of us, who while working, in the state of Nevada to serve our visitors, residents, and employers are hurt physically and financially without relief sometimes resulting in destitute situations for not only the employee but their dependents. Unbelievable (uploaded: Exhibit 1 Incident Statement, C-4 Employee Claim for compensation, March 11 2021 denial, FAA 14 CFR 61.51 Pilot’s log, February 12, 2021 recalculation denial, November 6 2020 agree to schedule IME ‘once all medical records have been received.’ (Unbelievable that denial of claims can be withheld pending receipt of all medical records) October 12, 2020 notice of claim acceptance, January 5, 2021 denial of payment due to needed ‘off work slips’ from permanently closed Vegas Hot Air Sin City Balloons business. March 19, 2021 Denial of acceptance of IME report, certified letter to Nevada’s Governor the Honorable Steve Sisolak requesting assistance.

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Posted By:

State

Posted On:

01-08-2021

Thank you for your additional concerns. This is an issue for your attorney to take back to court to figure out. Because the issue is a matter for the courts, if you later find in the court process that the insurance company possibly violated one of Nevada’s laws, you can contact us with your concerns at that time.

Tanishia

 

Posted By:

Submitter

Posted On:

01-06-2021

January 6, 2021

REF:
Response to Ash Nazeri’s  January 5, 2021 letter
Claim: 617-A16640
Employer: Vegas Hot Air Sin City Balloon
Date of Injury: September 12, 2019
Complaint ID: 50197


Dear Ms. Abarrane,

It is true that Liberty Mutual Insurance has accepted the court ordered determination to assume responsibility for my September 12, 2019 work related accident. However I consider them in contempt of court and Nevada law as to fulfilling their responsibilities for compensation for lost of income and payment of related medical expenses.

Mr. Nazeri’s January 5, 2020 response to my DOI complaint states that; “Subsequent determination letters were sent to Mr. Cloney advising that in order to pay benefits beyond October 17, 2019, off work slips were needed.” Mr. Nazeri is aware that Vegas Hot Air Sin City Balloon, et al, is no longer in business therefore “off work slips” are not available.  

I have delivered and continue to deliver copies of MRI, CAT scans, X-rays and doctors’ narratives as to the severity of my injuries to ASHLEE ISBELL, Technical Claims Spec II, WC, who continues to deny access to Dr. Kaplan , IME, (see NRS 616c.145 access to Independent Medical Examiner) stating that “once all medical records have been received” she will consider access to examination and payments (see 616D.120. “refused to pay or unreasonably delaying payment to claimant..)

Now over 470 days after the accident without employment and continued nonpayment by Liberty Mutual I implore that you take enforcement action against, ASH NAZERI, Claims Team Manager, ASHLEE ISBELL, Technical Claims Spec II, WC and Liberty Mutual Insurance et al. and continue to monitor this claim per your stated mission “To protect the right of Nevada consumers in their experience with the insurance industry…”

Sincerely,


Kevin Cloney

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Posted By:

State

Posted On:

01-05-2021

We have received a response from the carrier regarding your additional concern(s). I have attached it for your review.

Tanishia

 

Posted By:

Submitter

Posted On:

11-30-2020

Tanishia Today I left you a voicemail message.  This matter is not resolved!

 

Posted By:

Submitter

Posted On:

11-09-2020

Yes they have accepted the claim HOWEVER after 14 months of lost income and thousands of dollars in medical bills they continue to deny and defer all but the first month.

 

Posted By:

State

Posted On:

10-13-2020

I was advised by their counsel yesterday that your case was approved and they are working out the details of your back pay. Because this appears to be resolved, I will be closing out this complaint. If you need further assistance with payments after the fact, the proper agency is the Division of Industrial Relations and their number is 702-486-9080.

Tanishia

 

Posted By:

Submitter

Posted On:

06-17-2020

Extremely disappointed. Court today was continued to 8-11-20 as a result of your lack of action.

 

Posted By:

Submitter

Posted On:

06-03-2020

What is the status of this complaint?  Thank you

 

Posted By:

Submitter

Posted On:

04-23-2020

Policyholder’s telephone numbers office 702-468-2426  Bruce 208-941-2625 & 817-917-1700. Andrea 702-468-0823.

NRS 616A.105  “Employee” and “worker” defined.  “Employee” and “worker” are used interchangeably in chapters 616A to 616D, inclusive, of NRS and mean every person in the service of an employer under any appointment or contract of hire or apprenticeship, express or implied, oral or written,…

 

Posted By:

Submitter

Posted On:

04-22-2020

I just posted THE TEN WORST insurance companies in America. How they raise premiums, deny claims, and refuse insurance to those who need it most. Published by American Association for Justice.  It is Modus Operandi for Liberty Mutual. Where is the oversight, enforcement and justice promised by DOI?

 

Posted By:

Submitter

Posted On:

04-22-2020

No contractor condition exists therefore no insurance exists other than my medicare. Sounds like BAD Faith and professional liability.   Policyholder, all 3 principals, are stonewalling. All the while I am hurt and without income. Where is the justice and oversight?

 

Posted By:

State

Posted On:

04-22-2020

According to the carrier, the contract is needed per their policy to verify if the contractor has their own insurance. They state they’ve been trying to get a contract from the policyholder during their claim investigation.

Once the Deputy Commissioner has advised me on the next step, I can let you know if we need anything from you; but right now we are pending his review.

Tanishia

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Posted By:

Submitter

Posted On:

04-21-2020

There is no contract see SUMMARY (uploaded.) No signed contract as independent contractor. Verbal contracts are legal and binding.  See GA’s WC myth (uploaded) it defines EE vs IC. see TEXT MESS from owners (all 3)saying they will call (to resolve.) Why would they offer if not an EE. Journal note denying claim for drivers over 60 year. Then changing story. BAD FAITH. FAA finals will take up to 2 years. See FOIA (uploaded) FAA report not relative to proving injury see injury report.BAD FAITH

 

Posted By:

State

Posted On:

04-21-2020

Do you happen to have a copy of this contract they refer to in their denial? Did the company you contracted with ever make you sign a contract for the intermittent jobs?

Tanishia

 

Posted By:

Submitter

Posted On:

04-21-2020

I was seriously injured on Sept 12, 2019, original denial was because they don’t cover drivers over 60 years of ago.  I was flying. Now denial because of no FAA report. Preliminary report submitted I was injured while flying a hot air balloon for Sin City hot air ballooning FACT. I was an employee FACT. I’m in serious pain without income or medical benefits from Liberty Mutual FACT. BAD FAITH is not a violation? NRS 42.005?  Yes, hearing is June 17,2020

 

Posted By:

State

Posted On:

04-21-2020

So far we haven’t found a violation but I have further questions which need to be reviewed by the Deputy Commissioner. Once he advises me, I can let you know. We may have to wait for your hearing if it is still scheduled for June.

Tanishia

 

Posted By:

Submitter

Posted On:

04-16-2020

What is the status of this issue?  I am without income nor workers comp. support for medical assistance. Very disappointing.

 

Posted By:

State

Posted On:

03-11-2020

OK thanks for the information! 🙂

Tanishia

 

Posted By:

Submitter

Posted On:

03-09-2020

2-3-20 hearing was continued at the request of Liberty Mutual to June 17, 2020 :-/

 

Posted By:

State

Posted On:

03-09-2020

Hello! I was wondering if there’s been any result of your 02/03/2020 hearing? Thanks in advance!

Tanishia

 

 

                                                                                                                                                                            

As you can see “Pursuant to NRS 616D.120 DIR/WCS” nothing has changed other than I have spent thousands of dollars in my attempt to achieve a quality of life I had before the accident without assistance from entities empowered to help.

Sincerely,

Kevin Cloney

Cc: Rep. Susie Lee, Sen. Masto

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