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Sedgwick Claims Management Services
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1.4 389 Reviews

Sedgwick Claims Management Services Complaints Summary

41 Resolved
347 Unresolved
Our verdict: With Sedgwick Claims Management Services's very poor resolution rate, careful consideration is needed. Research their service comprehensively, and read up on how they handle customer disputes. If you face issues, be prepared for potential challenges in obtaining resolutions and explore other service providers as backups.
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Sedgwick Claims Management Services reviews & complaints 389

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3:10 pm EST
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Sedgwick Claims Management Services Customer service

My name is Ray Armour from the King Law, our office represents Nateisha Fullwood in a personal injury matter. Our office has sent the medical package to Debra Romero on JUne 7, 2021 Ms. Romero had family leave and Ms. Janet Galbreath claims to try to resolve this matter. The claim number is [protected]-GL we have not heard from any one or have they sent any emails regarding this matter in 6 months or more? When you call her on her phone the voice mail states she is on the phone on the first ring this continues all day I have tried to reach her 4 times in one day never to have any all returned and my boss has tried also.

Desired outcome: Need someone to call our office with a resolution [protected].

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3:08 pm EST
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Sedgwick Claims Management Services My claims adjuster, Joan DeLuca will not respond to any correspondence.

File# 4A22037JTQK-0001

Injury occurred on 3/07/2022 at the CVS Pharmacy store in Helena, Montana. I was shopping and fell. My orthopedic physician and my physical therapist have completed their care related to my injuries. I still have limited range on motion in both my right shoulder and right hip. Right ankle remains more swollen than the left ankle due to the fall.

I have received the final documents from CMS/COB&R.

Desired outcome: Can I speak to a supervisor regarding a final settlement?

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6:33 pm EST

Sedgwick Claims Management Services FMLA process

My yearly FMLA ended in 11/22, I received a notification for extension. I responded yes, got the paperwork filled out & return on 10/20/22. Received a text stating I was approved from 11/04/2022 through 11/03/2022. Then another text stating if extension is needed submit in 20 days. 11/14/2022 I opened a new claim, new paperwork was returned by 12/01/22. On 12/06 received a call stating my doctor missed #8, doctor completed #8 & returned on 12/07/22. 12/23/22 I was told on12/20/22 the paperwork has to be resubmitted & reviewed. I've been called stating days was denied for days I didn't report.

Desired outcome: I've called for a supervisor and requested a new lead and received nothing but problems & no response from a supervisor.

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Update by Cassandra Germany
Dec 23, 2022 6:46 pm EST

My yearly FMLA ended in 11/22, I received a notification for extension. I responded yes, got the paperwork filled out & return on 10/20/22. Received a text stating I was approved from 11/04/2022 through 11/03/2022. Then another text stating if extension is needed submit in 20 days. 11/14/2022 I opened a new claim, new paperwork was returned by 12/01/22. On 12/06 received a call stating my doctor missed #8, doctor completed #8 & returned on 12/07/22. 12/23/22 I was told on12/20/22 the paperwork has to be resubmitted & reviewed. I've been called stating days was denied for days I didn't report. I never had this problem before; I have done what has been asked and every time I call with concerns my rep retaliates with a new problem that shouldn't be. This is causing more stress with my health.

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4:16 pm EST
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Sedgwick Claims Management Services Sedgwick claims company headquarters is Tennessee

This grievance isn't about a specific date or name. It's more of a "more than 60% of the phone calls to Sedgwick about my temporary leave resulted in different answers from the different Sedgwick associates manning their company lines". My temporary leave began on September 26th 2022 and was originally dated for October 31 of same year. My first leave ever. I certainly did not have any guidance from my specific Walmart store so did not realize I was only making my requests difficult for me as the suggested specialists i needed to see would not be able to accommodate such a short leave. So having to repeatedly contact Sedgwick to extend my leave resulted in pay interruptions. Walmart company uses Sedgwick as their claims service company. A couple of things i am realizing is 1: Sedgwick does not update my claims file with pertinent information like who took my call and what was said or information they gave. 2: Because their records on my claims are not updated and they give out information associates on leave want and need to hear, when asking to complete said survey I gave a thumbs up because i believed them. Now, over this temporary leave that dates to December 31st, i am not being told the same information. For example, on December 5th 2022, I called to make certain my pay leave had been approved and would drop on December 16 (told this) to today, December 15th, am told December 22. I am a single income that is going without pay from November 21 to December 22. I cannot get to my physical therapy appointments without money. Please help Sedgwick to understand consistency and updated records are a must for associates on leave. If this isn't part of their claims work, what is? I am Debbie Jones and my phone number is 903.219.1466. My win # for Sedgwick is [protected]. Thank you

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WN916
, US
Jan 18, 2023 9:14 pm EST

I believe the time has come for a Class Action lawsuit from everyone around the country injured or incapacitated in some way having to undue additional stress and risk to their health, well-being, and overall success in recovering.

Document everything.

Be polite

track how much time is invested by you and anyone else helping you

Document any expenses incurred in having someone help you

File a complaint with your state

File a complaint with federal agencies for matters such as FMLA or ADA-related matters.

File a complaint with the company that has hired Sedgwick. In some cases, the company may be responsible for the vendor's actions.

Use a speaker phone and talk at a coffee shop where there is no expectation of privacy. You can in many cases record the conversation. Alternatively ask for all correspondence to be done in email, fax, or a medium that is available as evidence.

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10:37 am EST

Sedgwick Claims Management Services Claim

On 11/09 I filed a claim for STD I have been having neck pain and needed surgery. The agent assigned to my claim lied and said he tried to contact me but was unsuccessful. He never contacted me and denied my claim. I would have to file a appeal I just had major surgery on my neck 11/29 He denied my claim on 11/30 No communication was sent to me and I was told that a Nurse Care Team member would call me none of that happened. I called and a Employee in Advocacy Services Dept named Jacqueline hung up on me because I'm not supposed to be upset about this apparently. I spoke with another employee named Sara who made me aware that no one even looked at my appeal paperwork I submitted 3 days ago when I received a text message saying someone would be calling me back 2 days ago. They have treated me very much so like trash and I will definitely be letting my employer know asap.

Desired outcome: My claim to be approved and to receive all my back pay owed

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1:58 pm EST
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Sedgwick Claims Management Services Claim not paid despite sending all documentation

I have not received my payment since July 2022. I am waiting for my payment from July to November 4th. My claim rep keeps telling me the supervisor is reviewing. It’s been over two weeks.

I received a call from a nurse and when I called back, I was transferred to Kaiser?!?! I tried calling again and they said they didn’t have any record of me calling. When I asked to speak to the nurse again they said my claim was with the supervisor. I received a message from my rep saying they didn’t have enough justification to approve the claim but my doctor has provided all the documentation they have requested and even called and left a message. Still waiting. Rep advised me to have my doctor call the general number! And then what? No Instructions on whom to ask for, nothing! This is ridiculous!

Desired outcome: Get paid and close out my case. I’ve been released back to work.

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4:55 pm EST
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Sedgwick Claims Management Services workers comp. checks not received

waiting on my checks for 3 wks. It was coming regular in Oct. it started coming later and later, they say it's the postal service, then they say they're waiting to see if I cashed it well it doesn't take 3 wks. I'm glad they're receiving their check cause I'm not . They're just telling LIES to try and make people happy. I hope they have a wonderful Christmas because I'm not. I can't even pay my bills. now they're saying my checks come from Ca. and Ilive in N.C.. Well if they do come from Ca. what in the hell happened? Like I said one LIE after another

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9:50 am EST
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Sedgwick Claims Management Services Claims Examiner Workers Comp

My claims examiner Marilyn Mack had been unresponsive to my questions. She contradicts herself thru email and will not take my phone calls so we can discuss my case and my concerns. I am being paid but my providers are getting very rude responses from her. I was contacted by One Call Care Management which is a vendor of Sedgwick. They set up my PT appointments and after 2 appointments Sedgwick denied payment to the PT by saying I could not set up the appointments myself. I explained to Marilyn that if was her company/vendor that set up the appointments. She continued to say my PT was not in network. I have been leaving phone messaged for her that are never returned and emails are short and vague and does not address my issue

Desired outcome: I would like to have more open lines of communication and to continue with my Physical Therapy treatment program with the originally approved facility

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8:56 pm EST
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Sedgwick Claims Management Services Claims examiner

I have been on workman’s comp since May of 2022 & it has become a full time job. I do not feel like my new examiner is there to help facilitate my recovery. My first examiner was great. She went above & beyond to help but then they switched my examiner on me 6 months into my claim & it has been nothing but a hassle. Her name is Ciara Gilpin & she has no empathy or compassion for the situation at hand. She sends authorizations without following up & I end up finding out from my Physical Therapist that she continues to send the wrong forms/authorization over & over even after I inform her. So I have to leave emails & messages on the portal to tell her that she needs to send the same authorization that was always sent & not switch it up. My Physical Therapist has a protocol to go by just like Sedgwick does. It took almost a month for her to send the right authorization & in that time I had no PT on my shoulder & it froze up on me. She claims she doesn’t get the new scripts which I know they were sent because nothing has changed except for her being my new examiner. And I call my doctor & they tell me it was sent & they give me the dates. So I have them send it again. This never happened before. I feel like my recovery is being prolonged due to her negligence. I spend so much time dealing with all this when I should just be focusing on my recovery. I just had an IME appointment & the doctor suggested I get a cortisone shot in my shoulder to free it up & in my finger that is locking up on me due to my shoulder injury. Which has been a Sequela injury that occurred from my shoulder injury a month after I was injured. And now her exact words to me are “As for the cortisone shot for your finger, that will not be approved due to your IME report findings. Thanks!” No empathy whatsoever. I am very frustrated. I was injured on the job & cannot work & only make a fraction of what I was making. All I want to do is heal & get back to work. I should not have to do her job. She should follow up to make sure what she sends is actually right & it goes through. That way there is no glitches in my recovery. As soon as I send my work release from my follow up appointments with my doctors there is ALWAYS a new script that follows. You know this because my work release is still to not return to work. And if she doesn’t receive the script like she says right after I send the work release then she should call & see what’s going on. That would be caring. Instead I just assume she gets it because I know my doctor sends it & when I remind her to send the new authorization she tells me she never received the script. My question is why doesn’t she let me know she hasn’t received the new script within a week of me having my follow up? Or why hasn’t she called the doctor? It is not my fault that I was injured & I expect to be treated as so. Sincerely.

Desired outcome: I would like an examiner that has a little more empathy or compassion. And will go out of their way to make sure things are taken care of so all I have to do is recover. Sincerely.

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12:24 pm EST

Sedgwick Claims Management Services Aaron Price

He is my claim adjustor for over a year & I have only spoken to him ONCE. He does not respond to email or voicemail & most things I need have to go through him. I am still under workmens' comp so they will only do what he approves but since he does not respond to anyone I have been waiting around with no way to actually resolve anything. It is a very bad way to do business and is very frustrating as I have been extremely patient.

Desired outcome: I'd appreciate a response and concurrent follow-ups regarding my claim as I cannot do anything without him.

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12:06 pm EST
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Sedgwick Claims Management Services an error in my last claim.

i request a loa for medical family care . i tarveled out of my state to suppor a family, sedwick is asking me for my medical documents and they decline my LOA, i was not the person tha was sick , i can"t understand why they are asking for that and denied my LOA, i need somebody rewiev my case please, thanks,

Berta leon

walmart hourly associate

W#[protected]

LOA DATE: 10//22/2022

Claim #:4A2210R0GF10001GL

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10:54 am EST

Sedgwick Claims Management Services I am complaining about the nonresponse I receive from the claadjusters

My name is Surayya Benjamin. My storage was compromised. I filed a claim. I sent the pictures, police report etc. I have had three different claim adjusters and they all have the same attitude which is not responding to the emails nor the calls. I have emailed and called daily for months. It's frustrating having to have an unit compromised (some items will never be replaced) and not giving the updated or just to speak with someone is unacceptable. I have contact BBB to help as well.

Desired outcome: I would like to speak with the adjuster personally to ask questions I have in regards to the claim and to see how much longer will it take to be processed.

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11:40 am EDT
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Sedgwick Claims Management Services Non responsive to claim

I have a claim that Sedgwick administers on behalf of AT&T. My claims examiner is non-responsive to my dozens of emails and phone calls. I would appreciate someone giving me a response on my claim. AT&T did the work laying fiber in our neighborhood. This caused a wash out under my driveway and required repair. We filed a claim over 2 months ago and our "claims analyst" has been non-responsive to my calls and emails. We have submitted all the required paperwork, photos, etc that they required to be sent to them in 14 days. Yet, they can go quiet on you for over 6 weeks with no recourse. The fact that AT&T allows this to their customers is unbelievable. This is poor customer service!

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11:35 am EDT

Sedgwick Claims Management Services FMLA Claims Management

April 22. 2022 - My primary care physician took me out of work due to stress and anxiety. At my appointment the date before my blood pressure was 170/110. I was informed by Sedgwick i had to be seen by a physiatrist within 30 days. I have been seen by 4 physiatrists and I am in Therapy with a talk therapist since I went on LOA. Sedgwick has so far denied my paid FMLA claim they did however approve my unpaid LOA. I am continuing under a physiatrist and Therapist. They always have an excuse why they deny my paid FMLA claim. I need help to be paid for my time out of work due to stress, anxiety and PTSD.

Desired outcome: I want to be paid for all my time out of work for the time period of 4/22/2022 thru 10/2/2022.

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10:44 pm EDT

Sedgwick Claims Management Services Sedgwick cms loss of use lost income and commercial vehicle diminished

On 07/29/2022 Im delivering freight. I go in the Truckers break room. Employee comes to me is that your truck you might wanna take a look. I go outside Truck is leaning to the side. I go back in to the check in clerks window . She says we had a accident. Management told forklift driver to use pallet jack but shift changed and worker used forklift. Ill let you in Secured warehouse to take pictures. Forklift has crashed onto Truck. I file claim immediately. I was not even near the Truck when negligence happend. 1 week later Sedgwick is handling claim and fault is clear. The company they represent is contacting me hey our vendor couldn't fix as parts have been discontinued you can have your insurance come get it. Sedgwick comes in separate communication. We can fix it in 2 days this is 1 month in. Offerd the price of rental truck for 2 days and payment to get it fixed. I decline immediately. Send a letter to Sedgwick and Company they represent stating what happened and price for rental and price for same Truck along with 90 days of companies invoices in a spreadsheet as im a Owner Operator but also have contractors drive rental Trucks . Now i get a different adjuster who promise to get Truck fixed by outsourcing parts. For a month trucking going to be pick up and towed to shop. Finally adjuster says truck is in the shop being fixed. I ask for damage report they give me nothing. Finally I file complaint with Insurance Commission and get a lawyer. I asked for copy of policy adjuster will not comply. I say its for Insurance Commission Investigation still nothing. insurance commission contacts me hey we need the insurance info since Sedgwick is just a third party. I email adjuster agin to get info nothing and still no damage report . So adjuster comes back hey your Truck is fixed and has been returned to the facility where accident happened over 200 miles away and 62 days in. I state since I have no income for 2 months and paid company bills for August thinking claim would be finished theirs no wayI can come down their. Meanwhile send damage report and oolicy info. They send a invoice estimate of supposed work done. My lawyer advised me to pick up truck since they fixed leaf springs but not rest of rear suspension for boxtruck. So i pick Truck up. Truck is wobbly shaking jumping and hard to control. Almost crashed multiple times. No way I could haul anything. Plus Company stole my pallet jack and straps. So i get it to parking lot near home. Email adjuster truck is not fixed she swears it was fine when they dropped it off. Tells me send repair estimate from my mechanic. Also to have Insurance Commission contact her. He is steaming and says add them to email thread. Meanwhile I submit actual rate cons for loads Ive personally done not from contractors I hire. So I finally get Truck to my mechanic he went underneath the parts they fixed is still broken. Probably other things as well especially since you drove with it broken

Desired outcome: I would like for Truck to be fixed how it was before their client damaged it. Also loss of use of commercial vehicle, downtime lost income, diminished value lawyer fees

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4:36 pm EDT

Sedgwick Claims Management Services Fraudulent statements by worker

The worker Rick Pope has been making false statements to my employeer.. he has been relaying them wrong information and refusing decisions from a workers compensation law judge.

Advising my employer I do not have a valid WC claim when I do and it has resulted in over $200,000 in lost wages as well as being wrongfully terminated due to a work related disability.

Desired outcome: Restitution for $250,000 for lost wages and pain and suffering.

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2:26 am EDT

Sedgwick Claims Management Services Complaint / acceptance

I had two hand surgeries this year to repair tendon and nerve laceration. Surgery is a small part of this type of repair with immediate commitment to physical therapy as being equally important if not more so any positive outcome. My job is 90% typing Sedgwick repeatedly denies my STD claims in the past 2 mths. My surgeon spells this out but Sedgwick LIES about receipt of paperwork. Their job is to make sure employee gets to collect their benefits. It's frustrating, unnecessary stress, even leading to bankruptcy in extreme cases. I do not know how this company is allowed to operate legally.

Desired outcome: I want my claim approved and back pay issued.

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1:59 pm EDT

Sedgwick Claims Management Services My claim management

Hi my name is Maria Rodriguez I have been dealing with my claims management for the last two months and i am not very happy with him when i try talking to him he talks over me to where dose not want to here me out I feel that I am being discriminated against because of my name I have been getting paid every month around the 12 every month and know he wants to pay me where when every he wants to and because of him I am behind on my bills. I dont remember his name because I have had to deal with 4 claims Managements in the last 7 months.

Desired outcome: I would appreciate if I had a different claims management that willing to work with me and treat me with respect I am a 3rd genration I was born In Prescott Arizona.

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8:43 am EDT

Sedgwick Claims Management Services Negligent auto repair

On September 3, 2022 I brought my vehicle to National Tire and Battery in Houston, Texas for a simple oil change. The service technician improperly installed the oil filter resulting in a total damage of my engine. I immediately filed a claim with their insurance company Sedgwick. However, I have discovered that Sedgwick's primary practice of handling claims is simply to allow your claim to drag out with little to no communication from the claims adjuster or representative, it has now been a month and two weeks, and I have heard absolutely nothing from them. It is no wonder that Sedgwick has a D-

rating with the Better Business Bureau.

Desired outcome: I need to fully compensated by NTB and their insurance company Sedgwick, so far my out of pocket expenses are well over $2000. and estimated vehicle repair is $7,500.00.

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4:08 pm EDT
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Sedgwick Claims Management Services Short term disability

I filed for short term disability for Anemia and also, from injuries caused by a car accident 11/04/2021. The claim for Anemia was denied. It was due to the Nurse of my Hematologist not hearing me in regards to the severity of my fatigue April of 2022. I went on to continue the claim due to my injuries from the car accident. I had gotten MRIs of my neck, back, and right hip. I was referred to a Chiropractor, Physical Therapist, and Pain Management Dr. I have two herniated disc, and tear in a nerve of the ball joint of my right hip as a result of the accident. I suffered from chronic pain whether I sat or stood during the day. I constantly rotate using cold compresses and heating pads to control the pain as much as possible. I had a very hard time sleeping through the night because of the sharp pain from my lower back and hip. I had severe Bursitis and my butt muscles were extremely stiff because of pain. I could not walk at a normal pace. I didn't pass 7 of 10 exercises outlined in my Physical Therapy Plan. My job is a desk job. Although I was provided an ergonomics desk and chair, I still suffered a lot of pain from alternating with sitting and standing, because my back, neck, and hip were never at rest. I submitted short term leave. tI was denied. I appealed the claim, and provided what I could. The appeal was denied, based on solely on the notations from the pain management doctor.

He did not conduct a thorough examination and went against the clear findings of my MRI results. Sedgwick denied my claim siting it was based on their independent investigation. Reviewing my full medical records and the outcome of the denial, Sedgwick didn't not conduct a full investigation. The claim was denied based solely on the notes of the pain management doctor. Sedgwick acted Arbitrary and Capricious. The investigation was not just nor wasn't thorough. There are many missing parts in their investigation.

Desired outcome: I a thorough investigation done, which would include the report of my MRI findings and physical therapy notes. I want the appeal to be overturned, and paid out accordingly.

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Sedgwick Claims Management Services In-depth Review

Company Overview:

Sedgwick Claims Management Services is a leading claims management company that has been operating for several decades. With a rich history and background in the industry, Sedgwick has established itself as a trusted provider of claims management solutions. The company operates on a global scale, serving clients across various industries and sectors.

Services Offered:

Sedgwick Claims Management Services offers a comprehensive range of services to meet the diverse needs of its clients. The company provides claims management solutions for industries such as healthcare, retail, manufacturing, and more. Their services include claims administration, risk management, and loss control. Sedgwick is known for its expertise in handling complex claims and providing tailored solutions to meet specific client requirements.

Customer Experience:

Customer satisfaction is a top priority for Sedgwick Claims Management Services. The company strives to provide an exceptional customer experience by delivering efficient and effective claims management services. Clients have expressed high levels of satisfaction with Sedgwick's professionalism, responsiveness, and attention to detail. Testimonials from satisfied clients highlight the company's commitment to delivering excellent customer service.

Expertise and Industry Knowledge:

Sedgwick Claims Management Services is recognized for its expertise in the field of claims management. The company's team of professionals possesses extensive industry knowledge and understanding, allowing them to effectively navigate complex claims. Sedgwick's experience in various industries enables them to provide valuable insights and solutions to clients, ensuring optimal outcomes for their claims.

Efficiency and Timeliness:

Sedgwick Claims Management Services is known for its efficiency in processing claims. The company has streamlined processes in place to ensure timely handling of claims, minimizing any potential delays. Sedgwick's commitment to prompt and accurate claims management is reflected in their impressive response time and high resolution rates.

Technology and Innovation:

Sedgwick Claims Management Services leverages technology to enhance their claims management processes. The company utilizes advanced tools and solutions to streamline operations and improve efficiency. Sedgwick is at the forefront of innovation in the industry, constantly adapting to technological advancements to deliver cutting-edge claims management solutions.

Communication and Transparency:

Sedgwick Claims Management Services prioritizes effective communication and transparency with their clients. The company maintains open lines of communication, providing regular updates and information throughout the claims management process. Clients appreciate Sedgwick's accessibility and responsiveness, as well as their commitment to keeping them informed every step of the way.

Cost and Value:

Sedgwick Claims Management Services offers competitive pricing for their services. The company's pricing structure is transparent and reflects the value they provide to clients. Compared to competitors, Sedgwick's value proposition is highly regarded, as they consistently deliver cost-effective claims management solutions without compromising on quality.

Reputation and Trustworthiness:

Sedgwick Claims Management Services has built a strong reputation in the industry for their exceptional track record and successful claims management. The company's commitment to ethical practices and trustworthiness is widely recognized. Clients trust Sedgwick to handle their claims with integrity and professionalism, making them a reliable partner in the industry.

Overall Rating and Recommendation:

Based on the comprehensive evaluation of Sedgwick Claims Management Services, the company receives a highly favorable overall rating. Their expertise, efficiency, and commitment to customer satisfaction make them a top choice for clients seeking reliable claims management solutions. It is highly recommended that potential clients consider Sedgwick Claims Management Services for their claims management needs.

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