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Sedgwick Claims Management Services
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1.4 390 Reviews

Sedgwick Claims Management Services Complaints Summary

41 Resolved
348 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 390

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12:21 pm EDT
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Sedgwick Claims Management Services denied relapse claim

My name is Beverly Anderson .I am a re-hire since 10/2/2011. In December 2012 I had an injury that triggered an underlying medical issue called Degenerative Cervical Disc disorder. It created pain so severe because of 2 damaged spinal discs, my entire upper right extremities, and could not sit, or type for long periods . I was**approved for FMLA on the initial claim # B225012754000-10. In February 2013, I had a relapse and was ** approved for short term disability, claim # B2250127540001-11, and was under Orthopedic care 2 weeks physical therapy. I returned to work, as my Dr said, too soon and had to leave work early on 3/10/13, I was rushed to after hours urgent care . The issue had worsened, a Surgical Nerve Block was ordered, by the same Ortho Physician, for the recurring, worsened issue. . I was ordered to be off work prior to the surgery, , follow-up and PT was ordered for an additional 2weeks, I was not released to return to work until 4/4/13. (documented )ATT IDSC agent advised this would be considered a relapse because it happened within 45 days of the last claim. My claim was denied, stating the Dr did not provide enough clinical evidence that I should be approved for short term disability . I have appealed and included the US Department of Labor Law 29. CFR 825.306 & 29 CFR 825.307 that states: Under regulations issued by the Dept of Labor, an employer cannot require the diagnosis of the employee or covered relative . Furthermore, once medical certification is provided, the employer **may not** request additional information from the healthcare provider. While the employer may contact the employees healthcare provider for purposes of clarifying and authenticating the medical certification, the contact must be made by the healthcare provider representing the employer "only". 29 CFR 825.307. Not only did they deny a claim that was recurring, it was at a more serious level, and they had the case worker contact the hospital staff before I was even out of recovery, the day of the surgery, the agent Monica Brewer, called my phone before the anesthesia wore off and threatened to deny my claim if they did not get the surgeons clinical notes by the end of 3/20/13, ( the same day of the surgery ) I was off 3/10 thru 4/3/13. and my claim is still in denial. I am of again because the surgery failed and I am scheduled for yet another and am afraid I may lose my job now. This is not legal or fair, Please help Beverly Anderson

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Sedgwick Claims Management Services sears tech caused water damage

I had my appliances insured through American Home Shield. My wash machine was making a loud noise and I called American home Shield. They sent a Sears tech out and he stopped the noise but when he left I put a load of clothing in the washer. I turned the wash machine on and left the laundry room and returned a few minutes later to find the kitchen flooded with water. The water ruined my kitchen floor and went down into the basement and ruined my ceiling tiles. I called Sears back and they came out the next day. The tech guy claim that he could not find where the water was coming from. I believed that he did not put the water hose back down in the drain and when he came back the next day he realized it and put it in the drain and pushed the wash machine back up against the wall. He told me that his insurance was with sedgwick CMS. I called Sedgwick many many times and left messages after messages. They never would returned any calls. Finally, I got to speak with someone who asked for pictures and 2 estimates. I sent both and again they would not return any calls . Finally I was able to get a supervisor that was very rude and said that she was not going to pay. I contacted American Home Shield and Sears and both said that Sedgwick CMS should pay.

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Joshiventure
El Dorado Hills, US
Jun 02, 2013 5:09 am EDT
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Based on your experience, I believe that American Home Shield hired Sears tech to repair your appliance. Sears tech., screwed up and that screw-up caused you damage to your property. Do I have this right so far? If so, then Sears has Sedgwick CMS to do its dirty work to deny your claim. Sears is trying to sell their home repair service business and they don't not want to payout any money for damages caused by its products or service. So, I would strongly urge you to file a complaint with your contractor's license board and state that Sears did substandard work which caused you damage. Stuart Reed is the overall manager for their home services at Sears. He will likely not respond favorably your complaint. His division is about to be sold and likely there won't be Sears home service much longer. So complaint to your attorney general, contractor's licensee board and every regulatory agencies you can find. Also be sure to include in your complaint American Home Shield as well since they are the one sold you a bill of goods. As far is Sedwick is concerned, they are very dishonest and their only job is to deny legitimate claims on behalf of the companies that here them. So be sure to file a complaint with your department of insurance. Good luck.

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1:58 pm EDT
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Sedgwick Claims Management Services denial of claim

I was recently terminated from my job due to my FMLA running out. I was on short term disability with Sedgwick CMS (which Sedgwick denied the claims until my FMLA time ran out, then they back approved them) they approved me for 6 months of long term disability. Now that the 6 months are up, they have denied my claim. I've read things about this company and they find reasons to deny people, without merit. For me, I feel like they are just denying me for the heck of it and just to see if I will appeal. I know these companies think the claimant will just go with the flow and give up. But my condition is serious and I am not giving up. My job basically forced me to go out on FMLA leave. I knew I needed to, but I was pushing myself to work as long as I could not taking into consideration the effects it was having on my family. Recent google searches for Sedgwick has shown up many scams. I do not trust them and feel that they are not taking my claim seriously.

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12:35 pm EDT
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Sedgwick Claims Management Services insurance

Been having the same problems as the other complaints posted on here. They do not return phone calls in a prompt reasonable amount of time and are trying everything in their power to not pay up even though it is their responsibility. The only way I been able to get anywhere is leaving a message that I am filing a complaint with the Insurance Commissioners Office. I would recommend anyone else having a problem to file a complaint as well. The more they get the sooner something can be done about their poor service and possible fines for them.

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8:16 am EST
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Sedgwick Claims Management Services sears home delivery damage claim

Sears Outlet delivered a fridge to my house and in the process there was damage done to my old fridge. This is 6 months ago and Sears fails to respond, fails to do anything other than give me the run around. Apparently there is an insurance company called Sedgwick that handles their claims and no one ever calls back or does anything. It has been months since the claim was filed and I can't even get a call on it, forget the money I am owed! No one speaks english when I call and that makes the process take forever! So annoying! Who has time for that? Sears has really gone downhill! I used to shop there a lot and get all of my appliances from them. Now I've moved to home depot.

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montigny
, US
Jul 13, 2020 9:25 am EDT

new fridge delivered december 2019 - floor damaged by crew - have claim w/sedgewick - emailed estimate w/pictures followed by mail registered w/return signature - sev calls no call back - am about to call tv station w/trouble shooter

am aware am not the ONLY property damage on file but a quick courtesy call or email !

Renee Daubenspeck

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Melinda Johnson
, US
Jun 25, 2019 12:03 pm EDT

My dishwasher needed repair and the first Sears repairman cleaned out some glass bits from under the motor cover using his own vacuum. The dishwasher worked for a while but then would not turn on. The second repairman came and sucked out more glass bits but used my central vacuum system. When I went to use the system dark brown water and glass bits poured out of the opening in which you plug the vacuum. I had to call the vacuum company who had to replace the system for over $1, 200.00. I called and called and then was given a number at Sedgwick. They said they had to assign someone to my case. Finally a Delores Holder to whom I sent the vacuum bill, the number of the vacuum company and all the details. I have called her SIX TIMES so far and she has not returned my call. All I get is voicemail. Incidentally, a third repairman had to come and he then replaced the computer system. What do I do? I think I need a lawyer.

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L. Schaffer
, US
Jun 25, 2019 2:36 pm EDT
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From Sedgwick's horrible track record, I agree that you are on track w/thinking that an atty needs to get involved. Who knows, they just might fold w/an atty demand letter if you are lucky.
A few questions:
1. where did the glass bits come from originally? Did glass break in your dishwasher?
2. why did the repairman use your vacuum system the second time and not his?
3. did your vacuum repair company assign blame to the Sears repairman's actions entirely? You need that in writing. Same w/your computer system.
Don't let the SOL expire, BTW (delaying). Sedgwick seems to count on that and/or you just giving up.
Good luck, sorry I didn't have a better suggestion for you.

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McKinley Johnson
, US
Feb 06, 2019 9:28 pm EST

Let me add to the disappointing comments concerning Sedgwick and how they handled my claim. Sears delivered a dishwasher to my home. It leaked and destroyed my kitchen floor. I let them know and I was told to contact Sedgwich. Everything seemed to be swimming along. I sent the information requested to process my claim. There were some delays on my part and theirs. I was ok with the pace...life happens. However, once they had all of the required information and it was all systems go...nothing. The agent, Walter Mitchell, said he would be out of the office for the holidays and would get back to me afterwards. He finally got back to me on January 29th. Can you believe that? I was so frustrated that I contacted my insurance company and took out the claim weeks before he finally emailed me back that he was ready to process my case. MY INSURANCE COMPANY has sent me the funds needed to take care of my floor and I am on my way...thankfully. Oh...and the defaulted dishwasher that destroyed my floor - it was a GE product, it is still in my home! GE would not even take it back or allow me to return that one and pay the difference for a higher end machine. Run run run from this company and GE products! No one cares or even bothers to think about how your life has been inconvenienced. They got THEIR's and that's all that matters to them! Run. Run. Run. If I could give them a minus star, I would!

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L. Schaffer
, US
Oct 19, 2018 11:37 am EDT
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My claim is still processing, but I am dealing directly w/the 3rd party carrier that Sears contracted out to deliver my refrigerator. XPO adjuster came back out and re-did their estimate as they failed to figure in the mold damage the first time. Sedgwick is absolutely USELESS but I did finally get a letter out of them disavowing their responsibility for future reference if need be. Anyway, it looks like the 3rd-party (XPO) is offering more than they did at first. Their excuse was that they "didn't know" about the mold at first, even though they had pictures and you could SMELL it (my pantry that buts up next to the fridge can't be used because of it. Actually had to take a crowbar to the baseboards to the baseboards and the shelves in the pantry and remove them so they could SEE the mold up front and personal (Custard adjusters). Crazy.
Anyway, and I'm sure not giving you legal advice, but if I were you I would file a lawsuit. IDK what the cap is in WA for small claims or the amount of your damage...file in small claims or file in limited civil (10k and 25k respectively in my state). You can go to the WA Secretary of State website and find out who exactly accepts service for Sears and/or Sedgwick (service agent). That's who you send your lawsuit to besides your court. Probably pretty easy to DIY, as (I hope) WA uses forms and you primarily check boxes, LOL. The last required form is called a Proof of Service (it's a judicial form) and after you get that back, file that with the court, too. The court will assign you a court date.
You can bring up the forms you need (if WA has them) for free by visiting WA court's website. Hopefully with instructions. Again, IDK about WA, but here you need a cover sheet, too (another form).
Not sure how the bankruptcy thing is going to work out, but you might also need to file in bankruptcy court as a creditor of Sears to protect yourself. Keep ALL your paperwork/photos/(evidence) and attach to your lawsuits. Most importantly, get it in writing that Sedgwick/Sears is "holding" your claim because of the bankruptcy. DON'T MISS YOUR SOL (Statute of Limitations) or else you will have no recourse.
Hope that helps.

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Hawks 12th Fan
, US
Oct 18, 2018 10:45 pm EDT

L Schaffer, did you settle the claim? My claim is over 2 years old and is for a flood caused by the Sears washer repair person. I immediately gave them pics, estimates, etc— everything they asked for — and the claim dragged on! I was told a month ago (Sept 2018) that the adjuster had closed my claim and then quit her job! I placed many phone calls to Jamie “incompetent” Lesniak and reminded her that a resident of Washington State has 3 years to file a lawsuit for this kind of incident. Jamie then reopened my claim, but they again dragged their feet. On 10/16/18, I received a call from adjuster Brigid Duda that the claim is now on hold due to Sears filed for bankruptcy on 10/15/18! In other words, they aren’t proceeding with my claim! Did anyone else receive a similar call? What can I do? Thanks

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L. Schaffer
, US
Sep 21, 2018 10:50 am EDT
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Going to add to this list. Bought a refrigerator from Sears Outlet, paid them for delivery and installation. They incorrectly hooked up the ice-maker water line and caused severe water/mold damage, to the tune of 11k+. Sears/Sedgwick has refused to take responsibility and closed my claim while directing me to their 3rd-party delivery service. The 3rd party "XPO" has offered less than half for settlement. Contacted an attorney, was advised that it was SEARS responsibility, not XPO, as I paid Sears for delivery/installation. Re-contacted Beth Rodriguez at Sedgwick, she refused to re-open my claim, said that Sears does not install refrigerators, and said, "that's just too bad for you". When I asked for a letter stating Sedgwick's rationale, she refused to provide one. I then asked to speak with her supervisor, Jamie Losniack. Instead of transferring me, Beth hung up. Have left several messages since to Sedgwick/Jamie. No response. Finally got hold of Beth again and asked for their contact information (service agent) so that they can be served with a legal Complaint. Beth refused and said that they have no contact information, no physical address, no nothing...and asserted that I would need to sue Sears, not Sedgwick. Note: Both/all will be named in the Complaint, plus Does.

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SearsNoMore2
, US
Apr 25, 2018 2:25 pm EDT
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I was finally paid! It took over 8 months for Sedgwick to get their act together, me arguing with clerks that don't seem to like their jobs and don't seem to care about what customers are going through. The person dealing with my claim, Ms. Rebecca, was useless and rude. I'm not sure how those people keep their jobs. I'm glad I'm over the aggravation of dealing with Sears and Sedgwick. Good luck to you all
SearsNoMore2

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Mindy Clark Steen
, US
Oct 30, 2017 8:46 am EDT

Wow. I was searching for a particular contact from Sedgwick when I came across this page. We had a dishwasher installation issue through Best Buy's Geek Squad which resulted in water damage to two levels in our home, and they use Sedgwick Claims as well. Eventually they sent out another subcontractor for reinstallation, and they damaged our cabinetry and countertop! Sedgwick has been responsive, but they had another subcontractor ("Custard") adjuster come out and they claim to have still not heard back from that adjuster - for the FIRST claim. This was FOUR weeks ago now. Absurd. I'm ready to threaten legal action. We are a family of seven and it has affected our quality of life.

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SearsNoMore2
, US
Sep 11, 2017 3:11 pm EDT
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I am having the very same issues people have been describing. I have filed a claim with all supporting documentation more than 2 months ago. A Sears tech came to my house to fix a door issue and broke my dishwasher's drain hose. My house was flooded, walls damaged, and hardwood warped. The Sedgwick representative (Rebecca Suwanski) ignores all emails and phone calls. It seems like their business model is stalling claims, frustrating customers, until the customers give up. Has anyone considered a law suit agains Sears and this insurance company? How have you managed to solve your issues?

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Kim Hodson
, US
Jun 19, 2017 9:43 pm EDT

I'm having the same issue with Sedgwick. We purchased a GE dishwasher from Sears Hardware in March 2017. It was the floor model that was on clearance. First time I ran the dishwasher the water would not stop running into it. Had to shut off the water and electric to the dishwasher to get it to stop. Water leaked out under and ruined my kitchen/den floor which had to replaced. Been getting the run around from them and Sears for three months.

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Sedgwick Claims Management Services terrible service

I recently had back surgery Nov. 8th. At first everything seemed fine the first wave of claims were approved and all was good. Then I went to my second Dr. appointment and it went to( H3LL ). My Doctors office made a slight error by saying that “he has been able to return to work” rather than saying “has not” So Sedgwick denied the claim. When I called they said that I was able to return to work. Even though I have a work slip that says return February 4th 2013. After the dr. corrected that error and sent it to Sedgwick they found something else wrong, just trying to keep from paying. At this point the company I work for, said I had to return to work or it’s a voluntary quit. So in other words Sedgwick was trying to force me back to work against dr. orders and the company would be liable if I were to be hurt, that’s if the company would even let me set foot in the place without a dr. slip, cause the dr. has me off until February 4th 2013. Nothing got done about this, until my union got involved and forced Sedgwick to properly evaluate the circumstances. One of the few good things left, about unions I guess. Although I still have not got a check in three weeks.

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Update by readysetgo
Jan 20, 2013 7:40 am EST

Citizens need to ban together and bring forth a class action suit against Sedgwick for the harassment and mental anguish they put on people. There are enough people here that someone has to know someone that has connections with an attorney looking to make a name for themselves. Where do I sign up?

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not happy chuck
Spring City, US
Feb 16, 2013 2:51 pm EST
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my grandauther was ran into by a truck that was owned by a company owned by another bigger co. that this so called. THIRD PARTY ADMINISTRACTOR OF THE BIGGER CO.
SEDGWICK CMS CLAIMS MANAGEMENT INC. BASE OUT KY., CO. AND OTHER CITIES IN THE USA.
after many, many phone calls [15 DAYS ] to there so called liability claim examiner 111, by myself, grandauther, and own ins. adjuster.
and no calls in return i found another way to get some real person. a super.vistor. wow what joke she was. i've send them a police crash report, saying there driver was at fault 100%, two of the parities taken to the [E R] by grandauther going to the doctor. my car at a towing / storage yard, that i had to get removed . that cost me [$1145.00] of borrowed fund. they could care less about me or the injured parities. i just don't unsterstand how they can operate in the***[THE COMMONWEALTH OF PENNSYLVANIA ] AND GET AWAY WITH THESE ACTIONS. still waiting for them to step up and show there a real co. mean while i've got no car, plus i had to get a lawer. more cost they are taking this matter from a minor case to wre i don't know .maybe they like deal with the courts in this [ PA, COMMONWEALTH . MY REAL FEELING ABOUT THEM **THEY S_____ .. [ CHUCK ] 2/16/2013

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Sedgwick Claims Management Services deception by agent

Tyan Nanka Bruce claims examiner is very deceptive, mean spiritired, combative and not to be trusted. After requesting purchasing documentation she reduced the replacement cost of my families HD television by $1800.00 making it impossible to get the replacement for my set destroyed by AT&T 'S cable wrong equipment installed in my home. No cost for overload strip, electrical outlet and replacement labor of $500.00 were never received. A $2300.00 lost was never paid.

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Totaloasis
, US
Apr 30, 2013 12:00 pm EDT

Yes I am dealing with them now and they are trying to screw me too.

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Sedgwick Claims Management Services employer

Sedgwick CMS is one of the worse companies to work for. They will promote people not because of the skills they may have to do the job, but because of popularity. The supervisor was horribly abusive and had even poked me in the shoulder one day while yelling at me. I worked an average of 15-18 hrs per day and at the end of the week I was still told what I had not done. Abusive comments about the way the claim was handled was placed in the actual claim file, which is discoverable by a court of law as well as the client. I pushed to a nervous breakdown. When I filed a formal complaint against the supervisor, she made my life hell and nobody at the corporate office was doing much about getting the problem resolved. Finally I could not take anymore of the abuse and quit.

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LeftBrokenbyHCA
Palm City, US
Jun 03, 2013 11:28 pm EDT

I actually told them I WISH I could work there! Where else can you wait on "hold" for 20+ minutes being repeatedly told by the "professional call screener" that there is NOBODY available to assist you! I said "I've written down the names of FIFTEEN different "managers" of my case..how can SO many people work there while NOBODY is available"?
I want to work where you just leave ONE message and your job is DONE! Wash your hands of the situation and NEXT WEEK somebody ELSE will be assigned to the case! No FOLLOW-UP, and you and your coworkers can LIE LIE LIE! Just tell the MOST ridiculous excuse and apologize for yet ANOTHER mistake while leaving somebody's life in SHAMBLES! Nobody is accountable for SQUAT at Sedgwick. Even the so-called HEAD HONCHOS don't return calls! So, why should those lower on the totem pole bother to return calls. The MOST inefficient and CORRUPT organization I have EVER dealt with!

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worker1234
, US
Dec 11, 2012 9:45 am EST

I work at Sedgwick until I had enough I worked 10-14 hour days and most weekends because the claims representatives would quit or be removed from the account and we had to pick up their work load as they have a hard time getting people to work there. I could not keep up with case load demands and was eventually fired due to" time management" problems . Corporate policy is to ignore the problems and make people's life a living hell while supervisors go home after a 7.5 hour day because it is easy to blame the worker who has to do the actual work they unreasonably promise to the clients.

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Sedgwick Claims Management Services workmans comp

Search the Department of Insurance or Department of Industrial Relations and file a complaint. Be sure to document every call and message you leave. I've been trying to see a Physician for about 8 months now and all I get is the run around. I've had 3 different adjusters and they never call me back although they do answer their phone most of the time. I've had just about enought and will be filing a complaint. As a person that works for a major insurance company with no relation to Sedgwick we do not like to hear from the DOI and I'm sure it goes the same for Sedgwick. These people propbably count on you to stop calling them and bothering them about the benefits you are entitled to.
Then they try to blame my injury on my current job. What in the world? Shady people, Shady company.

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UCDMC Injured worker
, US
Feb 10, 2015 10:51 am EST
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I've had a similar issue with Sedgwick. I was injured on the job at the University California Davis Medical Center in Sacramento California and received no proper diagnostics or medical treatment by them. 30 days after my injury, (as allowed by California law) I attempted to see another physician to get the proper medical care, but Sedgwick quickly denied my claim. I then attempted to see my primary care physician but was denied in doing that because it was a work related injury. It's been 2 months now and I still have not received proper medical care for my injury and my employer (UCDMC) will be terminating my employment because of my inability to return to work.

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salvador paredes
Mission Hills, US
Oct 18, 2012 10:56 am EDT
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I have 5 operation in 10 years i like to see my dr a cant get true the phone

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Sedgwick Claims Management Services donna augustynovich/erin hall

I have been treating since 2009 with great respect until a claim rep by the name of Donna augustynovich took hold of my case. For starters she willfully and illegally went and told my doctOr that I was seeking treatment for my injury because "I wanted to get on pain medication"! Can you imagine the amount of gumption and nerve it takes for a RN case manager to come out and say that to a treating physician? Of course this altered thcare I received by my doctor. He became extremely critical and insulted because of her lie. I mention SedgwIck because they are the third party manager for my case and given ms Donna augustynovich comment they have become a thorn in my side. Please know I am angry and wonder how a manager can maintain her position while spreading wanton lies and personal feelings about my case and still be employed. I will write to bunch and associates about this and keep you informed of my progress. Thank You,

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Moondoggy1959
, US
Jul 06, 2019 1:43 pm EDT
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I was retired from Los Angeles County in 2000. After going through five TPA's in 19 years only one performed with professionalism and empathy (INTERCARE). I was tired of complaining without result, so I had my WC attorney take my issues to the WCAB and had fines imposed on two of the TPA's. So far Sedgwick has not made an effort to advise me who my adjuster will be. If Sedgwick continues to stonewall me I will file a bad faith insurance claim against Sedgwick and the Los Angeles County, which is self insured for Worker's Comp. That's a promise.

There is a "bad faith insurance attorney" in Pasadena, CA. ( a lady) who has never lost a case against insurance companies.

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Sedgwick Claims Management Services harrassment

Sedgwick is a horrible company. They deliberately harass people that are sick, sending them the same forms over and over. Even my doctor feels harassed by them. I finally got some law advice after they repeatedly denied my case. He said appeal the decision, most times it does overturn, if not we will sue for 'bad faith". So, I called them up and told them that they were not acting in "good faith" and I would appeal their decision, I also told them they were harassing me and when they said they were recording the conversation, I told them that I was too. They changed their minds the next day and approved my claim. Mmmmm. Wonder why?

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Sedgwick Claims Management Services playing the appeal process

Sedgwick has acquired a mediocre company Bunch & Associates. The entire claims process has been a joke with Donna Augstynovich RN nurse Case manager with a horrible sense of people skills have now joined hands to form a bureaucratic mess. I have obtained authorizations in the past and now that Sedgwick has their dirty claws they are going to contaminate the positivity of my case. They should be disbanded but don't worry a federal inquiry is underway.

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Sedgwick Claims Management Services poor business practices

Hello, I was recently injured at a retail store, well as luck would have it, they retain Sedwick as their third party claims admin. They have a deceptive practice of getting permission for a "statement", but then ask twenty questions. I think there needs to be a class action lawsuit filed against them! They also have the "gift" of turning the injury around to make it seem like it was your fault.

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Sedgwick Claims Management Services ridiculous company

I have been on disability due to a heart attack and two heart sugeries. Sedgwick CMS has been horrible to work with and even though I have tried to jump through all their hoops, even while at death's door, I still can't get my payments properly. My doctors have sent stacks of forms as Sedgwick requested, I have spent hours on the phone, and STILL.. my last 2 payments have been for about 1/5 what they should be. I just now called Sedgwick to see if everything was in order for my August 10 payout so I could pay my rent and bills (all LATE already, penalties on all of course!), and was told again that they are waiting on their nurse to approve it, for another signature from my doctor (he just sent a book size fax a week ago), and all the reasons why I am still probably going to get another tiny check. Every single period has been like this, I am in terrible shape financially thanks to Sedgwick CMS, and besides all this... when a person is close to DEATH, why are they terrorized every few days by this company and asked to do something else, only after which they don't get paid anyway. I am a person who is very slow to anger and slow to complain, but I have had it. I intend to report this company to everyone I can think of to try to get something done so that others don't have to go through this. I am close to returning to work now and am feeling good enough to fight back finally. This has been the most outrageous process. I feel really sorry for the phone reps who have to sit there and tell people these things when it isn't their fault. I bet they don't stay long.

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Lllaann
, US
May 19, 2016 7:50 am EDT
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I was hit by an Avis car rental, who Sedgwick insures. The party who backed into my car admitted fault as well as 20 witnesses. Sedgwick would not return my calls so after three weeks I had to file on my personal insurance. To date I am out over $2k and their claims adjuster has been incredibly rude the ONE time she returned my call. Almost five weeks later and they still have not paid ONE DIME on my claim, refuse to return calls or acknowledge even receiving information.

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barbaraj247
, US
Jan 28, 2013 10:26 pm EST
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Has anyone heard of Sedgwick PAYING a claim? Have you ever wondered why you can't locate a physical address for them? Just a P.O. Box? They claim they have called and left numerous messages, but I believe it was just a stall tactic on their part. I feel sorry for people that don't have the know how to fight back. I'm not giving up and I hope you don't either. This company is nothing but a scam.

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readysetgo
Lima, US
Jan 20, 2013 7:49 am EST
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Citizens need to ban together and bring forth a class action suit against Sedgwick for the harassment and mental anguish they put on people. There are enough people here that someone has to know someone that has connections with an attorney looking to make a name for themselves. Where do I sign up?
I recently had back surgery Nov. 8th. At first everything seemed fine the first wave of claims were approved and all was good. Then I went to my second Dr. appointment and it went to( H3LL ). My Doctors office made a slight error by saying that “he has been able to return to work” rather than saying “has not” So Sedgwick denied the claim. When I called they said that I was able to return to work. Even though I have a work slip that says return February 4th 2013. After the dr. corrected that error and sent it to Sedgwick they found something else wrong, just trying to keep from paying. At this point the company I work for, said I had to return to work or it’s a voluntary quit. So in other words Sedgwick was trying to force me back to work against dr. orders and the company would be liable if I were to be hurt, that’s if the company would even let me set foot in the place without a dr. slip, cause the dr. has me off until February 4th 2013. Nothing got done about this, until my union got involved and forced Sedgwick to properly evaluate the circumstances. One of the few good things left, about unions I guess. Although I still have not got a check in three weeks.

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MarcChaz
Noblesville, US
Oct 24, 2012 9:00 pm EDT

I wish this wasn't so but this seems to be the norm. I am a 13 yr General Motors employee and have been treated nothing short of a criminal. I have chronic heart problems, 4 yrs ago I had my heart reconstructed yet my problems have returned and I have been prepared for a life long battle. I am the just a statistic and am facing multiple surgeries. My Dr(s) have provided books worth of monthly tests reports and office notes etc AND even gave a return to work date of 2014 at best if not permanent disability. Get this, Sedgwick even reported to my employer I was a voluntary quit until I got the union involved to get this changed and almost a month of terminated health care coverage amiss my treatment etc. This has been nothing short of a nightmare. I've lost everything and this company still manages to find a way monthly to turn what is left of my life completely upside down. I called today and was told payment will be withheld till each surgery so I get paid once a month or every other month at best. I would be more than happy to file suit with anyone willing to tackle this horrible company. We used to have Met-life as our disability admin and I never had this much difficulty. They need to be stopped.

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johnathan summers
Colorado Springs, US
Sep 07, 2012 4:06 pm EDT

I only had a claim for damages to my vehicle from a company that is insured by sedgwick. After googling them they have multiple attourneys in every state (just another monopoly) However, they are fallable- they became irate when I asked questions and seemed to make multiple mistakes. I would suggest filing a complaint with your *** STATE INSURANCE REGULATOR**** Dial 1800 fed infor for the number in your state and fed info may help you with any orther questions about who to contact. I found it EXTREMELY UNUSUAL that the adjuster that I talked to wasn't even familiar with city codes and statutes. Perhaps some of you with similar cases against this company should consider working together on your complaints. Bullies don't like to be bullied back and this company seems to enjoy dividing and conquering. Also, the BBB is another option. Consumer protection-I'd go all the way. I'd go after their business liscense if possible. The bigger they are the harder they fall.

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christine1234
Hughson, US
Aug 29, 2012 7:03 pm EDT

Now Sedgewick is questioning my doctors integrity. They set up a "peer to peer" appointment so that my doctor (a board certified nephrologist) will speak to their doctor who is board certified in who knows what. They set the appointment for 330 and of course when my doctor called they didnt know what he was talking about. So here I sit and wait. What more does Sedgewick want? What I do believe is that they want to frustrate you so much that you just give up! Well I wont give up. I will be calling the California State Insurance comissioner tomorrow.

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cheated 2
Belleville, US
Aug 28, 2012 11:08 am EDT

Perhaps a HUGE lawsuit against sedgwick for harrassment is in order. It is criminal what they do. Reading all of the above complaints are exactly what I have gone through. I cant add anymore. No check, oops, dont know how that happened, we forgot, changed computer systems, on vacation, overlooked, etc. Does anyone know of any attorneys willing to take this on that are NOT in the insurance companies back pocket or attorneys that are REALLY willing to represent JUSTICE?

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christine1234
Hughson, US
Aug 25, 2012 5:07 pm EDT

same here. I am on kidney dialysis for 10 hours a day 7 days a week. My doctor has faxed them piles of paperwork and they still state they need more! According to the State of California I am 100% disabled but not according to Sedgewick. They call when they need something and you are expected to jump through hoops for them, but it takes them longer than 2 weeks to get back to you! It is a shame that people at deaths door have to fight for what is right! These people have no medical training at all, my caseworker didnt even know what dialysis was and never showed on bit of empathy. I will be getting an attorney!

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Janice Sullivan
Danville, US
Aug 24, 2012 9:02 am EDT

Totally agree. Segwick has been a nightmare; I would descibe it nothing short of harrassment. My husband works for AT&T and was diagnosed with terminal cancer in April and Segwick refuses to cut us any slack. They have AGAIN denied his claim for this past month saying "there's not enough information" since he only had ONE doctor's ppontment and a CT scan. They demand tons of paperwork, and then claim they don't "read medical-eze" when they get it. Who else can we complain to?

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Sedgwick Claims Management Services liability for auto damage

The valet attendant damaged my car by driving over a parking block (twice)--in and out of the parking space. We filed a claim with the Embassy Suites hotel and subsequently their claims processor (Sedgwick) determined no liability on their part. Pictures of the damage were sent and pictures of the car "strattling the parking block". There is no doubt that they damaged my vehicle and are liable. I have contacted Embassy suites to dispute this finding by Sedgwick cms.

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Sedgwick Claims Management Services rude, unprofessional, iars

I have been on workers comp due to a lowes injury I incurred last may while working, and was assigned to claims adjuster Maryanne Morgan. She recently told me on 6/28/12 that she is no longer my claims adjuster, and gave me an email for someone else, which is apparently fake. I am an i/t student who just graduated with my associates, and know when an email comes back as permenatly failed to send that its a phoney. I needed to know how to set up my mileage reimbursement again since its been almost a year, and also to get approval for more physical therapy, but get the same reply, "I'm no longer your claims adj."She is rude, unprofessional, and a huge liar. I contacted her multiple times about stuff, and she never calls back..I always end up calling her boss' boss, and still get no calls back...I end up gettin a call back when I threaten to et a lawyer.

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Christine Mullaney
, US
Sep 08, 2018 1:07 pm EDT

waiting 2 months, following up for physical therapy for broken wrist at work. Sedgwick should be called Sludgewick! I am needing to begin asap to heal and return to work

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Christine Mullaney
, US
Sep 08, 2018 1:09 pm EDT

and they told me I couldn't have phys ther yet with cast on, cast WAS removed-sorry typing with 1 hand!

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Jlsn
, US
Dec 28, 2017 6:18 pm EST
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We have had nothing but heart ache dealing with Sedgwick for the past couple months. My spouses' claim manager name was Jamie and his appeal manager is Beth. They are both incompetent. We can never get a hold of them. We have had some contact with Zachary Bahler who is supposed to be their supervisor. All I know is that I also have Worked in the WC area and a monkey could see my spouses claim is legit. This is just for Short Term. A month's pay is all we are asking for from this company. My spouse pays a portion of the fee his company pays. It is just plain crazy. WE NEED A CLASS ACTION SUITE against Sedgwick.

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Brandon Landon
Chicago, US
Apr 02, 2015 4:25 pm EDT
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Jacqueline Ryan - I too have been a victim of SEDGWICK CMS. I was in a work related accident and they have denied numerous claims for no specific reason or the dumbest reasons. I myself have done workers comp claims for another company in the past. I know that as a claims adjuster we can't please all parties involved, but we can try and do the work required to have everyone in good standing. Also, the company I worked for in the past only hired individuals with hands on experience. "I feel that Sedgwick needs to hire actual trained insurance claims adjusters". My adjusters name was ELISA JOHNSON based out of Deerfield Illinois. She is incompetent and plain dumb. She is a class act and not trustworthy. I wonder if this is the same individual? I have heard and experienced the worst with SEDGWICK CMS..

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Jacqueline Ryan
Ross, US
Nov 13, 2013 2:10 pm EST
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Elisa Johnson is the most incompetent claims agent I have ever dealt with.
I do not believe a word she says, and I do not trust her.
She has denied my claim, for less that $70.00 and will NOT provide me with
evidence that I have requested.
I just wonder if Sedgwick ever pays out a claim for any one?
Sedgwick Insurance Company stinks !

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Sedgwick Claims Management Services false information

I also agree that Sedgwick doesn't care about anyone but themselves. I've been dealing with them since Feb of this year and it's the same run around like everyone else has complained about. They feed you false information to cover their own butt. It takes forever to get an approval from them. I was told by an employee of their that to get workman's comp paid you have to be gone 3 days...which is a lie...you have to be gone 4 for them to pay out. So they denied my workman's comp claim and screwed me out of money I could have used while off work two weeks. They do play dumb and act like their are totally trying to help you out, but it's like a warranty from a company. The warranty protects them not the consumer. They do stab you in the back every chance they can get. And when I did get hurt on the job in Feb, she told me that I had to file a workman's comp claim with the company insurance where the incident took place. That is the biggest BS I've ever heard. You can't file a workman's comp claim with a company that you don't work for. She should have known that as an employee of Sedgwick, but yet...she's trying to place the blame on someone else and not take responsibility. So if you deal with Sedgwick in Texas and you get claim representitive by the name of Devon McLeod...DON'T trust her. False truth and lies come from her lips. I just hope these people understand on what they are doing to those in need of help. I can sleep at night...can they?

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Sedgwick Claims Management Services do you have to die to get you money or what?

Omg i work for United Health Care and my job title is customer service. I lost my voice and was diagnosed with laryngitis which lasted almost 2 months and during the process i had to get my tonsils taken out well they denied my claim stating that it wasn't enough medical information to cover the claim which i don't understand i talk to customers and set up deliveries for pt's now how can I do my job if i can't speak to the patient it's not like i can just go to work and file papers and the thing that hit me the most was that they approved it and denied it all in the same day smdh wth i lost my home my car and i have 4 children this company is a crock of bull and my company needs to invest into another company.

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Johnny310
, US
Sep 12, 2015 10:21 am EDT
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Ive been dealing with these inhumane people for 2 years, they have stopped payment on me stating i missed a Doctors appointment when in fact i did not. I had micro lamenectomy surgery not only did it take them 8 yes 8 months to authorize phyiscal theropy but as well tried to say i did not need it. They were over ruled but by then im right back where i started with back and leg pain, Doctor says now i have nerve damage. They skipped a check on me recently 7 weeks to get it by that time im in disarray i mean im getting max 230.00 a week on perm disability which is nothing close to what i was making where i was employed for 12 years 6months into injury i get laid off i mean if i had to do all over again i would have never even said i was injured at work and took care of ut on my own. My milage check takes minimum of 8 weeks to recive after i fax in. I finally said screw it and got a lawyer. Nothing is going to give me that peace of mind these people have so rudly took from me. Worst company by far i have ever dealt with in my life. I hope the come round kicks them square in the pants.not metion to get authorization for xray or mri takes bout a month to 2 months.

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JJJJLL
San Antonio, US
Aug 13, 2013 5:40 pm EDT
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I too work for UHC and they are jacking with me... They have 40 pages of medical records just from July 20 and the medical records indicate that I was inpt for 12 days and now doing outpaitent rehab. But yet they tell me they don't have enough info to make a dec.
Give me a break, any normal everyday person, who read my records could see I couldn't go to work if I was hospitalized for 12 days.

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double distaught
, US
May 31, 2013 12:25 am EDT

I also work for uhc. I have severe pain from nerve damage. I can't sit for more than 30 mins without feeling chronic pain in my back, buttock and leg. I can't stand for more than 15 mins. There is no way I can sit for 7 hours without getting up. And they do not allow you to just get up. You have to put your computer in personal just to go pee. The back and leg pain is unbearable. And sitting only puts more pressure on the nerve
I am on nerve damage pain meds. I've had tons of injections. My dr. Has sent sedgewick all the information they requested. The dr. has given me clearance to be off due to my condition. He has sent them a detailed letter on behalf of my first denial. My adjuster told me since the first claim was denied, to submit a new one and she would review it and try to get it approved while I appeal the first one. I have not heard from her. I waited for the call saying it was approved but instead. I heard nothing when I called to check. The rep said someone tried to call you to tell you it was denied. I never recieved any call, no message was left, and no missed call. I still have not recieved the letter. So now I have to appeal again. I have the letter only becaused someone from the ltd another company emailed it to me.I showed it to the dr. He was so angry. He said they are impossible to deal with. They want you to keep sending the same info over and over they ack like they don't understand even though its clear as day in writing. They want people to just give up and just go back to work. I requested a email of my denial letter from them 3days ago. I still haven't recieved it. I spoke with an attorney. She said the same thing. It's sedgewick, they are well known for dening claims. They make it a practice. She advised me to fax her both my letter and my request for them to fax her all my info the dr sent them. I have not gotten paid in two months. I am close to getting put out and loosing two cars. I can't pay my bills with no money. I pray with the attorneys help and i will get justice. They should be put out of business for treating people this way. Just heartless.I hate them and pray, I never ever have to deal with them again

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Sickandscared
Huntington, US
Apr 23, 2013 10:11 am EDT

I am sorry to hear of everyone's trouble's but have to admit I was glad to see that I am not the only one struggling with Sedgwick. They denied my Short term disability claim and I did put in for an appeal, this too was denied. They state they send the appeal to an outside (independent) physician, which is crap! Sedgwick pays these doctors to review your claim. There is no way I can work, never mind work the outrageous 70+ hours a week working for Optum Health. The stress of having severe/chronic medical conditions is overwhelming all on it's own, and then add on the stress Sedgwick is putting on me and my spouse is despicable.

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tired of Sedgewick
La Jolla, US
Dec 13, 2012 3:55 pm EST

The reps at Sedgewick dont care, are rude, insensitive, and so are some supervisors...its the most horrible company I have ever had to deal with !

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tired of Sedgewick
La Jolla, US
Dec 13, 2012 3:48 pm EST

I too work for UHC and I'm having major problems with Sedgewick. Not returning my calls, denying my claim, I have lost my apt, had to sell second car, borrowed loans on car that is paid off. They took their time with my appeal from 5 months ago it's still being investigated and the claims rep called me from his home informing me my appeal was denied

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Californa Now MN
Buena Park, US
Sep 14, 2012 5:43 am EDT

report them to the DOI (department of insurance

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FrustratedandANGERY
Beverly Hills, US
May 18, 2012 4:45 pm EDT
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I too work for the same company and have an injury that leaves me in bed and pending a possible surgery. Sedgwick has approved one claim and today i found out has denied my last claim. They are rude and insensitive telling me I should try to go back and do my job. Now I might loose my job even though I have proof of my disability. Have you obtained a Lawyer?

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Sedgwick Claims Management Services benefits to kill your employees with

My wife had a short-term disability with Sedgwick CMS that continues to be ongoing, to this day, despite her having returned to work weeks ago. Constantly changing stories about the status of the claim, poor communication, poor training, and an overall attitude that you are a criminal and that nothing provided is going to be sufficient for them to pay your claim. Charles Schwab and Company claims to care about their employees financial health, but don't mind if one of their employees doesn't get paid for five to six weeks because of negligence and a bottom-line is our only concern attitude. Shame on any company that uses Sedgwick CMS in any capacity, you didn't do your homework.

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Sedgwick Claims Management Services can't get loss time pay

This is a horrible company. I got hurt at work back in October last year and have had nothing but a horrble time with these people. Your calls always go to voice mail and then they never call you back. I was suppose to have some of my lost time pay by the 13th of april but that never happened and now i Keep calling and no one will get back to me! I cannot live off of no cash! this company should be looked into for their practices. Time to get rid of them!

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crazypamie
Hilliard, US
Aug 17, 2013 7:31 pm EDT

I have the same problem with Sedgwick doctors even trying to contact Sedgwick and the person covering my case review was on vac. So I had to go see my own doctor for treatment. But I have gotten an attorney because I had to use my vac. time so I could get a pay check while I was out of work with a back injury. This is the second time that I have filed a claim with Sedgwick and they have never paid for my lost time .I guess maybe that is why company's hire them so they won't have to pay for job injury's. I will post what the outcome of my case ends up being win or loose . My claim was filed in Georgia .

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barbaraj247
, US
Jan 28, 2013 8:46 pm EST
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I totally agree with you! We are having the same problems. If we don't get results soon, I'm considering filing a Class Action Lawsuit. I anyone is interested, please email me at barbaraj247@yahoo.com and type "CAL" in the subject line.

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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