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Sedgwick Cms Insurance / failure to pay claims/unreasonable delays of treatment

1 United States Review updated:

This company has given us nothing but grief with it's constant delays, lies, and failure to pay claims. My previous doctor dropped me because they could not get payment for services / medications. The claims worker claimed for 4 years that she could not find my file everytime I called. I finally had to go to previous doctors and track down all the records myself and give her the information in order to get medical treatment for a back and neck injury that left me at risk for quadriplegia.

Once I got the OK, I could not find a doctor to take my case and they finally supplied me with a list to search for a doctor. I have had 5 surgeries on my back and neck and anticipate more in the near future. EVERY TIME I go to the designated pharmacy for my prescriptions, I am told that Sedgwick has denied payment and I have to call the worker to get a response from the company. Some medications require continued use or weaning, or the patient can suffer serious consequences. I have suffered nerve damage, loss of feeling, limited use of limbs, and as I said earlier am in severe pain and at risk for quadriplegia. They don't care. I am lied to constantly and my communication is ignored until the point of frustration and feelings of hopelessness.

My claim was settled to provide me with lifetime medical in leiu of a cash settlement, yet I was deprived of treatment from them for 4 years and had to pay myself at Urgent treatment centers and county med clinics and county hospital. It's unfortunate that I must file this complaint and pay from my limited income and taxpayers paid for the treatment that Sedgwick is responsible for.

I have been lied to so many times. They say after all this time that I need a prescription card. They said they had sent it to me at my parents address. (A lie) I have received other correspondence from them at my current address where I have lived for over 5 years.

I have confirmed my correct address over and over again. I waited for these cards and what happened? They sent a letter to my parents address asking if I wanted my scrips sent to me by mail 3 months at a time; no prescription cards like they said they were sending. More lies and tactics to thwart my treatment. Why did I not receive any prescription card? Why did the pharmacist say that they have problems with Sedgwick all the time? The pharmacy had never asked or required a card from me in the past.

Now I try to reach my claim worker and of course she is out of the office until the end of the month. I sent e-mails, and was advised of this. I then sent it to her supervisor and she too was out of the office. Their lies and efforts to delay and thwart my treatment is very stressful, which increases pain and impedes my recovery. (My last cervical spine surgery being only 2 months ago).

I looked online to find a number where I could reach someone to OK my medication. I found page after page of complaints against this company.

I also discovered that my brother in law has this same company and he has been suffering greatly for years trying to get approval for treatment and surgery. Because of his disability and the poverty that follows, he lives in a travel trailer at a campground, and in winter rents a room, needing help from family to survive while he waits and hopes to be able to work again someday.

Something must be done about these greedy insurance companies that fail to have any compassion towards people who are sick or injured and need help. Instead their tactics cause needless stress and additional pain and suffering to those who depend on them for help.

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  • Ir
      17th of Dec, 2011
    0 Votes

    I understand your frustration very well. My husband still fighting for his rights after almost 7 years. Sedgwick denied and delay treatments and medication without compassion. This is a criminal organization.

  • Wh
      4th of Feb, 2012
    0 Votes


  • Wh
      4th of Feb, 2012
    0 Votes


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