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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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9:36 am EST
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Sedgwick Claims Management Services services

Had a tooth broke and provided all information and dential records..had to drive 35 miles one way just to get a estimate for the adjuster... then she lost it 3 weeks later ..had to go back 2 more times for her..over 200 miles both ways...this has been going on since October 2017...thats 4 months working on 5 months this is so redictuless the amount of estimate is only 1, 542.00...can you help me solve this issue plz...claim number #..[protected]=0001...Thank you very much...

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5:42 pm EST
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Sedgwick Claims Management Services various issues with disability claim

Sedgwick took over my company's disability management on December 4, 2017. Up until then, we had an internal department which dealt with our claims seamlessly. As soon as Sedgwick took over, I began to have nothing but problems with my claim.

First, there was no way to contact my new "examiner" (formerly known as a case manager), directly. I had to leave a message, and then hope it was relayed. Most of the time it wasn't. I know this, because when I finally got to speak with him directly, he confirmed it as true.

Next, I had to speak with a different person each time I called, none of whom could "access my claim" without an excessively long wait/hold time. Meaning five minutes or longer. The person had no power to do anything other than give me basic information about the status of my claim and either leave a message for my examiner (see above), or tell me whether a request for extension had been sent to or received from my physician.

Then, during follow up calls, (necessary every weekday to attempt to confirm sending/receiving status), each person told me something different.

Although each experience with Sedgwick was frustrating, the absolute worst is the most recent (and still ongoing). I followed all the rules. I contacted Sedgwick the day after my last appointment with my surgeon; January 19, 2018. I requested an extension form be sent to my surgeon (whom I identified by name; Dr. Osama Ahmed), and was assured it would be done. This was on a Friday.

The following Monday, the 22nd of February, I called Sedgwick to follow up. I was told it had been faxed--to Dr. Monis, my pain management doctor, NOT my surgeon. I then had to request it be sent to the correct physician, then call Dr. Monis' office to tell them to please ignore the request, as it was sent in error.

By the way, the last date for Sedgwick to receive the form was February 6th--tomorrow, as of this writing.

I called the next day, and was told by Sedgwick that it had been faxed. But my physician did not have it, so I called the next day, and was told it was NOT, in fact, faxed to the physician as I was told the previous day. By this time it was Wednesday, the 25th. The person told me they'd be sure it was faxed. Also, my examiner was not in; would I like to leave a voicemail? Yes, and I did so. With no response.

On Thursday I called again, and was told that the form still hadn't been faxed, my examiner still wasn't available, and would I like to speak with one of his colleagues? I said yes, please, and received a call from the colleague. I explained that I was very concerned, because time was running out. My physician requires 7 to 10 business days to process these requests (something I have mentioned during every call to Sedgwick, and which each person I spoke with was very surprised to learn). He assured me he would make sure the form was faxed "immediately."

When I followed up the next day, I was told no record of any faxes were "in the file" and my examiner would reach out to me directly. Which he did.

He also faxed the request to my physician, whose office told me they received--on Monday the 29th of February. Subsequent calls to and from Sedgwick confirmed that it had been faxed, but no response had been received. Not surprising, given that the physician's office had to move my request to the front of the line, and it takes time to fill out and fax back.

I spoke with my examiner on Friday, February 2nd, and he advised me that he would call the physician's office to request a verbal confirmation of the request. Which he did, and I confirmed with the physician's office.

He called me back to let me know that that office was unable to give the information by phone, so he would follow up with me on Monday (today) to let me know the status, and oh, by the way, he is no longer my examiner. A new person had been assigned--who wouldn't be familiar with my case, but would most certainly be able to help me. Meanwhile, the physician's office advised they had faxed the form back.

Then he called me again several hours later, to let me know they had not received the fax. A quick check with the physician's office confirmed they had faxed it, and received a confirmation. I requested they fax it again.
They confirmed the fax number, and advised they would do so.

During all of this, I am in the process of recovering from brain surgery. I have also had to check with the person at Chase, my employer, who deals with disability for our region/department. I checked with her today, to ask if my job was in jeopardy, due to all of the incompetence involved in getting a 10 day extension on my return to work date. She told me I did not have to go to work tomorrow (which would automatically close my claim), and I should continue to do what I've been doing--what amounts to Sedgewick's job.

This has been without question the most difficult part of having three surgeries in as many months. Dealing with this three times for each surgery has not helped my stress levels, and in fact has no doubt delayed my recovery.

I want to return to work. But I don't want to not follow my doctor's orders and return too soon. Somehow I feel sure that Sedgwick has a vested interest in the same thing.

If Sedgwick again tells me that they have nothing from my physician tomorrow, (as has become the new normal, since I've gone through the exact same scenario with the previous two extensions), I will have no choice but to seek legal advice.

The lack of consistency among your employees (except they are consistently inconsistent), and the prevalence of incompetency indicates I can't possibly be the only person with these issues.

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Tpurvis06
, US
Nov 05, 2020 12:50 pm EST

Dealing with this right now, since July 20th 2020. Every few days asking questions and getting nothing

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creighton jones
, US
May 02, 2018 4:53 pm EDT

Get in on a class action suite against Sedgwick

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8:49 am EST

Sedgwick Claims Management Services disability pay

I have had my physicians send in the paperwork that they filled out stating that they have examined me and that I am not able to return to work. Everytime the doctors send in paperwork it seems to be denied or its never even looked at. Because when I call I am told that the medical examiners findings are the ones that are correct not my doctors. So what's the point of wasting my doctors time if there paperwork isn't even being considered. I haven't been payed for 4 weeks now. Because the paper work isn't being reviewed correctly I have lost my health insurance. So please fix this. This is the second time that I have emailed you with a complaint I would like a response.

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9:45 pm EST
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Sedgwick Claims Management Services I am having problems getting my medical needs and medication needs met. my attorney and I are requesting a medical buy out.

My Name Is Estella Mimms Claims # [protected]. Social Security # [protected]. Date Of Injury 10/29/2008. 12433 Antelope Dr. Victorville Ca. 92392. [protected].
I Am Having Problems Receiving The Medical Treatment I Was Awarded. Your Representatives Don't Return Calls, I Am Contantly Ignored Since This Claim Is Several Years Old. Kaiser Will Not Treat Me Because My Injuries Are Work Related. I Have Problems With My Back And Neck. I Am Having Problems With My Daily Activities. I Need A Care Give To Help Me. I Have Been Borrowing Pain Medication From Friends. I Can't Get Approval For My Meds. I Need Help. Please Buy Out My Medical So I Can Close This Case And Take Care Of My Own Medical Care. I Need A Walk In Bath Tub And Someone To Clean My House. I Am Getting Older And There Are Thing I Can No Longer Do.
Thank You,
Estella Mimms

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Teri Williamson
, US
Jun 15, 2018 3:31 pm EDT

It still shows your private info in the summary.

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Kate Thompson2
, US
Apr 10, 2018 2:35 pm EDT
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yikes, you may want to take your SSN off here.

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8:07 am EST
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Sedgwick Claims Management Services my car

I was reseeded in my car by one of your rentals .The person who hit me said that Sedgwick would pay me.When I first filed my claim I was told that my damages will be recovered through Sedgwick.The accident occurred on 11 /24/2017.My name is Denise Forte..y claim number is: [protected].My claim is supposedly being handled by Michele Holiday:[protected].All needed paperwork has been given and faxed.This letter is intended to put you on notice.Since 11-24-17 up to today 1-18-18 no one has contacted me regarding my claim.Numerous phone calls I have made and no one will ever give me a call back.I have researched your company and that is just one of negative and bad faith reviews.If I do not have any resolution regarding my claim I will be contacting and hiring a lawyer to sue Sedgwick.I also would like an expedient response to this letter.

Denise Forte

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Hailey G
, US
Feb 14, 2018 4:11 pm EST
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i am currently dealing with this company (different adjuster) but i am having nothing but issues with them. they have received all paperwork 3 TIMES and 2 of which there was a confirmation email sent back saying that they received it but the second that my insurance company contacts them it magically never was received by them and needed it again. This company is AWEFUL! one of the zipcar drivers hit my car (them being deemed 100% at fault) and totaled my vehicle over a month ago and i am still awaiting being compensated for it. i am seriously contemplating getting an attorney to sue this company for their negligence on making things right in a reasonable fashion.

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12:36 pm EST

Sedgwick Claims Management Services dishwasher

GE Dishwasher purchased at Home Depot in Frankfort IL leaked and did damage to my kitchen hardwood floor. Home Depot referred me to GE who referred me to Sedgwick Claims Management. Their claims adjuster ( Mark Silverthorne, [protected], Mark.[protected]@sedwick.com) said in order to file a claim I had to produce the leaking part for testing. After the dishwasher leak was fixed the technician instructed me to dispose of the old parts. If send me an email to respond to I will attach my correspondence with Mark Silverthorne.

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9:48 am EST

Sedgwick Claims Management Services customer service

I am a Comcast employee out on short term disability leave for mental health reasons justified by the counselor I was sent to by accolade to fill out my paperwork. Three counselor provided a return to work date and sedgwick continues to tell me I'm only approved thru a date sooner than the provider stated. I was told that I just needed more paperwork filled out (there same paperwork she originally sent in with the original return to work date) in order to have it approved all over again. This is fine. However, each time I've called to discuss this with Sedgwick I get nothing but attitude INCLUDING getting hung up on twice. I then asked to speak with a supervisor because naturally I am panicking that I will lose my job if this isn't done correctly but can't get an agent on the line that intends on helping to assure me I'm getting things done in the right manner. Sedgwick is the company Comcast directed me to contact for this issue and they are nothing but rude and treat you as if you're bothering them. The last agent I just spoke to Gore's through the whole timing with her condescending tone and finishes by asking if there anything else I need. I immediately replied asking if they could get me the additional documents needed to be filled out to "extend" to the date the counselor provided and she says "ok bye"-never answering the question. I was able to stop her from hanging up and she says "oh I thought you weren't there you didn't say anything?"

This company is supposed to provide a non bias third party assistance to get me the help I need to get well but treat you like you're an inconvenience to talk to. Its really just horrible if you consider what they're supposed to be doing for people who are seeking help not a vacation.

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5:26 pm EST

Sedgwick Claims Management Services unethical behaviour

I have a claim that I'm making payments toward for a car accident I was involved in a rental car from Avis in 2015. This company contact in February 2016 threatening to turn the account over to collection unless I pay in full or set up payment arrangements. I set up the payment arrangements monthly on the 28th of each month. Sedgewick won't accept payments online, won't keep my information on file, and won't answer the phone when I try to call to make the payments. Each month on the 28th I call the number they provided to make the payment and each month I get a different voicemail from a different person who never return my call. It's unethical to threaten to turn my account over to collection but when I try to make the payment to not all the only method I have for making the payments.

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2:32 pm EST

Sedgwick Claims Management Services customer service

I have been awaiting a call back from Sedgwick. A woman named Sanda finally called three times. The first two she was typing away and never responded, hanging up. Apparently she must not have heard me? When I did speak to her she was rude and nasty. She was upset about the information received from the doctors office or lack thereof. She took her aggravation out on me. I cannot believe that a customer care center has such sour people representing them! Not only I but the doctors office dislikes dealing with Sedgwick due to some of the horrible people you employ.

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8:12 am EST
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Sedgwick Claims Management Services unethical behaviour with adjuster rosemarie sedalis

Good Morning,

I am writing you; because I have a claim that was only partially, and I have been faxing reconsiderations over to the adjuster for over a year on these unpaid bills. I called bill review, and was advised that they never received our reconsiderations, and these bills were not paid, and to call the adjuster. When I call Rosemarie she was very rude, loud, and hostile for no reason. She started yelling at the top of her lungs that the claim was closed and that she paid everything that needed to be paid. I explained to her that these bills are payable and they weren't paid. I was trying to go over them with her but she wouldn't even do that. She then kept on telling me to fax it over, I explained that I have already done this for over a year and still have not received payment or denial. She said "I don't know what to tell you this claim is closed" well I would like you to do your job and pay these bills before I have to get an attorney involved. I asked for Rosmarie Sedalis for her supervisor because she was just rude, loud, and very ignorant. She would not give me this information; I had to call around to find out it is Tom Constance. I did call him and left a voice message, but I would really like this to be resolved and I also don't want any other provider being attacked they way that she attacked me over the phone, over a few simple questions. This was unprofessional and very benighted of her to act in such a way. If my issue can be resolved that would great.

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3:45 pm EST

Sedgwick Claims Management Services short term disability claim

I submitted a claim for short term disability on 10/13/17 and has been denied because the representative that is working claim did not submit documents to my doctor and is never available to speak with and never returns any phone calls. As a result of this representative non compliant behavior I am in financial distress. Every time I speak with a representative I am given a sob story and the supervisors are always unavailable.

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9:31 pm EST
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Sedgwick Claims Management Services payment denied

Walmart sent me home on aug.30 saying i was not %100, can not work..Have doctor put you off..I did, they paid two pay periods, then stoped..They said they were not receiving info from doctor..I spoke with my doctor on oct.25 she said she sent out two packets on me..I kept calling and giving as much info that i could, still not paying..I called on nov. 13 and found out that my case was closed..But someone called on nov. 1, i informed that person that i was having gallblader surgery on the nov.8..Case closed on nov.13..What is going on? i am sitting here with no money since oct. 19..This is a very poor service..I have at least 3 medical problems and it takes time to get it all..Please help me get paid..Thanks william wills

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4:11 pm EST
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Sedgwick Claims Management Services problems and lack of response on worker claim

I was injured over a year ago at work and have struggled getting wage reimbursement and that is now cut off? I am still waiting for them to pay the hospital from initial treatments, reimbursement for anti-biotics, getting an ok for a brace, lack of response to messages I have left
I can still not wear shoes or stand or walk for any length of time. I am pretty much housebound and I NEED help. Please help me I am still just waiting for help so that I may be able to lead at least a substance of normal life. Thank you for your help. Kathy Jan McAlvey claim #7373502. employee #[protected]

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6:40 am EST

Sedgwick Claims Management Services the way my case is being handled since you represent sears

I had a sears warranty since 2007 on all my appliances. This last year, sears has put on at least 2 times a faulty part which caused my dishwasher to leak.
They have the pictures (I kept 2 of the part which are the same part number), When they filed a claim, i'm now being told it is a manufacture issue not a sears issue. But Sears is the one who put on the faulty part.
I have requested for a manager to review this case, and instead I received a letter (as if I have not contacted Jay many time through email and phone)The letter states: This was forwarded to our clients business partners for handling. Please let us know if you have not received a call or letter from them.. (Which I have not). If we do not hear from you within 30 days we will assume you have been contacted and that the business partner is working with you.

I have been dealing with this for a long time, my floor is bad enough I have cut my foot on it.. This is not ok, and is not anyone else issue. This was a faulty part put on by Sears repair men 2 different times I have proof of.

The sears repair man, took pictures, documented him records that this was caused by the prior repair.

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8:45 pm EST
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Sedgwick Claims Management Services medical bills.

I was hurt on the job about a month ago it took me almost 3 weeks to finally get a claim number from Sedgwick. When I finally got the claim number I was relieved because I thought that meant no more out-of-pocket payments for me to see my doctor but boy was I wrong. When I went to my physical therapist and told them I finally had a claim number for my workman's comp they called my Sedgwick claim adjuster and he denied them using that claim number for any bills because the investigation was still going on! So basically I guess I have a question is it legal for Sedgwick to do that or do they need to pay for my doctor bills.

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12:05 pm EST

Sedgwick Claims Management Services std earned benefits denied do to dr faxes are with confirmation are not received on sedgwick's end

I keep having to fight for my disability pay. My case worker keeps telling me they are not receiving my Dr's faxes to update my medical records and report my return to work date. I have hired a attorney and my union rep has to look into it every month. I have no husband and no family to help me pay bills. I had to use all my 401k and apply for Food Stamps due to lack of professionalism on Sedgwick's end. It has also exasperated my diagnosed PTSD. I just had below knee amputation and my claim was denied twice with both appeals upheld for my condition that resulted in me losing my leg. I felt harassed and my Dr's do as well by Sedgwick. The response is always the same when I call Sedgwick customer service or speak with my case worker that it is my fault for not getting my Dr to fax my records. But they have in 4 separate occasions and the response is the same. They still haven't received them. I deserve my back pay and my pay up till my return to work date of Dec 4th 2017. I feel Sedgwick does not respect the American Act. Also, they contacted my counselor for my personal records that I have no authorization for them to see my info on my personal life. My counselor refused to give them my file under the HIPPA law. You don't get to read my personal struggles but I can tell you Sedgwick has been a negative experience in my recovery. I wish the company actually cared about their customer's.

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12:44 pm EST

Sedgwick Claims Management Services workers comp. case

I was hurt at Lowe's 2015, Aug.7. My 1st worker paid me answered my phone calls, etc. After he left it went down hill, they passed my case around from person to person, no-one would call me, or pay me, and no-one knew what was going on with my case. My Dr referrals were denied and I had to hire a lawyer, I had my car repoed, and my husbabd has stuggeled to pay our monthly bills. I recently won my case but I was informed by my Dr's office that Melissa Hale isn't my worker anymore, and that my new referrals have to be sent somewhere else and could take a while. Well by hell I'm sick and tired of waiting... I'm hurting and I've been NEGLECTED FOR FAR TO LONG. .. APPROVE my referrals please! !

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3:48 am EDT

Sedgwick Claims Management Services lack of service, delays, lies

Sedgwick Insurance covers Workers' Compensation Injuries for Northern California's Kaiser Permanente Hospitals. This Insurance Company is a real headache to deal with. I have had about 8 Claim Adjusters as the claim keeps getting passed on to different people. This is a tactic so that the company can deny knowledge of whatever my former, previous Claim Adjuster said or did. This company is fraudulent. I Mapquested my office visit and Physical Therapy round trip mileage and printed it out for Sedgwick and mailed it to them with Certified USPS mail. Sedgwick said that they lost the mileage. I put mileage calculations on emails to Sedgwick with nothing. These people are big liars and cover up addicts in my opinion. They seem dishonest. I am owed over 400 dollars in mileage compensation. It has been about 4 years and no payment.

" Nearly all states' workers' compensation programs provide for some type of mileage reimbursement. In some states, such as California, injured workers can get reimbursed for any miles driven to and from a doctor's appointment or other reasonably necessary treatment for their injuries. "
" The rate for mileage reimbursement also varies from state to state. Many states adopt the IRS's mileage rate, which is 57.5 cents per mile for 2015. Other states set their own mileage rates, which can often be found on the state's workers' compensation agency website. "

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10:48 am EDT
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Sedgwick Claims Management Services washer

My wash machine was dripping water so one of sears repair man was sent out. He sat in his truck 2 hours claiming he on a call so when he finally came in and did some work he claim the pArt needed he will have to get and come back. So he comes back installs it and leaves we fun the washer and it floods my laundry room and damages everything in my sons room downstairs and this was in July 2017 here we are at end of October and there stil in denial about there no qualified repair my who blamed the bad work on a faulty part.

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9:36 pm EDT
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Sedgwick Claims Management Services stove

We have American Home Shield for insurance on our appliances. Our stove wasn't working correctly and AHS called for Sears repair to service our stove. The first repairman came to our home and troubleshooted our stove. He ordered the parts. The second Sears repairman came to fix the stove. He had to take off the back of the stove to replace the parts. After, he put the stove back together, he told me that he tore the face plate for my stove. He told me that he would order the parts and that Sears would get back with me. This took place in June 2017. After weeks I did hear from Sears and the repairman never ordered the parts. After going back and forth between AHS for help and Sears. Sears finally said that they didn't make that part anymore. That's what they told me. AHS told me to call there property damage claims. I called they put me through to Sedgwick. I have never dealt with such a unprofessional company. The person I was put in touch with was rude hasn't returned my calls or the email that she requested I communicate to her. I called
Back to Sears property Damage and ask
To speak to her boss. I have left 2 messages on her phone and have yet to hear from them. It is now September 26, 2017. This is not the Sears that I grew up with. On to the next step. The person that was helping had said " your stove still works". If this was her car and someone put a scratch on her car, she would want someone to fix it.

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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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+1 (800) 221-5473 +1 (818) 557-8000 More phone numbers

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