Insurance Claims Processing
Sedgwick CMSHeadquarters
This business is NOT BBB Accredited.
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Important information
- Customer Complaint:While the BBB continues to accept and report complaints against this business and fulfill its responsibility to inform businesses of communications from its customers, this business generally responds that the Better Business Bureau online complaint resolution system is not the proper forum to respond to allegations in this complaint.
Complaints
This profile includes complaints for Sedgwick CMS's headquarters and its corporate-owned locations. To view all corporate locations, see
Customer Complaints Summary
- 546 total complaints in the last 3 years.
- 170 complaints closed in the last 12 months.
If you've experienced an issue
Submit a ComplaintThe complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.
Initial Complaint
Date:08/27/2024
Type:Customer Service IssuesStatus:UnresolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I have been paying into disability my whole career. I have been dependent on this company when I go out and have surgery to actually pay me my money that is owed. I have called this company for three weeks now with no resolution on my first disability check, which is only for one week, I have asked multiple times to have a supervisor call me only to get a message back saying that someone did call me and they actually didnt the advocates have 24 hours to return your messages so if I send a message they dont have to return it until the following day . At this point they have just been dragging this out for three weeks with no resolution and now I believe no intent to actually fix the problem. This company has even admitted that it is their fault and was a system error 2 1/half weeks ago, but still has yet to resolve anything with me Even though I have stated several times that I have to have my money to pay my bills and when youre disabled from having a surgery, you are dependent on that money to survive . I also had surgery two years ago, and the same exact thing happened to me then. I even called a month prior to my surgery and spoke with my advocate to make sure that this was not going to happen to me again I was assured over and over that this would not happen to me and yet it has, so now Im going on three weeks with no pay and just keep getting shoved aside by this company! They need to figure out how to fix these issues because this is what the company is for to pay disability to people that pay into it. They obviously dont know how to do their job if they can mess up a simple claim like this that was processed over three months! I just want my money that I was supposed to get originally but for some reason nobody can help me and I talk to them every day each week. Nothing but empty promises no one ever calls you back when they say they will and then apparently somebody lies and says that they talk to you if you ask for Supervisor.!Initial Complaint
Date:08/27/2024
Type:Customer Service IssuesStatus:UnresolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
This company is a scam. They are supposed to provide medical treatment and handle your work comp issues. I received a Caseworker name ***********************. This woman is the rudest person *** ever spoke to in my life treat you like you less than human Because youve gotten hurt. ****** made several remarks stating will see if youre really hurt. I was given the runaround with medical treatment made to miss work For doctors appointments, I did not schedule was not reimbursed or paid mileage to set appointments. I was then dismissed from Workmens Comp. and told to see a regular Physician. I did so where I was sent to a specialist.They found the problem And wanted to immediately operate. I reached out and told ******* the new findings and the new doctors report where I was told I had to have the operation and then called them back. I did so where I had to come out of pocket for the operation. Post surgery I have sent paperwork and all documents needed. I was told by ******* I cannot return to work until I had no doctors restrictions. Which was seven weeks of no pay. After providing all the necessary documents, I was Told that I did not have the surgery that I had and I had to Send a operational report. I sent the operational report as asked. Only for ******* to say, they wanted to get another opinion on the matter. That was 6/21/24. I have called to check on the report several times. The only thing I can get back is that the report is not in and were at the doctors Mercy. Theyll let me know when the report has came. Initially, they said the report might take two weeks. It has been well over two months and every time I call were still waiting on the doctors report. I believe this is a scam and they do not want to pay me or the doctors bill for injury that was clearly happened at work.Initial Complaint
Date:08/25/2024
Type:Customer Service IssuesStatus:UnresolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I rented a storage unit from Public Storage. The unit I rented flooded. All my items received water damage. I have video and photos of the water in the unit. I filed a claim with the Sedgwick insurance. I emailed my forms and photos. The emails kept coming back. I verified the email then called the company. No one ever answers or returns phone calls. I left a message for my claim adjuster and never heard back. I only had the unit a few weeks before it flooded from *****. Im still having to pay for the unit and my items are damaged beyond saving. I have 5 children. I recently had a premie baby and everything from her crib to her baby clothes are water damaged. My kids dont have beds to sleep in and I had to replace their clothes for school! I dont have any receipts because I wasnt expecting us to lose everything in a climate control storage unit! No one will talk to me and I need the money to replace everything! The max is $5000 and that will only probably cover mattresses for us! Plus they want a $100 deductible! I cant even get anyone to answer the phone! Bad business! Im still required to pay for that unit on time every month! Do your job and pay me for my damaged stuff!Initial Complaint
Date:08/24/2024
Type:Sales and Advertising IssuesStatus:UnresolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
In January 2024 I filed a worker's compensation claim regarding an injury sustained while at my current employer. A claim was processed and surgery was needed. After said surgery, I was off of work for a short amount of time and later released with restrictions. My claim representative ********************* had as little contact with me as possible. I never received payment for time off, although my medical bills were paid. I have reached out via phone, email, and through My Sedgwick portal with no correspondence back. I now have a closed case, and no money in my account. All proper paperwork was given by myself and the doctor.Customer Answer
Date: 08/30/2024
Claim Admin #4A2408PZH0011 JCN#*********
These are the numbers I would use to check my claim.
Business Response
Date: 09/04/2024
Thank you for the opportunity to respond to the complaint filed by ******************************. Please note that Sedgwick CMS is not an insurance company. Sedgwick CMS is a third party claim administrator. This complaint arises from a dispute related to a claim ****************************** filed against our client, (Nebraska Methodist Health System).
A review of the claim file reveals that Sedgwick CMS has administered this claim in compliance with the laws and regulations governing the alleged loss.
Sedgwick CMS respectfully maintains that the Better Business Bureau online complaint resolution system is not the proper forum to respond to the allegations contained in *******, ******** complaint.
Again, thank you for the opportunity to respond and clarify,as able.
Business Response
Date: 09/09/2024
Thank you for the opportunity to respond to the complaint filed by ******* *******. Please note that Sedgwick CMS is not an insurance company. Sedgwick CMS is a third party claim administrator. This complaint arises from a dispute related to a claim ******* ******* filed against our client, Nebraska Methodist Health System.
A review of the claim file reveals that Sedgwick CMS has administered this claim in compliance with the laws and regulations governing the alleged loss.
Sedgwick CMS respectfully maintains that the Better Business Bureau online complaint resolution system is not the proper forum to respond to the allegations contained in ******* Reinekes complaint.
Again, thank you for the opportunity to respond and clarify,as able.
Initial Complaint
Date:08/22/2024
Type:Sales and Advertising IssuesStatus:UnresolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
**** was laying high speed internet lines in my neighborhood and they had dug up in my front yard in the evening. The next morning when I woke up and went downstairs I noticed that the whole lower floor was flooded with water which was backing up from the downstairs bathroom. When the plumber came to look at it in a few hours he tracked the blockage to outside the house right next to where the construction crew had dug out to lay the line. He cleared the blockage but by then the damage was done. They had broken the main line outside the house which had caused it to be blocked by debris and mud which had caused the issue. I tracked them down the next evening and they promptly dug everything back and saw that their line had indeed broken our main line. I created a claim with **** who then forwarded it to Sedgwick and I was told that they would promptly help me close this out and I submitted all the documentation and photos proving everything. And ever since then it has been radio silence since then. I keep asking them for updates but always reach voicemail. They made me create an account in the portal that does nothing. They keep reassigning my claim to new people. I am now on the third claims adjuster who is again unreachable and goes straight to voicemail. It has been more than 2 months without an update. This is unacceptable. I am looking for a swift resolution of my claim and be reimbursed for my out of pocket costs that I used to fix up the house because the house has 4 kids in the and I couldn't afford mold to develop and cause them any physical harm.Business Response
Date: 09/04/2024
We have received the below BBB complaint. However, there is not enough information to assist (namely, the Sedgwick client who was involved, claim number, name of the party of the moving vehicle, etc.). We would need to be provided with that information to help her/him get in contact with the proper parties.
Please ask the complainant to provide this information, so we can not only respond to the complaint, but get the proper person in touch with H***************************.
Thanks!
Sedgwick Legal
Initial Complaint
Date:08/22/2024
Type:Service or Repair IssuesStatus:UnresolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I am writing to formally lodge a complaint regarding the claims handling processes and procedures employed by Sedgwick Claims Management Services, Inc. Over the course of my recent interactions with Sedgwick CMS concerning my short-term disability/leave of absence claim (Claim Number: 4A2405GLDLC-0001), I have observed several troubling practices that raise serious concerns about the fairness and impartiality of the claims review process.First and foremost, I believe that Sedgwick CMS's handling of my claim was not only inadequate but also potentially biased in favor of the company that contracts with Sedgwick to administer its employee benefits. From the outset, there seemed to be an undue emphasis on minimizing the companys financial liability rather than objectively assessing the merits of my claim based on the medical evidence provided.Specifically, I have the following concerns:Inadequate Consideration of Medical Evidence Lack of Transparency and Communication Perceived Bias Toward Contracting Companies: There is a pervasive perception, both in my experience and in discussions with others who have dealt with Sedgwick CMS, that the companys claims handling procedures are skewed in favor of the organizations that contract with Sedgwick. This apparent bias compromises the integrity of the claims process and undermines trust in Sedgwicks role as a fair and impartial administrator.Delays in Claims Processing I am deeply concerned that Sedgwick CMSs practices do not meet the standards of fairness and impartiality that claimants should expect from a third-party administrator. The apparent prioritization of corporate interests over the well-being of claimants not only damages Sedgwicks reputation but also erodes confidence in the employee benefits system as a whole.Business Response
Date: 09/04/2024
Thank you for the opportunity to respond to the complaint filed by *******************************. Please note that Sedgwick CMS is not an insurance company. Sedgwick CMS is a third party claim administrator. This complaint arises from a dispute related to a claim ******************************* filed against our client, (Delta Air Lines).
A review of the claim file reveals that Sedgwick CMS has administered this claim in compliance with the laws and regulations governing the alleged loss.
Sedgwick CMS respectfully maintains that the Better Business Bureau online complaint resolution system is not the proper forum to respond to the allegations contained in ************************ complaint.
Again, thank you for the opportunity to respond and clarify,as able.
Initial Complaint
Date:08/19/2024
Type:Service or Repair IssuesStatus:UnresolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Claim # ********* We rented a vehicle from Budget at the ************************************* (*******) this Spring of 2024 after arriving from ***********. From which we drove to our new home in ******* ******* 75 minutes away to prepare for several days of furniture deliveries and tradesmen services. The next day, we realized that the vehicle was leaking fluids from multiple locations onto the driveway of our new home. So we parked the vehicle on several large sheets of cardboard to keep it from doing further damage. A professional grade oil stain product was purchased and applied immediately, and repeatedly over the next several days while visiting our new home, but wasn't successful. We contacted Budget Rental and they said we could bring the vehicle back to them and swap it out. We asked if they could send someone out to exchange it and they said no. So we explained to them that we did not have 3 hours to do the round trip back to the airport, and informed them we would just continue to park it on cardboard until we were able to return the vehicle a few days later. They said that was acceptable, and would make note of our complaint for the record. Several weeks later, Sedgwick Liability Mgr, ******************************* sent us a letter stating that our claim was denied since we continued to use the vehicle and allow oil stains to resume. I have sent multiple emails of appeal to her to share the fact that we did not continue to allow oil stains to develop and that her investigation was flawed. And over the last 3 months, she has not responded to my emails or phone calls to rectify this matter. At this point, I do not wish to deal with her and would prefer another adjuster contact me to settle this matter equitably. If ignoring my requests persist, I will file with the Attorney General to satisfy this claim.Business Response
Date: 08/26/2024
Thank you for the opportunity to respond to the complaint filed by *******************. Please note that Sedgwick CMS is not an insurance company. Sedgwick CMS is a third party claim administrator. This complaint arises from a dispute related to a claim ******************* filed against our client, Budget Rent a Car.
A review of the claim file reveals that Sedgwick CMS has administered this claim in compliance with the laws and regulations governing the alleged loss.
Sedgwick CMS respectfully maintains that the Better Business Bureau online complaint resolution system is not the proper forum to respond to the allegations contained in ********************* complaint.
Again, thank you for the opportunity to respond and clarify,as able.
Initial Complaint
Date:08/16/2024
Type:Service or Repair IssuesStatus:UnresolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
My home was damaged by Best Buy in ******* due to installation done wrong at my neighbors condo. Damaged my whole unit. Admitted fault. Has not paid me one ***** to be whole. I have made a claim. Im almost 2 years no one cared. Ignored all my witnesses. Evidence. I have to love out of state now paying rent and my morgage because they dont want to make me whole again. Its been almost two years. I was willing to settle for ******. They want to throw ***** at me. How can I fixed my unit with this. There adjuster never showed up after initial visit. There are evil. I can not even live in my home almost 2 years. I have no money for attorney. I have tons more evidence. Witnesses too. Please helpInitial Complaint
Date:08/14/2024
Type:Service or Repair IssuesStatus:UnresolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Hello,H3**73733373832373835H has been impeding the ability to return exploding devices by limiting ********************** for Fitbit Ionics through a 5 device limit. They say to contact them to return more, but when they are called, they say "use another email", and that isn't how their system is setup to block recall claims. Their system looks at the address, and limits 5 devices per address. Just that there is any system in place to block claims is crazy, and it shows that H3**73733373832373835H has no concern over the safety of individuals with these explosive devices. The United States ********************************** (CSPC) never said intentionally delay people's recall refunds 2 years. It never said that there is any device limit, and they never said that it matters where the devices are obtained. All it emphasized was that these devices need to be sent back asap to protect consumers. They never said it mattered if the devices have never been registered to our accounts (mentioned in a Georgia small claims case & further blocks (by ****** not Segewick)).All that matters like the representative told me was whether it's a Fitbit Ionic or not, but the system should reflect that by not putting limitations on quantity. Me and my brother are tracking each claim we make, we had to go through hoops to do it, but if 6 weeks hits with no refund, action will be taken. I've filed multiple complaints on this intentional blockage of claims of explosive devices. You guys better get your act together, because this is unacceptable. ************************* ****************************************************************** Multiple claims #** devices coming in as of writing of thisInitial Complaint
Date:08/14/2024
Type:Service or Repair IssuesStatus:UnresolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
on August 2 2024 while shopping at ********** located at ****************************************************, Al my vehicle was damaged by a number of carts that had exited the shopping cart corral. i had reported the damage at *********** the claim was turned over to Sedgwick Claims Management Services, Inc. i was contacted on Monday 8/5/2024 via phone. the conversation was followed up with an email requesting information regarding the claim. that was provided promptly. i followed yp two days later ensuring the had all information needed no reply. a second email requesting confirmation of required information was similarly ignored. I had called Sedgwick on Monday 8/12/2024 again to inquire if all required information was provided. i was informed i would get a call back within 24 hours that was similarly ignored. Today i called ********** customer service sent me to ********************** and was again assured i would get a call back again
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