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Business Profile

Insurance Claims Processing

Sedgwick CMS

Headquarters

This business is NOT BBB Accredited.

Find BBB Accredited Businesses in Insurance Claims Processing.

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

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Sedgwick CMS has 24 locations, listed below.

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    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 Complaint

    The 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.

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    Complaint status

    Complaint type

    • Initial Complaint

      Date:08/13/2024

      Type:Customer Service Issues
      Status:
      Unresolved
      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 ******************************* and I am a Georgia Pacific employee located in **********, **. I am requesting your assistance with an ongoing problem related to my short-term disability payment for time away from work after experiencing two hospitalizations. This complaint may sound familiar as it is in direct relation to a previous complaint (BBB# ********) sent regarding one of the other agencies affiliated my unsuccessful attempts to get assistance with receiving my disability checks. Included in the attached documents is a complete background of what has transpired regarding this matter. I am hoping your agency's involvment will motivate Sedgwick to do the correct thing and pay me the monies that are owed to me as a result of my short-term disability.Respectfully,*******************************

    • Initial Complaint

      Date:08/12/2024

      Type:Service or Repair Issues
      Status:
      Unresolved
      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.
      Complaint Regarding Claim # **********-01- Damaged Sprinkler System by **** I am writing to formally submit a complaint regarding the handling of my claim **********-01, initially filed on June 30, 2024, concerning damage to Zones 2 and 3 of my sprinkler system. This claim is being handled by Sedgwick employee, ********************* (License #********. ********************** is a contractor of ****, with whom I have been in contact since the beginning. Unfortunately, despite my efforts to resolve this matter, I have not received a satisfactory response, especially following my escalation request to a supervisor.On July 31, 2024, I was informed that my case had been escalated to ***************************. I have received no communication or response from **************** since then.In May 2024, during the installation of fiber optic infrastructure in my neighborhood by ****, the construction team hired by **** inadvertently damaged the main wire of my sprinkler system. This damage has resulted in a complete disruption of the functionality of my irrigation system, particularly affecting Zones 2 and 3. In addition, the digging operations carried out during the installation have caused significant damage to my yard, including large holes, areas of dry grass, and water leakage from the damaged sprinkler system.The damaged system in question is a Hunter Pro-C controller, a sophisticated irrigation management system designed for efficient landscape watering. The main wire, which serves as the communication pathway between the controller and the individual valves or zones, was severed during the installation process. As a result, the system is no longer able to communicate with the zones, rendering it incapable of executing the programmed watering schedules necessary for proper irrigation.Location of the Incident:The damage occurred on my property, which is a corner lot in the neighborhood. Extensive digging was carried out in my yard by the **** construction team during the fiber optic installation.

    • Initial Complaint

      Date:08/11/2024

      Type:Sales and Advertising Issues
      Status:
      Unresolved
      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.
      ************* uses Sedgwick to handle the buy back for a lemon. My car was deemed a lemon. I had the car for two months and ******** could not fix for three months so I was under the Florida Lemon law allowed to hand the car back. After a month of not hearing from anyone I had to hire an attorney. My attorney stated that they do not know the Florida lemon laws and want me to pay Mercedes 7500 for the extra services when the law clearly states that Im supposed to get back the 7500 not pay them. They said that is their offer and sticking with it. I need to go to arbitration now and that will take 4-6 months. I went to my Mercedes GM near me and she said that they have no idea what they are doing. The car will be a year old soon. I do not drive it. I make lease payments on this car and Im beside myself Sedgwick wont take a call My lawyer only does lemon law and says hes never lost a case ever and will handle this but the agent should know the law and what they are asking is ridiculous. And she wont change her position Please help me *****************

    • Initial Complaint

      Date:08/09/2024

      Type:Customer Service Issues
      Status:
      Unresolved
      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 tried to contact this business for the past week and have gotten no response. I have called multiple times a day left voicemail and emailed. This is quite unprofessional in my opinion. Thank you *******************************

      Business Response

      Date: 08/16/2024

      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, *******.

      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:08/08/2024

      Type:Customer Service Issues
      Status:
      Unresolved
      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 car was hit while parked by the trucki reached out to ******* and gave them all my infothey sent someone to inspect the car Last week and i havent heard from anyone or anything also i sent the video and all prove of this incidenti need my car fixed asap claim number is 4A2407TPQD20001

    • Initial Complaint

      Date:08/07/2024

      Type:Order Issues
      Status:
      Unresolved
      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 May a delivery was made to our house from *********** ********** used a third party company called Roadie. The driver pulled into our garage and damaged ou4 garage door frame. We immediately reported the incident and were assigned a claim and ***. The *** was from ******* has been extremely unresponsive, unprofessional, and has proven to be extremely incompetent. The damage to our door frsme has not only not be resolved but has continued to create an un safe environment for our children. We've called and emailed the *** (************************************ | Liability Claims Representative) with no resolution. When we first submitted the claim we had to give Roadie (the drivers company) 10 days to respond. They did not. We reached back out to ******** and we're told she could offer $400 but didn't know if that would cover the damage. We were told to get a contractor quote. We provided the quote only to be told she was waiting on Roadie. The quote more than doubled what she offered. After over two months of back and forth with ******** and her giving us the run around or not answering phone calls or emails she just recently asked for photos of the damages. Photos of the damages were provided back in May in order to start the claim. Regardless I provided photos again. After that, she then stated again she could offer 450, which we already rejected based on a contractor quote (she asked for) that clearly doubles the amount offered. We've been dealing with this issue for over 3 months and we simply want to to get the money it will take to fix the issue which was provided by the contractor quote or to have Roadie fix the damage. The lack of attention to detail to our previous correspondence, unwillingness to escalate the issue, or simple fact that ******** appears to be incompetent to handle claims has left us frustrated and continues to create a unsafe environment at our home. We are still looking to get this issues resolved.

      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, The Home Depot.

      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:08/07/2024

      Type:Customer Service Issues
      Status:
      Resolved
      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.
      It's over a moth since a Safelite Autoglass employee damaged my vehicle, when he replaced my cracked windshield, on my 2024 Land Rover Defender. *******, which manages claims for Safelite Autoglass, has sent someone to do a visual inspection of the vehicle (08/23/2024). Sedgwick has also received an official estimate by AutoBahn Body Shop in ********** VT for needed repairs. Since then I have not been given any clear information as to what is going on with this process. I was promised an answer form Sedgwick representatives, ************************** :Phone ************, and Mr ************************** I've written emails and left phone messages with Sedgwick, however, I'm still left in the dark about the status of my claim (Safelite Autoglass claim). Claim number 4A24073172-0001

      Customer Answer

      Date: 08/08/2024

       
      Hello *****,
      Re: 22104828

      Thank you, and the BBB, for your expedient help with my complaint. 

      Upon receiving a notice from you, Sedgwick Claims Management Services was quick to take action by finally communicating with me. They sent me a Property Damage Release form, citing the full repair estimate, to settle for the damage done by Safelite Autoglass (their client).

      I can now move forward in getting my vehicle repaired.

      Best Regards,
      ***************************

    • Initial Complaint

      Date:08/06/2024

      Type:Service or Repair Issues
      Status:
      Resolved
      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.
      An internet service provider ****** was laying fiber in my neighborhood which required digging into my lawn which is on an easement. In the process, the workers damaged my irrigation lines. I contacted the internet service company to try to find a resolution for them to fix the damage to my property. The result was them creating a claim number and pawning the issue off to Sedgwick. Since then, Sedgwick has been beyond useless. It has been over two months since my initial claim and I have been unable to get an actual person on the phone to discuss my issue and work towards a resolution on my claim. They have a customer service number that never reaches an actual person. I have called over 50 times in the last couple of months and left multiple voicemail messages that are never returned. There is an online portal which is also useless as my messages also are never responded to. I received one message over a month ago where they asked some clarification questions, which I responded to within 3 hours and again radio silence for another month. It is so frustrating that I have no way of contacting anyone, no one responds to anything or provides any updates, there is no movement on my claim, and no one to take ownership of my issue (including ****** Sedgwick is such a scam company to not have any way for me to follow-up on my claim and to just ignore all of my inquiries. Just process my claim or give me a way to actually talk to someone about what is holding it up!

      Customer Answer

      Date: 08/13/2024

      I was just contacted by Sedgwick yesterday (8/12) through their online portal after six weeks of no responses. They claim that they are issuing me a check that will resolve my issue. Once I actually receive this check and it clears, I will consider the issue closed. Based on their lack of professionalism and terrible response time, I'm not expecting to receive this check anytime soon, but I would be glad to be proven wrong.

      Customer Answer

      Date: 08/27/2024

      I received a check from the company in the amount of $150 to cover the damage. This number came from an estimate I received from a contractor that I had onsite to fix the issue myself, with no help or communication from the company. We can consider my issue resolved, but I would still like to stress how absolutely abysmal Sedgwick was in regards to providing a way to communicate with my adjuster. Their messaging system goes months with no response. No one ever returns voicemails. You will never get an actual person on the phone line. I am just dumbfounded that a company like this is allowed to operate in ***************** with no repercussions.

      Customer Answer

      Date: 08/30/2024

       
      Better Business Bureau:

      I received a check from the company in the amount of $150 to cover the damage. This number came from an estimate I received from a contractor that I had onsite to fix the issue myself, with no help or communication from the company. We can consider my issue resolved, but I would still like to stress how absolutely abysmal Sedgwick was in regards to providing a way to communicate with my adjuster. Their messaging system goes months with no response. No one ever returns voicemails. You will never get an actual person on the phone line. I am just dumbfounded that a company like this is allowed to operate in ***************** with no repercussions.


    • Initial Complaint

      Date:08/04/2024

      Type:Service or Repair Issues
      Status:
      Unresolved
      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.
      03/29/2024 ************************************ Medical Claims Adjuster Sedgwick Claims Management Services, Inc.EMAIL ******************************************** FAX: ************ DIRECT ************ | EMAIL ******************************************** www.sedgwick.com|Caringcounts Got $3,182.40 bill from ****** Accident and ************* on 3/29/2024 in the mail. Called ************************************ at contact info above at 12:30 PM CST on 03/29/2024.******* stated that ********************* and ************* did not request the claim correctly "processed it like direct pay vs. insurance pay and that Sedgwick was waiting on a Tax ID in which they received it" (confirmed receipt of tax ID during call and was told the bill would be paid in 1-2 weeks).Then left message for ********************* and ************* at ************ as no one answered aorund 12:38 PM CST 03/29/2024. Left all information that they should be paid in 1-2 weeks and was due to the way the processed the claim is why they originally did not go through.05/16/2024 Called:************************************ Medical Claims Adjuster Sedgwick Claims Management Services, Inc.EMAIL ******************************************** FAX: ************ DIRECT ************ | EMAIL ******************************************** www.sedgwick.com|CaringcountsAfter recieving Bill for $3,182.40 from ****** Accident and injury Center in the mail 05/16/2023. ******* stated "the claim was resubmitted again, today 05/16/2024, that it is still a workmans comp claim and that I should call ****** Accident and injury Center to let them know to contact her if any issues". I called ********************* and injury Center and talked with the receptionist/****** who took down the number ************ to confirm.08/04/2024 Received another bill stating Sedgwick still has not paid.

    • Initial Complaint

      Date:08/03/2024

      Type:Service or Repair Issues
      Status:
      Unresolved
      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.
      SEDGWICK Claims Management Services.Two months after a very straight-forward and uncomplicated on-the-job injury the 'staff' continue to require micro-managing of medical bill resolution. Claim administrators are initially friendly enough but quickly lose interest in managing your case after the second week. After nearly two months post-injury the claims adjustor, *****************************, has yet to be proactive in the resolution of the medical bills incurred as a result of the injury. In addition, invoices for driving expenses incurred as result of the injury (suture removal and the like) remain UNPAID.I have spent my own valuable time on the phone with Blue Shield to assist them with claim subrogation in re Worker's Compensation/Sedgwick. This is NOT my responsibility.I need prompt and timely communication regarding my claim. At nearly 60 days after the injury this case should be closed.

    Sedgwick CMS is NOT a BBB Accredited Business.

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