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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

    • 544 total complaints in the last 3 years.
    • 169 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:01/14/2025

      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.
      Hello,My name is ******** ******. I need Sedgwick contact me towards the CLAIM #4A25012HWY6-dash0001 , Policy # AAP6400015266 | ****-***** ****** My car was hit by ****** L ****-***** in December 31. His insurance *************************** transferred me to the claim department Sedgwick. I have tried to reach out to the Sedgwick towards my claim many times, but they dont answer and keep ignoring me for more than 2 weeks. If Sedgwick dont reach out to me, I will be forced to go to court, because my car is damaged and I need a compensation.

      Business Response

      Date: 01/22/2025

      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, AIPSO.

      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 Rozaliia Raisons complaint. 

      Again, thank you for the opportunity to respond and clarify,as able.

    • Initial Complaint

      Date:01/11/2025

      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.
      **** had contractors in my neighborhood and this company dug in my yard and caused damage to my property. I cannot get in touch ***** The company has a third party company, Sedgwick, handling the claim. I received a letter from Sedgwick stating the ***************** was responsible for the damages. That company's Fleet and Safety Manager, ***** ****, emailed me on December 16, 2024 that her company was not in my community and was not responsible. I forwarded the email to ****** **** and ****** *** from Sedgwick on December 16, 2024 . I have not received any communication from the Sedgwick representatives.

      Business Response

      Date: 01/22/2025

      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, AT&T Services, Inc.

      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 ****** Dodsons complaint. 

      Again, thank you for the opportunity to respond and clarify,as able.

    • Initial Complaint

      Date:01/10/2025

      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.
      I was rear-ended by a truck on August 9, 2024, and my vehicle had to be towed by the authorities due to the damage. I contacted a repair shop I had used previously, and they released the vehicle and had it towed to their facility. They handled everything efficiently, and I was very happy with their service.Once we obtained the police report, the shop filed the claim, and the truck company's third-party administrator, Sedgwick, represented them. On August 27, one of Sedgwick's adjusters inspected my car, but it wasn't until October 9 that the shop received a call stating that the vehicle was determined to be a total loss. Sedgwick requested the shop's charges, including towing and storage.Between the inspection in late August and the total loss determination, the shop made multiple attempts to contact Sedgwick's claim handlers but received no assistance or update on the claim's status.I was also injured in the incident and hired an attorney. During a three-way phone call with Sedgwick and my attorney, I was asked questions, but I didn't fully understand them. However, I assumed my attorney would handle the ************ mid-October, Sedgwick contacted the shop to discuss charges. but ***** was not handling anything close to fair.Throughout this process, I was provided a rental vehicle by the shop. They explained the process to me and mentioned multiple times that they believed the vehicle was a total loss but had to wait for the insurance company's determination. I was CC'd on all emails between the shop and Sedgwick and tried to encourage them to resolve the issues, but Sedgwick was **************** of January 6, 2025, my leased vehicle's account remains open and unpaid. The Jeep is still at the shop's yard, and I have an outstanding rental invoice that the insurance company needs to cover. The shop has been helpful and understanding, but they want to receive payment for their services. I am seeking advice or assistance in resolving this matter.

      Business Response

      Date: 01/16/2025

      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 ******* Drezdners complaint. 

      Again, thank you for the opportunity to respond and clarify,as able.

    • Initial Complaint

      Date:01/09/2025

      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.
      June 3, 2024 ************ Inspect inspected our home, including the boiler. On page 13 of the report the boiler is listed as operational and he recommends a basic annual service.Oct 1, 2024 one boiler maintenance technician came to perform the annual service but the technician declared our boiler legally unsafe to operate and disconnected it, citing high carbon monoxide emissions, melted wires visible from outside the unit, extensive evidence of carbon monoxide corrosion. Additionally, the boiler took 20 minutes to turn on the first time and when the tech tried to start it a second time it was unable to start. This was the first time we had attempted to turn on the boiler since taking possession of the home. The recommendation was to replace the boiler. By flagging the boiler as operational instead of noting these obvious defects we were harmed in that we lost the opportunity to find a home that did not need such expensive repairs or negotiate the repair/cost with the sellers and as a result we had to pay $12,000 out of our own pockets unexpectedly. As a remedy, we are asking Midwest Home Inspect to cover the cost of the replacement. At this point we called Midwest Home Inspect asking them to remedy the situation of this costly and unexpected repair and they put in a professional liability claim with their insurance, Sedgwick Claims Management Services. Sedgwick denied our claim on November 22, 2024 saying there was no responsibility to test for carbon monoxide and ignored the other components missed by the inspector. On November 27 I wrote back noting they ignored the rest of the evidence we presented and it's outrageous to think an inspector isn't responsible for checking an appliance won't kill us and asked them to reevaluate the claim with the full information provided. Since then, Sedgwick ignored the 11/27 email, a voicemail, and an email on 12/21.I would like them to reopen the case and pay us for the error made by the inspector that cost us $12,000.

    • Initial Complaint

      Date:01/08/2025

      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.
      On October 3 2024 I opened a claim with Sedgwick. It was for the damage that was done to my house as a result of a defective dryer hose for a dryer I had purchased from **. I called ** who advised me to call Sedgwick. I did this and the installer sent Sedgwick a note on October ************************************************************************************ Sedgwick asked that I send the hose to them and Sedgwick had the hose on October 18. I then received a call from Sedgwick on November 20 advising me that the claim was "on hold" since the ** lab determined the hose did not leak. I asked Sedgwick if the hose was tested in the same manner as it was at the point of failure and with the pictures I took of the leaking hose at the time of failure. I sent the setup as outlined on pg 11 of the installation manual. I also asked if the ****** had researched that the part I had received at delivery was not the part that was compatible with my dryer. The installer takes post installation pictures so they can verify that it is the hose installed at delivery. Had it been the correct part, it would have had a curve in the same area where the leak occurred as on the part I had it did not curve and the hose was under strain. Sedgwick never followed up after 8 inquires. I was later advised to send in estimates for the damage when I spoke with them on December 5. I had scheduled estimates, but then sent a note to Sedgwick inquiring if I could have a claim determination made since I could not get estimates for a month out in some cases. They advised I had to do this to get a claim decision. Later they got a BBB case I sent to ** in error and asked about filling out damage amounts. I advised the BBB case should go to **. I now have sent multiple emails to Sedgwick and inquired as to who is handling my claim as the Insurance Commissioner of Wisconsin has advised me that Sedgwick does not have a license in my state to handle liability **********************. No one will respond

    • Initial Complaint

      Date:12/30/2024

      Type:Product 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 a claimant receiving *** benefits administered by Sedgwick CMS on behalf of ******************, as I am a former employee number ****** Claim ID ******. I receive benefits continuation forms annually physician statement and claimant supplemental statement and I've asked Sedgwick and my claims examiner Ms. ***** W or ***** M or ***** J I've known her with each surname initial as she has been the examiner of my claim for two decades but this year I didn't receive the forms and they are threatening to terminate my benefits because I haven't returned the forms, because I haven't received them. The last disbursement I received was October 28, 2024 for approx. $1976. and I haven't received anymore disbursements nor will they send the forms. I'd like BBB to assist in resolving this issue so I can complete the form and won't be billed for November payment I never received due to a Sedgwick error or oversight. Thank you

    • Initial Complaint

      Date:12/30/2024

      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.
      On 10/28/2024, I had a plumbing issue that required professional repairs, including clearing my line and breaking through my driveway concrete. Upon investigation, it was discovered that an **** line was improperly installed, damaging my plumbing line. ****** *****, an **** representative, came out to the property while the repairs were being done and confirmed that **** was liable for the damage. I was instructed to contact him with repair photos, costs, and estimates after the work was completed. The total cost was $3,984 for plumbing repairs and $1,600 for concrete restoration.I filed a claim with **** and was received an email from Sedwig with Tavaughn Commack, I then providing all necessary details to Tavaughn, Tavaughn forwarded the case to a third-party company, which investigated and determined they were not liable. They provided contact information for the responsible party to both Tavaughn and me on November 15, 2024. Since then, I have received no further updates despite leaving over 15 voicemails, sending numerous emails, and even including a supervisor in my messages. I have received no responses from Tavaughn or anyone else at Sedgwick.This unresolved claim has caused significant financial strain, particularly during the holidays. I am seeking assistance from the BBB to have this claim resolved so I can be reimbursed for these expenses.I was sent a claims representative through Sedwig: TaVaughn Commack | Claims Associate **** *. ******, Qualified Manager, CA license #******************************., CA license #******* A ******, Qualified Manager, CA license #******* DIRECT: ************ | FAX ************ Mailing Address: ********************************* EMAIL: ******************************************* Supervisor: ****** *** I Email: *************************************

    • Initial Complaint

      Date:12/29/2024

      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.
      I had an accident 9/19/24, Sedgwick is the company insuring the person who hit my vehicle. They took long to send someone to get an appraisal. They gave me an unrealistic estimate. They did not answer my emails or phone calls when the check was supposed to be sent. When the check finally arrived almost 2 months after they said they sent it the check was in Canadian dollars. Lets go back to the estimate they sent me on 10/31/2024. They had sent me an estimate in US DOLLARS USING NJ STATE SALES TAX. THEY MAILED ME A CHECK FOR THE AMOUNT PROMISED BUT IN CANADIAN DOLLARS WHICH IS ALMOST $200 LESS IN US DOLLARS. THE ADJUSTER DOESNT REPLY HE ISNT HELPFUL. AND NOW ALSO NO ******* WANTS TO ACCEPT THE CANADIAN CHECK SO IM OUT OF LUCK TRYING TO escalate this issue within the company no one helps.

    • Initial Complaint

      Date:12/27/2024

      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 was injured at work on December 4th, 2024 and missed work most of that day and also on December 6th, 2024. I have asked my claims adjuster *********** ****, and also reached out to his Supervisor ***** *******. I was told by Mr. **** he put those hours in on December 6th, 2024. I called him back when I did not received those hours on my pay check. I just received my pay for this week and those hours are still not there. I reached out to ********. I was told those hours never got put in. I work 10 hour shifts and I am missing at lest 18 1/2 hours.

    • Initial Complaint

      Date:12/19/2024

      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.
      Hello my Name is ****** ******* and the reason why I am contacting you is because I'm hoping you can help get a issue resolved with the *** reimbursement department. I filed two claims October 8th #******* and ******* for repairs to my vehicle that were under warranty I paid for out-of-pocket at a *** dealership. From what I understand the claims was processed on October 28th and needed a manager's approval for payment. Since October I've had called several times requesting and call back from a manager. The Sedgwick claim manager name is ***** ****** today is December 10th and I have still not heard back from him nor has the claim been approved yet. I called December 6th and spoke with the agent who indicated that ***** was off so he referred this issue to ******* supervisor ******* ****** who is the Ops Manager for Sedgwick. The representative called me back later that day and told me Mr ****** was very sorry for my experience and that he approved the claims and that the checks would be mailed out Monday 12/9 Overnight and that I would get a phone call confirming everything. After I didn't receive a phone call yesterday I called today and was informed ***** needs more time. When I asked if I could speak to him I was told he was in a meeting. I have been a *** customer for over ********************************************************************************* BMWs quality and performance. The Sedgwick's representatives on the phone have been great, But my experience with management and Mr ***** ****** has been very unpleasant with his lack of due diligence. Maybe he needs more customer service training. With that being said I'm hoping ********************************* can do a thorough investigation and also help me get this issue resolved. Please feel free to reach out to me if you need any more information. Thank you for your time.

      Business Response

      Date: 12/24/2024

      We are unable to locate a claim matching the customer's name using the information provided. We need additional information in order to respond.

    Sedgwick CMS is NOT a BBB Accredited Business.

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