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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

Find a Location

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:12/18/2024

      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.
      This in involving an approved short term disability claim that has been misrepresented and miscommunicated about multiple times. I am currently out on STD through sedgwick due to a severely herniated disc that is well documented through MRI scans. Common symptoms were extreme pain in back followed by collapsing which is why I was kept out of work. I met with my doctor on 12/2 to discuss surgical options where he advised to not move forward with it at this time and instead suggested a final round of injections. I was looking to extend my STD one month to account for my final injection and recovery time per my doctor. I was given a deadline of 12/14 to return my paperwork for an extension and they received my paperwork on Tuesday, 12/3. They have a 48 hour review policy which is shown in their previous replies. Despite this, I heard nothing for the remainder of the week. I called on Monday December 9th and was forwarded directly to my case manager *** alerted me she denied me last week but forgot to alert me. I asked what was needed in order to appeal the decision and she told me I needed to call my *** I explained I did not have a lot of time to meet her deadline given this miscommunication on her part and she promised to assist me and prioritize me. I called my Dr *** laughed at me and said it is Sedgwick's job to let us know what is needed. I then spent the next two days calling Sedgwick unsuccessfully, I was hung up on two times, and twice I was also told my case manager and her supervisor wanted 48 hours before calling me back despite the deadline rapidly approaching and their mistakes. I finally was told by someone not related to my case I needed the surgeon's letter which I gave them same day and was approved within the Wednesday deadline I was given to be paid despite still not hearing back from my case manager. Despite meeting the deadline even when it almost seemed impossible, I was never paid and now I once again can't get ahold of Sedgwick to fix it.

      Business Response

      Date: 12/20/2024

      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, Vanguard.

      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 ****** Slussers complaint. 

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

    • Initial Complaint

      Date:12/18/2024

      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 receive a temporary partial disability Check from said Sedgwick I have not received a check in over five weeks and I have made 20 or more phone calls with messages, phone numbers and claim number to this company with no response and I seem to get a big runaround trying to get someone to call me about my claim this has happened before and I still received no communication with this Sedgwick and now that its a week before Christmas, I have had no checks in five weeks and I would like to have someone look into this company for wrongdoing their Clients

      Business Response

      Date: 12/20/2024

      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, ******************** Programs.

      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:12/16/2024

      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.
      My storage unit was robbed at public storage along with about 20 other u its in property. Sedgwick orange door insurance is the company that these people use. Ive sent in police reports reciepts and all identification needed for my claim now no one will call me back its been over a month. Something fishy is going on with these people someone in the company is stealing and they also dont want to handle business

      Business Response

      Date: 12/26/2024

      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, ****************************** Program).

      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 Crystal ********* complaint. 

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

    • Initial Complaint

      Date:12/16/2024

      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.
      Not returning phone calls emails or texts. Leaving me without payment due to this

      Business Response

      Date: 12/20/2024

      Thank you for the opportunity to respond to the complaint filed by Pandora ********************** 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 Pandora *************** filed against our client, Retailers *************************

      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 Pandora **************** complaint. 

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

    • Initial Complaint

      Date:12/14/2024

      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.
      I was injured on November 11, 2023 at my now former employer i twisted and rolled my foot to the right, I was sent to Med xpress once a week for a month before a ortho referral which took months. Foot went numb during the wait was then referred to Neuro who said it was my back , MRI done sent to therapy , therapist said no not the back contacted ** ordered a custom made brace for my foot. Neuro ordered a nerve test which the office has cancelled TWICE and another scan of near my rear but ** still wants to see me even though there is no results to read. Contacted my case worker ******* ***** and was informed she would contact legal to see about getting me another ** or scheduling the nerve test on her own to get answers, NOPE instead legal suspended my payments said waiting on determination of lumbar injury, ** ruled out back injury and ordered a foot brace, no notice no call nothing just suspended for a injury that either way would have been there responsibility to cover but has already been ruled out. I feel punished for the fact that they placed me with a ** that I feel is milking the system now all tests are obsolete and Ive lost income 2 weeks before Christmas, so thank you so much for making Christmas for my kids non -existant and not having the courtesy to even call or message to give me a heads up. You have all the documentation, there have been numerous calls discussing my concerns with this ** and no answers after a year, but im the one who is punished and ghosted.

      Business Response

      Date: 12/26/2024

      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, (****************.).

      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:12/12/2024

      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.
      In September, I had appliances delivered by **********/***************. They damaged my property while doing so. I filed a claim with them. Sedgwick Claims Management Services received the claim. I was working with an associate, ***** Hope. All items she requested were sent and I was offered a settlement in the amount of $3880.88. I was told that if I accept the offer to contact her and I will have to sign a release form. I have all of this in writing. Since November 25, I have sent 4 emails to her, have left voicemails for her, have sent an email to the Northeast Regional supervisor and an email to a main Sedgwick page and have received no response. I am trying to let them know that I want to accept the offer and need to sign that release form. They will not reply to anything. I am including evidence of all of the emails. You can clearly see where I am trying to accept the offer but can get to response to sign the release form.

      Business Response

      Date: 12/26/2024

      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, (*******************).

      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 **** Doves complaint. 

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

    • Initial Complaint

      Date:12/11/2024

      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.
      **** damaged my property when excavating and laying their **** line. My claim was outsourced through Sedgwick for resolution of the problem. The problem has not been resolved by Sedgwick and my claim has been wrongfully closed due to my Claim Examiner's inability to understand the situation. My property has experienced a thousand dollars of damage, it remains damaged, and Sedgwick and **** refuse to reasonably work with me toward resolution of the issue. My Claims Examiner is TaVaughn Commack **************** and his supervisor's name is ****** *** ***************************************

      Business Response

      Date: 12/26/2024

      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, (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 ***** ****** complaint. 

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

    • Initial Complaint

      Date:12/11/2024

      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 attempting to sign up for school, and received a voucher from my employer through my workers compensation claim, I have been unable to reach anyone, I keep leaving messages, about to miss my deadline to finish registration, through out my whole experience, I feel like I am being taking advantage of because I have no attorney, or simply just dont know the ends and outs, I am forced to settle a claim without a hard copy of my medical report, there is no way to report it, to anyone else because I am always routed to the voicemail, and never received a response back, major insurance company, is taking advantage of me by non compliance, even though it says online how to communicate, it never works for me.

      Business Response

      Date: 12/20/2024

      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:12/11/2024

      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 had an active Workers Compensation claim since 09/18/2024. During this time period I have had multiple issues with the handling of my claim. My claims manager on multiple occasion has misrepresented the settlement offer presented to me by my employer. Ignored my attempts to negotiate with my employer. Which has delayed the settlement process for over a month.Refused to take my calls/ respond to my messages. I have in prior months escalated it to the appropriate supervisor, with no resolution being reached. I have not been paid any of my Compensation benefits and I am suffering financially because of the negligence of my claims manager. The subsequent financial hardships have led to me being unable to continue the proper medical treatment recommended for my condition. I have been left liable for all medical bills associated with my work related injury. Most recently I asked for the corporate office contact information and was denied the right to reach out to Sedgwick **************** with my concerns. It is evident that Sedgwick has acted in bad faith and I am looking forward to hearing their responses and reaching a resolution on the matter.

    • Initial Complaint

      Date:12/03/2024

      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.
      I was rear ended by a cement mixer and Sedgwick handled the claim from the cement mixers insurance. They suggested that I go through my insurance and they would reimburse my insurance. As a result, I had to pay my deductible. Its been four months and they have not reimbursed me for my deductible and have not responded to emails. My insurance just told us Sedgwick has not responded to their requests to reimburse me for my deductible either.

      Business Response

      Date: 12/20/2024

      Thank you for the opportunity to respond to the complaint filed by Yaella ********. 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 Yaella ******** 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 Yaella Aronhimes complaint. 

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

    Sedgwick CMS is NOT a BBB Accredited Business.

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