Insurance Claims Processing
Sedgwick CMSHeadquarters
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
Customer Complaints Summary
- 538 total complaints in the last 3 years.
- 156 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:08/24/2024
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 againInitial Complaint
Date:08/13/2024
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 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 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.
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 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.
************* 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 *****************
Sedgwick CMS is NOT a BBB Accredited Business.
To become accredited, a business must agree to BBB Standards for Trust and pass BBB's vetting process.
Why choose a BBB Accredited Business?BBB Business Profiles may not be reproduced for sales or promotional purposes.
BBB Business Profiles are provided solely to assist you in exercising your own best judgment. BBB asks third parties who publish complaints, reviews and/or responses on this website to affirm that the information provided is accurate. However, BBB does not verify the accuracy of information provided by third parties, and does not guarantee the accuracy of any information in Business Profiles.
When considering complaint information, please take into account the company's size and volume of transactions, and understand that the nature of complaints and a firm's responses to them are often more important than the number of complaints.
BBB Business Profiles generally cover a three-year reporting period, except for customer reviews. Customer reviews posted prior to July 5, 2024, will no longer be published when they reach three years from their submission date. Customer reviews posted on/after July 5, 2024, will be published indefinitely unless otherwise voluntarily retracted by the user who submitted the content, or BBB no longer believes the review is authentic. BBB Business Profiles are subject to change at any time. If you choose to do business with this company, please let them know that you checked their record with BBB.
As a matter of policy, BBB does not endorse any product, service or business. Businesses are under no obligation to seek BBB accreditation, and some businesses are not accredited because they have not sought BBB accreditation. BBB charges a fee for BBB Accreditation. This fee supports BBB's efforts to fulfill its mission of advancing marketplace trust.