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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

    • 539 total complaints in the last 3 years.
    • 157 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:05/10/2024

      Type:Service or Repair Issues
      Status:
      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 filed a FMLA and short term disability claim with Sedgwick 4/12/2024 at that point I was told my claim worker would be in contact with me within 1-2 bd and I would receive my documents 3-5 bd which never happened. I reached out 4/19 requesting my claim worker to call me and for my documents, I got the docs 4/19 but no call. Ive left messages via the communication center on my Sedgwick account several times since the 19, called in leaving requests for a call at least 7x and have yet to get a call for my short term disability. I needed assistance with my documents, never received any. My employer TTEC isnt assisting. I uploaded my disability docs 5/6/24 which has a 2-3 bd tat to be reviewed and a decision made and they have not even been open yet by my claim worker. I still have not received a call. I have even left messages for supervisors of supervisors to call me which has not happened either. Oh, I did call Sedgwick again today and was not able to get in touch with my claim worker nor her supervisor so I requested an Escalation complaint be made. Doubt it will happen. Please help me.

      Business Response

      Date: 05/15/2024

      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, TTEC Services,Corp.

      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:05/10/2024

      Type:Customer Service Issues
      Status:
      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.
      Contacted **** on 4/17 gotten the run around. On 5/1 & 5/8 left phone messages at ************ and emailed 5/9/24 showing on website at ************************************************* and it bounced back. On 04/15/24, I had work done on my sewer line by Roto-Rooter. It was found after usage of a camera, that my sewer line was damaged. It was farther found that the damage was caused by ****. **** cable was found to have been installed over the damaged sewer line. I was charged $495.00 to clear the line (invoice #***********) and another $5005.00 to repair the line (invoice #***********). I am requesting at this time full reimbursement from **** in the amount of $5500.00 (Roto-Rooter **************, CFC: *******, Federal I.D. #**-0499300). Roto-Rooter has all of the pictures and evidence of the damage. Thank you for your help in this matter. *********************** ****************************************************************************** **************
    • Initial Complaint

      Date:05/09/2024

      Type:Service or Repair Issues
      Status:
      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.
      Minor traffic collision on 4/15/24. The at fault party uses ************* a claims management company out of *********, **. I have filed the claim and still no resolution. I am getting the "still investigating" replies when I ask for a status update. Very simple claim, just needs to be resolved.

      Business Response

      Date: 05/14/2024

      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, NCACC Liability and Property Pool.

      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:05/09/2024

      Type:Service or Repair Issues
      Status:
      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.
      4A2312J069R-0001, 12/15/2023 I purchased a ** and had it installed by Geek Squad. How the ** was improperly installed caused the ** to fall off the wall mount. The ** falling off the wall mount caused the ** screen to crack and the dresser near the ** to be damaged. When I filed my claim, I called Best Buy customer service, and they forwarded it to Sedgwick. I was assigned to ******************* Claims Representative Best Buy Stores, LP Dedicated Unit Sedgwick Claims Management Services, Inc., CA, license #*******. He issued me a check for $662.59 for the damage to the dresser ONLY. When I asked about the ** and the wall mount, he told me he needed to redirect me to Best Buy customer service for replacement. After over two months, I still had not heard from Best Buy, so I called. Best Buy then sent a Geek Squad rep to look at the ** and wall bracket to ensure they needed to be replaced. He came and took pictures and determined that the ** was broken and needed to be replaced along with the wall mount. After several weeks of hearing nothing, I reached back out only for Best Buy customer service to tell me I needed to call Sedgwick because the rep that came to my house thought he was taking pictures for Sedgwick to replace the **. I called Sedgwick, and they advised that it was a Best Buy problem. After being bounced between the two companies for several calls, someone from Sedgwick asked for receipts to determine the cost for the items required to be replaced. I emailed to him since March and no response. Since we will be replacing the ** and bracket now, another rep has to come and do the same thing so he can put in a note that we will pay for it." I was furious because, at this point, we were in May, and I'd been without a ** since December. Additionally, every time an appointment is scheduled, I miss a day of work, and I'm a lawyer. Just please give me the money to replace the tv and bracket.
    • Initial Complaint

      Date:05/07/2024

      Type:Service or Repair Issues
      Status:
      UnresolvedMore info

      Complaint statuses

      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      Answered:
      The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      I have a claim for property damages which is being handled by sedgwick. I have not been able to contact them for over 2 months and my property is still damaged. No information, no way of knowing what is going on, this place is ridiculous.

      Business Response

      Date: 05/13/2024

      We have received the BBB complaint filed by *********************************.  However, there is not enough information to assist (namely, the Sedgwick client who was involved, claim number, etc.).  We would need to be provided with that information to assist. 

      Thanks!
      Sedgwick Legal 

      Customer Answer

      Date: 05/13/2024

      4A2403KVXY8-0001 is the claim number I have, my address is 102 green acres *******************. Phone is **********. Email is *********************.  so somone at sedgwick can contact me.
    • Initial Complaint

      Date:05/07/2024

      Type:Product Issues
      Status:
      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.
      We submitted bills for a patient and on 04/23/2024 I called the adjuster ***************************************** at ************, he stated I needed to speak with bill review for status of the medical bill. I called bill review at the number he gave me and they stated the claim had been with the adjuster for over two weeks and I needed to speak with the adjuster, ***************************************** to get the status and reason it was not released for payment. I called the adjuster back and left a voicemail, I also emailed him. On 04/26/2024 I had not received a response, I emailed again and left another voicemail. I also called his supervisor from his voicemail, *********************** at ************. On 05/01/2024 I still had not received an email or call and I left them each another voicemail. Today, 05/06/2024 I called bill review to see if perhaps the bills had now been processed. the rep said they are still with the adjuster and there are a lot of bills for this patient pending. She gave me two additional numbers to call ******* at ************ and Sinead at ************. I called both and left voicemails although ******'s number has a Sedgwick employee named ***** on the voicemail.I just want a call back or email back with the status of the bills for the medical services we provided for the insured.
    • Initial Complaint

      Date:05/07/2024

      Type:Customer Service Issues
      Status:
      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 reported a claim, sent pictures and an itemized list 4/3/3024 and have yet to any response via email, or phone call in regards to my claim
    • Initial Complaint

      Date:05/06/2024

      Type:Service or Repair Issues
      Status:
      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 was sitting in my car with my mom and a grocery store employee scraped my car with a cart. I got out of the car, saw the damage, took a picture, etc. I spoke with the stores manager who also took photos of the damage, apologized, said that I would be taken care of and everything. They opened a claim which went through Sedgwick. Claim number 4A24013HNMG0001. I was assigned an examiner who was incredibly unprofessional. I asked for her supervisor and was completely ignored. It took her weeks just to tell me to go get cost estimates done for my car. I was under the impression my claim was approved, why would they have me get estimates if it werent? I got busy at work and couldnt get estimates right away, my case was transferred to someone else, who then closed my case without any warning after only one week, even though they take their sweet time relaying the most basic information. I try to get in contact with them, asking for it to be reopened. She asks for when Im available, I tell her, and hear nothing for over a month. I call multiple times, nothing. I email her, she lies and says she called me. I have no record of this call anywhere, I ask her to confirm the number she called and she ignores me. Finally 4 months after this all started I get on the phone with her (she didnt even call me within the time I provided) and she told me my claim has been denied. I asked why it took 4 months to tell me that, she didnt have an answer. She says the store cameras dont show my car get hit. Apparently they think I got out of my car and started this process, took pictures, etc. for no reason. I asked for their supervisor and was again ignored. Regardless of their determination, their customer service experience is an absolute disgrace. Both of my examiners were horrible. I have worked multiple customer service, ticket/case jobs. If I ever took so much as 48 hours to get back to someone, I wouldve been fired on the spot. Absolutely disgusting and unethical practices.
    • Initial Complaint

      Date:05/06/2024

      Type:Order Issues
      Status:
      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 express my dissatisfaction with the way Sedgwick ***************** handled my insurance claim. Specifically, I want to address the incidents involving my storage units at Public Storage, located at **************************************************************************. Despite the fact that the facility was burglarized around September 29th, 2023, I was not notified by Public Storage. Upon discovering the burglary on or around January 20th, 2024, I found that my unit (#****) had been closed and rented out to another customer without my consent. Additionally, another unit (#****) showed signs of tampering, indicating a further security breach.When I submitted my police report and completed claim documents to *********************** at Sedgwick Insurance on April 11th, 2024, she promptly dismissed my claim without proper consideration. Despite providing compelling evidence from both Public Storage staff and the local police department confirming the burglary, ***** refused to follow up on it. She also disregarded my signed insurance statements, granting permission for the insurance company to investigate incident details available at the local police department. Her dismissive attitude during our communication, including her abrupt termination of our conversation, was highly unprofessional.Although I have escalated my concerns to *****'s supervisor, *****************************, I have yet to receive a response. Due to the severity of the mishandling of my insurance claim, I am considering filing formal complaints with regulatory agencies such as the Better Business Bureau, ************************** and NJ ***** of ******* and Insurance.I respectfully request appropriate action to rectify the mishandling of my insurance claim. I suffered a $68k loss of my precious garaged items. I request the maximum allowable coverage for each affected unit, which regretfully only covers a fraction of my total loss.

      Business Response

      Date: 05/22/2024

      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, Orange ********************** 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 Kara ***** complaint. 

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

      Date:05/06/2024

      Type:Service or Repair Issues
      Status:
      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 Number: 4A240350PL2-0001 On March 22, 2024, I observed my storage belongings to have substantial water damage. At the time, I didn't know where the water had came from. I immediately filed a claim with Sedgwick CMS. After four days, I received a letter from an adjuster, requesting pictures of my bed and other stored items. I submitted images and a detailed list of what the items would be to replace. About a month to six weeks after, I sent the documents to my claims adjuster. She finally sent me a letter, stating that my claim was denied. This was very upsetting because, I pay insurance to protect my belongings. The water damage has ruined my my queen **** bicycle and the remote control to my adjustable bed. I am disabled and need my bed working. I have called the company several times and also sent emails to my adjuster for answers. The business is not working with me with my water damaged items. The insurance states that water damage is covered. I do not live in the are and are unsure how long the water was there or how it got into my storage unit. I need my claim followed up on by management.

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