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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

    • 536 total complaints in the last 3 years.
    • 154 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:10/18/2023

      Type:Service or Repair Issues
      Status:
      Unanswered
      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.
      The date of the claim is 08/27/23. I have attempted to work with Sedgwick to resolve a claim due to a robot vacuum destroying the finish on my hardwood floors. The process began the beginning September. This whole process has taken way longer than necessary. My calls and messages to claim examiner ***************************** have largely gone unanswered. He never calls me back. I have been put off multiple times, being told I would get a final decision in a few business days. Well a few business days has turned into weeks.

    • Initial Complaint

      Date:10/16/2023

      Type:Order Issues
      Status:
      Unanswered
      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 08/06/2023 my truck was totaled out by a customer of **** that failed to yield after a stop sign. I was doing the speed limit of ************************************************************** slow down from 55 mph. Highway patrol report states their customer was at fault and even received a ticket. Sedgwick is who is supposed to be handling the insurance claim sent me an email stating it would go to their customers main insurance but if that company denied the claim, send them the denial letter and they would take care of me. Customers insurance company denied claim stating the vehicle their customer was driving at time of accident was not covered by customers policy and sent me the denial letter. I sent the denial to Sedgwick and asked for a phone call to find out what was going to be done and after a week and a couple days I got nothing not even an email. I called the adjuster and left a voicemail and her message says she call back within 24 hours. Still nothing. I emailed and left a few more messages the next few weeks. Still have yet to get any response from Sedgwick. Emailed the main office of the company and STILL NOTHING. Its been over 2 months since the accident and Ive not had a vehicle to drive. Not been offered a rental. My truck was towed and still sits in storage and the bill is over **** dollars and rising daily. This has been the worst experience Ive ever dealt with.

    • Initial Complaint

      Date:10/12/2023

      Type:Customer Service Issues
      Status:
      Unanswered
      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.
       work for CarMax and went through a mental health crisis recently and was told by my management to use the ******************* Sedgwick & AbsenceOne to conduct my claim and get my leave instated. I had issue after issue getting in contact with the company and getting the correct information regarding my claim but I sent every screenshot I could, regarding *********** visits and messaged them in the app almost daily hoping to get some assistance. Without getting paid from my leave, I fell further into financial distress which caused my phone service to get turned off. I finally got a response in the app regarding what email to send the information to. I requested for my psychiatrist to send over a letter detailing the reason for my being out and what we have been doing during the time to address the issues. Few days go by and my claim has been denied, I called them a few times and finally got in contact with a woman who informed me that they couldn't help me and was rather rude about everything, through talking to the woman though, I learned that they have given me the wrong email to send my claim information to and then she proceeded to tell me it was still my responsibility. I have screenshots of the emails, the messages in the app, and more. Through all of this, it seems as if I also lost my job through failure to complete the claim information. I only want to be paid for my leave so I can get myself out of the hole and work towards further helping my mental health. Without my job, I do not have the insurance to cover my psychiatry visits or my medication. Sedgwick was quite possibly the most difficult app to use, most difficult to get correct information, and each person I talked to on the phone was rude and "transferred" me to other people but the phone would always hang up. Thank you.

    • Initial Complaint

      Date:10/09/2023

      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 had damages to my home by MCT- Sedgewick is their insurance company and Ive been waiting since May for a resolution. They have handed off my claim multiple times and are not responding to any of my emails or picking up the phone. ************************* was handling my claim and Ive emailed the company over ***************************************** with the settlement. Damages are approx $7,500. Please contact me if you need any more information. Claim number is 4A2304TXPTB-0001 and the damages were from MCT installing appliances and they irreparably (replacement needed) damaged my floor, counter and backsplash. Thank you

      Business Response

      Date: 10/16/2023

      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, ************* 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:10/07/2023

      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.
      Purchased refrigerator from best buy and paid for the delivery and installation that best buy offers. Wednesday September 20th Fridge is delivery at approximately 0800 and installed. No issues delivery crew was very polite and professional. They hauled away our old fridge.3:30 PM same day water is noticed on basement ceiling directly below refrigerator. The refrigerator was moved away from the wall and water was underneath the fridge leaking from the water line. I called Best buy multiple times that night who stated they allegedly had called the dispatch for the delivery crew with no answers. They promised someone would call me back to close the loop. I did not receive a call back. 9/21 I called best buy numerous times on this day; at one point I was on with a supervisor. The call was disconnected, and he never called me back. Everyone I have spoken to at best buy has a different answer. No on is on the same page. Multiple case numbers open. One of the representative notifies me she has filed a claim with their insurance company Sedgwick and tells me I will be compensated for this experience. Representative notifies me that the earliest then can have an installation crew come out to fix the issues is Saturday 9/23. I expressed great concern over this and she notified me she would work on getting a sooner date, but would call be back either way. I again was promised a call back by the end of the day for loop closure. I never received a call.9/22 I call Best buy, this representative informs me that a claim was not filed and the previous representative did not know what they were doing. we stay on the phone for over an hour while she files the claim and we speak with Sedgwick. I am told that a Sedgwick assessor will be in touch with me within 48 business hours. I inquired about the compensation that the other representative mentioned and I am told I should be more worried about my home. I reassured the representative I am greatly concerned over this entire ordeal. They schedule the installation crew to come back out Monday 9/25 to fix the issue- this is the earliest the claim they can get someone to come out. 9/25 Different delivery crew arrives at approximately 0700. They call prior to arrival asking if they are conducting a fridge installation. Inform them that it is not an installation the fridge that was installed last week has been leaking. One of the team members talked about how heavy the fridge is and how the original delivery crew should have been the ones to be called back out here instead of them. Instead of asking his team member for help he attempts to move the fridge out by its doors and pops a door off. They reattached the door and appear to fix the water line. The same crew member state that the original installers didnt know what they were doing and should not have attempted to hook up the water line. 9/26 Contacted best buy to inquire about insurance claim and the promised compensation. I was given a number for Sedgwick and given 100-dollar credit. Original installation crew calls to set up a time to fix the fridge, I informed them it has already been addressed I received an email from ******** who is a supervisor from ****** delivery service (original delivery installation crew who best buy contracted out for the job). Looking for information on a claim filed from best buy. I responded that I am working with Best buy on this. There has been no guidance to be working with the contracted vendor they hired for the job. 9/27 call Sedgwick and left a voice mail 2nd email from ******** and Apogee they are asking me for all of the same information I have spent hours on the phone with best buy providing. I inform her I will be working with best buy and their insurance company on this. No further emails received. Best Buy didnt mention anything about this company reaching out, I am weary to work with them I dont know anything about them or if I can trust them. 9/28 call Sedgwick twice and left two voice mails 9/29 call Sedgwick and left a voice mail 10/07/2023 I have not heard from Sedgwick, Best Buy or anyone else and this is still unresolved. I am concerned for the integrity the wood that was damaged and the possibility of mold and any other potential impacts this caused.

      Business Response

      Date: 07/01/2025

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

      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 ***** *****-Pleaus complaint. 

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

    • Initial Complaint

      Date:10/02/2023

      Type:Service or Repair Issues
      Status:
      Unanswered
      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, I was hurt on the job , company had promised to , process my long term disability, I was currently out on short term, for different body part. I have tried for months to resolve situation. I can not get a call back regarding issues, people nice who take your info but management is the issue. I have diligently perused this for at least 5 months, I dont understand, how cruel this company is. Unfortunately I am no longer employed with my employer, but they provided no assistance, lots of promises but no resolution

    • Initial Complaint

      Date:10/02/2023

      Type:Service or Repair Issues
      Status:
      Unanswered
      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 physician who has provided care for patients referred to my practice by Sedgwick Insurance services. I have not been paid on many claims. My office has spent countless hours attempting to resolve the non-payment. I understand that the BBB does not deal with monetary billing collections. My request is help with contacting Sedgwick. My office has called the company and it's representatives (aka adjusters) rarely speaking with them. Instead, countless messages have been left with Sedgwick and their adjusters without any returned calls. I have personally called to be able to speak with an adjuster and/or supervisor and have only been able to leave messages on an answering machine. I need help to speak with someone in charge of the concerns.

    • Initial Complaint

      Date:09/29/2023

      Type:Customer Service Issues
      Status:
      Unanswered
      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 owed $690.47 for a rental car reimbursement. I have provided all requested documentation and Sedgwick refuses to ************* or respond to email. I have been trying for months to resolve this. The company is virtually impossible to contact. The claims processor is *******************.

    • Initial Complaint

      Date:09/29/2023

      Type:Customer Service Issues
      Status:
      Resolved
      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      Answered:
      The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      My complaint regards the ***************** Sedgwick CMS. I do not know which office has handled my claim for coverage of minor damage to my car in June. The claims agent who began the process was *************************. She took information, issued a claim number and arranged a rental car for my use while my car was being repaired. I was required to complete and sign a property damage release in order for Sedgwick to provide payment for the repairs and rental. I returned the signed and notarized release on August 10. I have not heard from her since July. She does not answer her phone or acknowledge receipt of my emails. I recently tried to contact Sedgwick to speak with someone in the company for assistance in contacting ******* and have had to leave a voice message at the company's general mailbox. So far no one has responded. When my car was repaired I paid the full amount due to the repair shop and now I would like to be reimbursed by Sedgwick but am finding it impossible to communicate with ******* or the company itself.

      Customer Answer

      Date: 10/02/2023

      Thank you for pursuing this issue. Luckily it has been settled. The claim agent finally contacted me and took care of my concerns. I now consider the issue finalized.

    • Initial Complaint

      Date:09/27/2023

      Type:Service or Repair Issues
      Status:
      Unanswered
      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.
      Good evening,Id like to make a formal complaint against *************************** **** and ***********************. My case was approved after my Nurse Practitioner provided **** with the appropriate medical documentation. After 3 weeks she released a payment. Upon waiting for my next check..3 weeks passed and she sent a letter stating that she needed a clear picture of what is going on yet she had the clear picture or she wouldnt have approved it to begin with. She had Examworks schedule my appointment with a n Orthopedic surgeon which wasnt for 2 weeks out, then stated IN WRITING that it could take **** business days for an answer. After numerous attempts to contact her(once **** days lapsed) she obliviously answers as if I hadnt left a ton of messages and tells me it can take 14 days now. Meanwhile Im back to work thankfully, yet over a month behind on my bills! Her nonchalant, unprofessional behavior is unacceptable and illegitimate. After contacting the surgeon who she requested to see me, they informed me that the report was completed less than 3 days after my visit. Why hasnt she processed my check?Im requesting my check and disciplinary action . If I need to go to court and write letters to BBB, I will until this is resolved. Thank you in advance for your prompt response and attention.Best Regards,*************************** RN ************

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