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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

    • 545 total complaints in the last 3 years.
    • 169 complaints closed in the last 12 months.

    If you've experienced an issue

    Submit a Complaint

    The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

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    Complaint status

    Complaint type

    • Initial Complaint

      Date:06/13/2023

      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.
      The last month of April a crew representing *** came to my home and make a ditch to pass a pipe with fiber optic. After several weeks (May 15) I noticed that the water valve of my sprinkle system located in the same position where they dig the ditch did not expel ********. After the sprinkle system instalator came to check the problem, he let me know that the water pipe in that area has damaged, but instead of reporting the damage the *** worker block it in order to hide the problem. I called to costumer service ***, and they directed me to ******* the company who handle all the *** claims. After many attempts I could speak with somebody, she gave me a claim number (2305002135-01), and asked to send a quote of the damage repair. I sent it twice, and after weeks I have not received any status or information at all. Nobody answer the mails and there is no person in charge of the case. The manage everything in an anonymous way. I am tired of waiting and sending mails that have no answer, the costumer service of this is practically does not exist.

      Business Response

      Date: 06/19/2023

      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, 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:06/12/2023

      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.
      On 3/2-2023 I was injured on the job. Sedgwick started to make me payments without any notice for the injury. The they just stopped without any notice. I have received no calls , voicemails, emails or letters that stated when the payment would start or end , in fact I have never talked to a representative for their organization. I was told by an insurance representative that they do not leave messages due to plausible deniability ? I dont feel Im being treated fairly and Im definitely not being communicated with at this time. This put an undue burden on me and my family not including the stress on me and my recovery back to work.I hope that Sedgwick can start to communicate better by ensuring that their communications are received by leaving a voicemail message or email. This has been very confusing and challenging. Very disappointed, employee.

      Business Response

      Date: 06/16/2023

      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, Fairfax County Public Schools.

      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:06/08/2023

      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.
      I rent a storage with public storage and I have insurance coverage through ****** claims Management service a bullet hole ****** through the roof of my storage in February it damaged 80% of my merchandise and property that I have in the storage as of today Sedgwick claims Management service refused to pay out for the damage which I have insurance I've been paying since December at the rate of $15 a month to cover $5,000 worth of insurance they refuse to pay because they want certain documents and pictures and I have a temp several times to send them pictures in the documents I mailed them I emailed them and I text as of today they're still seeing that they have not received them I spoke with two people in 4 months they refused to contact me concerning this matter.

    • Initial Complaint

      Date:06/05/2023

      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.
      2/24/23 Home Deport delivered to me a defective GE dishwasher. 2/28 installer came out to look at dishwasher to rule out installation error. The dishwasher flooded area. ********** was not removed Installer stated he didn't have orders to remove so my son was only able to mop up water on outside of the dishwasher. 3/2 the dishwasher was removed and the cabinets and walls were damaged. I was then directed to *********************** of Sedgwick: She sent me an email. Being new to their system I attempted to call and email without response. I contacted by leaving a message and emailing a ********************* on 3/17/23. He instructed me to contact ******'s supervisor ******. I did and ****** called me back and informed me that their policy was different than homeowners insurance and they don't respond right away for me proceed with mediation. re:Claim #4A23031JNK1-0001. Team Delta was given the job by ******** 3/10 I received an estimate sent it to Sedgwick and mediation was completed. Today June 5, 2023 Team Delta and I are waiting for ****** to give us a response on them completing my kitchen. Team Delta and I have sent emails to no avail. I have called serveral times and today I was sent the ******'s voicemail. I want my kitchen repaired as of yesterday. Please help resolve. Thank you! ***

    • Initial Complaint

      Date:06/05/2023

      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.
      I'm not sure if this claim should be filed against Sedgwick or Zipcar but Zipcar was the company who's service I was using and Sedgwick is who they outsource claims to. I was in an accident in a zipcar in April 2022. I was not at fault and the other party was fully covered and took full responsibility. After 10 months of zero movement on the claim despite multiple calls to check in on the status, they finally assigned a claims manager on 1/30/2023 and immediately took $1,000.00 out of my account. While I have issue with the way they handled that, it was within the fine print of the agreement I signed with ****** and I accepted my fate. I spoke with the claims manager expressing my frustration and need for urgency on the handling of the claim and she confirmed that on 2/3/2023 Geico (the other person's insurance) replied saying they would pay 100% of the claim. Continuing to follow up with her, she confirmed on 2/17/23 ***** issued payment and that as soon as she received the check to allow ***** business days to receive my $1,000 back. From there she stopped being as responsive and I had to start calling from alternative phone numbers to get her to answer my calls as my emails were no longer being responded to. On May 2nd, I finally was able to reach her and she said there was a delay in payment processing as they hadn't received the funds from Zipcar yet and that she was reissuing it to payables to send out. Now it's been another month and I have yet to receive my refund despite them being paid in full 4 months ago! I cannot get a response to an e-mail or an answer on the phone. Please help. I've attached a copy of the e-mail chain with the claim number referenced as well. Let me know if you want anything additional in order to support me on this.

      Business Response

      Date: 06/26/2023

      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, Zipcar.

      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:06/04/2023

      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 filed a claim with Sedgwick on August 30th, 2022 and they STILL have NOT processed my claim. I have called, emailed and provided all the photos, videos, and quotes they have requested. We have reached out several employess, but o one has processed our claim.

    • Initial Complaint

      Date:06/04/2023

      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 was injured in a CVS store due to their negligence. Sedgwick claims adjuster got a hold of me and I followed the directions that I was supposed to do and took care of and mailed the paperwork in and emailed also and never heard back. I had an attorney also write a letter with no response to either him or myself. Then I finally found a phone number to call and they said the claims person that was working with me has not been in the office for quite some time and no longer works at that location. This is pure negligence there shouldve been somebody else to help with my claim, and now my statute of limitation has ran out and I am not happy about this . I believe it was purposely procrastinated and pure negligence. Their office is in ********* ********, but it does say that the business is closed. There is no help for me at all and when I called and finally was able to get a hold of somebody to speak to. She said sorry your statue of limitation has run out . I explain the whole situation to her and she did not care at all. I feel I got the short end of the stick and still having problems that will probably not go away due to the fall.

    • Initial Complaint

      Date:06/02/2023

      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.
      For months now everyone at Sedgwick has refused to return my medical providers calls or faxes. They have been seeking approval for treatments and office visits for a workmans comp injury that ******* has been administering since ****. They have always drug the process out during the entire duration of my suffering but this current length of time is ridiculous. for about 10 months they have been calling as I have been myself for the last month only to keep getting pawned off to a different administrator every few months that will never call back. Repeated efforts at trying to contact anyone for help only results in phone numbers that ask for extension(when I call back to ask for one they say they do not have one to give me) or other numbers that say stay on the line or hit zero that immediately either hang up on you or go to a voicemail box with a number but no name that results in no calls back.

    • Initial Complaint

      Date:06/01/2023

      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.
      Date of occurence was Dec. 13th,2022.Delivery truck from Best Buy tore down electrical wiring and halted service at **********************************(our property). After many calls,I heard from ************************* and was given a BBY01-80671788997. Later received Sedgwick claim #4A23020SMYD0001. After calling their location in *********,**.I was informed that ******************************* was assigned to this case.I have texted her multiple times and talked with her on the phone.She was sent a copy of the invoice, where we had to pay for repairs, months ago.She had contacted me from ************.Extensive attempts to get this settled have occurred since the Dec. date.The total was $420.00.

      Business Response

      Date: 06/19/2023

      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, Best Buy Co.,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:05/31/2023

      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.
      I rented a car from **** and paid for the **** Loss Damage Waiver, which states that **** assumes all responsibility for any damage. The car was damaged when an out-of-control riderless motorcycle struck it. After filling out all the requested forms, about a month after the collision I began receiving correspondence from Sedgwick saying they were a representative for **** and that according to my contract with ****, I was responsible for the damage. To settle the claim, Sedgwick demanded I send them almost $20,000 to cover repairs and fees. I made numerous attempts to contact Sedgwick by phone, fax, email, and US Mail to find out why they were claiming I was responsible for the loss. No one from Sedgwick responded. I am still waiting for Sedgwick to explain the discrepancy between what they wrote about me being responsible and what my contract with **** said.

      Business Response

      Date: 06/28/2023

      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, **** Budget Group.

      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.

      Customer Answer

      Date: 06/28/2023

      The Sedgwick response to my BBB complaint is factually incorrect.  I did not file a claim with ****.  While it is true that Sedgwick represents ***** the fact remains that it was Sedgwick demanding payment from me.  **** did not demand the payment.  Sedgwick is clearly hiding behind its relationship with ****, and still has not explained the underlying discrepancy between my contract with **** and the statements to the contrary made directly by Sedgwick.  For Sedgwick to claim they are operating within legal bounds, when I have in my possession both the **** contract and Sedgwick's demand letter, is truly laughable.

    Sedgwick CMS is NOT a BBB Accredited Business.

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