Insurance Claims Processing
Sedgwick CMSHeadquarters
This business is NOT BBB Accredited.
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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
- 533 total complaints in the last 3 years.
- 153 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:07/03/2023
Type:Service or Repair IssuesStatus:UnansweredMore 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 12/26 2022 I, ******************************* sustained a severe head and neck injury during my shift at *************************** cleaning an aircraft. My head hit the overhead bin and I sustained a considerable amount of injury and memory loss. I began receiving compensation for said injury but was advised that my payments would discontinue until I returned to work and commenced light duty work. I had a conversation with my supervisor, *************************- ************ regarding this and was advised that light duty work is not available. When I mentioned this to Sedgwick they were very rude and abrasive towards me and have since refused to continue my payments. Due to the injuries that I have suffered, I am not able to continue working at this time. The attached document from Sedgwick will show that I was promised payments if unable to make at lease 80% of what I was making prior to the incident. I have been unsuccessful at reaching my adjuster *************************** ************ to discuss the best recourse at this point. I am suffering physically and financially due to this and would like this to be investigated to the fullest extent. I feel that they are preying on my vulnerability and I would like them to be held accountable for their actions. I am on a fixed income and have had a very hard time making up for the lost income. Any assistance available would be greatly appreciated.Initial Complaint
Date:06/30/2023
Type:Service or Repair IssuesStatus:UnansweredMore 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 in a car accident on 2/13/2023 where the other party was at fault. They were driving a rental vehicle and I had to go through the rentals company insurance. My car was found to be a total loss. It has now been 5 months and nothing has been resolved. I can go as long as 4 weeks without hearing anything from them. I have gone through 5 adjusters since the accident happened and nothing is ever done about the claim. I had to spend $2500 out of my pocket for a rental because according to their policy they do not give you a rental, they only reimburse. I just want to settle my claim get my car paid out and get reimbursed for the rental. As of right now my adjuster is *********************. He was assigned to me a month ago. During this time I have only received one email from him. His supervisor is ***************************. I have tried calling her and emailing her but I have not heard from her ONCE.Initial Complaint
Date:06/23/2023
Type:Service or Repair IssuesStatus:UnansweredMore 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 severely injured at work on 03/07/2023. My workmans comp insurance is handled by Sedgwick. I am not able to get ahold of them I leave messages, ask for supervisors name and phone numbers. I am never paid on time. My questions and concerns go unanswered for days and if I do get a response it just brings up more questions. I am also contacting ********** workmans comp division and also looking into hiring an attorney. I am unsure of how a business like this that is playing with peoples lifes is able to still function.Initial Complaint
Date:06/23/2023
Type:Service or Repair IssuesStatus:UnansweredMore 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 12/28/22 at 11:15am I dropped my car off at Best Buy to have a compustar 2 way remote starter installed in my Infiniti FX SUV.I went to best buy around 4pm on the same day to check on the status of my car because I had an appointment at 11:30am, and I hadnt received any calls or updates regarding my car.Once I arrived I spoke to the gentleman who was working on my car (******) and he told me that he was running a little behind and started late on my car and ran into some problems. Specifically, that he was having trouble connecting the starter to my car he also had tried a few other types of remote starters and was continuing to have trouble. He said he thought maybe a fuse was blown and it was not communicating with the brakes. He said he could stay a little later and continue to work on my car and check the fuses. I said okay. ** car was finished around 7pm.after picking up my car and starting it, I saw the engine light was on. The store was close so I called Best Buy one 800 number who then transferred me to the claim department. A claim was started with Sedgwick Claims Management Services, Inc., CA license #***************** days after the install, my car completely stopped working. It was towed to Infiniti dealership and was there for almost 3 months. The battery was replaced. The card was returned to me in about five days later the remote starter continue to have problems. It has been starting on its own without me using the remote or being anywhere near the car. I cannot lock my doors or the car continues to start on its on I contacted *************************** to let him know this on 4/6 he responded to call infini back. I the contacted *************************** 4/15/23, 4/19/23, 4/28/23, 5/12/23, 5/17/23, 5/20/23, 5/31/23 no reply back. I left several voicemails on his direct line no call back. on June 1 I was told by ****** rep. ** claim was closed early April by *****. I would like to know why or how my claim was closed and nothing has been resolved or reimbursed.Initial Complaint
Date:06/22/2023
Type:Service or Repair IssuesStatus:UnansweredMore 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 6/22/23 at 3:14 pm I called the contact center due to receiving a email to complete recertification do to going over the amount of time per provider. Well when I talked to the manager I informed her that the recert stated that i went over for illness time when I hadnt. Upon investigation by the manager it looks like i went over for my treatment but according to the manager you get 1 time over and they can courtesy it which she states is what happened for my approved day on 5/15 for treatment. Well, I didnt know I was given a courtesy as no one contacted me to inform it was just approved as normal. Here we are at May 25th and i call in a couple hours under illness which I hadnt used in May. When speaking with the manager she started someone shouldve called me and informed me that I couldnt use any more time under fmla. Well they didnt and I didnt even know it was a issue until almost a month later. Mind you Ive used time in June already that they stated wouldnt be covered in the email unless they receive the recert. First, if i was called after the May 15 courtesy which is the only way to know you were extended a courtesy I wouldnt have used May 25th bc I wouldve been told that counted as 1 of my days. 2nd we are past 1 month for the 15th of May and almost 1 month for the 25th of May. How can any of my days be penalized when I didnt even know there was something wrong. Sedgwick has peoples lively hood in there hands. They dont know if Im able to get an appt or not. This was sprung on me and an I apologize is unacceptable. Whatever manager/agent that was responsible should be reprimanded. This isnt fair to me as the customer seeing as though there was no way for me to know any of this unless told. I think we should make an exception due to the fact that Sedgwick dropped the ball 100%. I can see not calling for a week or two but over a month and now its my responsibility to fix something I was never told I couldnt do. Per manager she even started the case manager shouldve been called. I need this rectified asap.Initial Complaint
Date:06/16/2023
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.
Sedgwick has the worst customer service. I've been waiting for 2 months to get my claim approved after they ended my one too soon. They said they don't understand why can't I work even though I had back surgery and have them 100s of pages of paperwork.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, Nordstrom, 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:06/16/2023
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.
We had a home warranty through Choice Home Warranty. Our claim was denied and it seems like it all stems from the ***** tech that came on the first call. He broke off a piece as he was diagnozing the problem. I am told by Choice that this is the specific reason that their technicians rejected the claim as it was clearly not due to normal wear and tear if a physical piece was broken off. I previously had filed a complaint under Choice, but now it seems I was trying to get resolution from the wrong party. Hoping that BBB can help.I have contacted Sedgwick several times and left messages without a single return call. We were told that it would take a while, but the last communication that we got from Sedgwick was on 3/17/23.Business Response
Date: 06/21/2023
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, ************** Corporation.
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:06/16/2023
Type:Service or Repair IssuesStatus:AnsweredMore 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 filled up with gas at the local ********** station. My wife was driving and I sat in the car after I pumped the gas. She pulled away and the hose from the pump came off. We apologized and expected to pay for them to re-attach the hose ( I took pictures and it was detached as it was designed). As I said we did expect to pay to re-attach. We got a bill for $822.27 *********** sent me a letter I have calle at least 10 attempts to reach *************************** @ ************, this is the name listed on the invoice I have been sent. And I have called ****** St. **** @************ at least 4 times and left messages at both of these numbers with a few good times to call me back. I have not heard from either representative. I feel like they are avoiding my call and are just gonna send me to collections... Actually they are collections and they can ruin my good credit rating. I feel I am being made to pay this enormiss anount to replace a hose that is made to detach. The design of the hose is for it to pull away. I have pictures and the hose looks totally good and actually still attached. but I am being charged for a entire new hose? Look closely and you will see I just pulled the emergency string.... The hose is still attached. I cannot reach this company and I keep getting new letters from them. I am very upset at Sedgwick. Can you help me please? I can send you pictures if you need.Customer Answer
Date: 06/20/2023
Hello BBB,
Attached are my correspondences with ******* from Sedgwick. I had called them repeatedly and I never get a return call. I have been asking them from day 1 why I am being charged to replace a hose that was not damaged or removed. in these emails attached, ******* stated that the hose was pulled of the gas pump and therefore they needed to replace it. I then sent her the photos showing the hose still attached that day and showing that the saftey cord pulled the hose from my car. So the saftey cord worked as it was designed and the hose was still attached. When I sent her these pictures she said the company had a video and the video showed I detached the hose. This is not true. I asked for a copy of this video and she said she could not release it...?
I have caught them in a lie, I only showed them the pictures after she said the hose was pulled off and detached. But now they wont send me their evidence.
I have attached our correspondences copied from my emails to them and I am happy to send these via another email or take photos of my emails or however you need those sent. I copied them to a word doc attached and taken pictures but I am happy to send you these via email if I can.
I feel I am being pressured into complying with an unfair charges, namely the hose replacement. I am happy to pay them for the resetting of the saftey cord. But I feel they are taking advantage of me with the hose charge. And they expect me to pay them without question because they can effect my good credit.
Thank **************** ***********************************
Business Response
Date: 08/17/2023
Hello,
I have completed my investigation pertaining to this claim per Sedgwick guidelines. We have accepted an offer from the customer and have closed our file.
Initial Complaint
Date:06/15/2023
Type:Service or Repair IssuesStatus:UnansweredMore 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, does anyone know how I can reach someone about my claim? My vehicle was hit by a driver insured with Sedgwick through no fault of my own. I filed my claim in October, filed a police report, and have been unable to reach my previous or current analyst through phone or email or receive any type of update.I've spent the majority of my nights in recent months stressing and wondering if I've somehow missed a step or did something that's resulted in sedgwicks unwillingness to resolve my claim. As a single mother who's little one isn't even yet one year old, this extra stress and worry has not been easy on me. If there's another way to get in touch or another recommended route, please let me knowInitial Complaint
Date:06/13/2023
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.
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.
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