Sedgwick Claims Management Services’s earns a 1.4-star rating from 396 reviews, showing that the majority of claimants are dissatisfied with claims handling process.
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unprofessional
This company is International Papers disability and Fmla claims administrator . I have dealt with so many different people there it is not funny. They are the most unprofessional group I have ever had to deal with. These people do not have any common sense and think it is fun to disrespect people with disabilities such as myself. This company has no...
Read full review of Sedgwick Claims Management Services and 5 comments3rd denial
Dear mr. david north,
Just wanting to say I hope you (mr. north) and your family are having a very good christmas, as your company has ruined ours, two very wonderful kids of ours “didn’t” get a christmas this year thanks to your pos company and un-knowledgeable staff who dose the claims, its just wrong that you teach your employees to deny 95% of claims, (http://www.gesupplydiscrimination.com/files/htm1/david%20north%20sedgwick%20cms.htm, plus many others…
Coming from what I have read on the net). we are now on the 3rd appeal waiting for a decision from sedgwick, again.. we are about to lose our house as we are 2 months behind, our lights are about to be turned off, as well as the water and gas, so as for the moneys my wife is due, I hope you used it to buy your loved ones all the gifts they wanted while we are here waiting for another answer and about to be homeless, I just don’t see how you can sleep at night knowing what your doing to people who really need this money to make it in life, it seems as if you are a heartless man. my wife has paid for this insurance, its not like she getting it for nothing, it makes me very angy and I now see why people do stupid things in this world to get even! my wife has been pretty much bed ridden for the past 3 and a half months due to lupus, and failing kidneys (which sedgwick know nothing about), my wife is a nurse and had to leave work due to this illness as she couldn’t do what was asked of her and had to be put on a short term leave, and possibility longer as she’s not getting any better! her “3” doctors have written note after note to sedgwick stating that my wife “can not” work due to her illness and bad side effects of these hard meds she has to take. why do you treat people like this and leave them hanging and suffering? you should man-up and do what’s right and care for those who really need this to survive as your getting older and your time is coming and karma is a, you know what. my wife is a wonderful person/nurse who has always helped the sick, but now that she’s sick we have to deal with your company (how the heck is she supposed to get better when all she’s doing is worrying about weather or not she going to get denied again), she doesn’t deserve this at all, as well as the thousands of other people who are constantly getting denied. it’s the holidays and cause of the pain your company has caused we suffer and don”t get one, thanks to your deny rate, … how do you see this is fair mr. north? i’m sure if it where “you” or “one” of your family members it would be a way different story….. things need changing, time for you to stop being the grinch/scrooge and change your ways for the better, as when its time you will go up not down. like I said I hope you have a wonderful christmas while we are crying and suffering thinking how are we going to put a roof over our heads and food on the table. you should know that our two kids didn’t get one christmas gift under the tree this year thanks to sedgwick, and that’s sad mr. north and that puts a big grudge towards you. the effects your company puts on good people are not good ones but god is the #1 who will judge you.
God bless you mr. north and hope to hear from you, but that I truly doubt, as this is like the 6th letter I have sent trying to get a hold of you.
M. tyler
The complaint has been investigated and resolved to the customer’s satisfaction.
denial of short term disability
I had complex foot surghery on 8/1/2013 and was granted 3 weeks of FMLA having to return to work on 8/28 where I requested an extension since I was still in my post-operative bandages having to keep my leg raised above my heart however, Sedgwick CMS who is the Leave Administrator for my employer, UnitedHealthGroup, denied my FMLA along with short term...
Read full review of Sedgwick Claims Management Services and 2 commentsmonthly medications
It seem like they like to cut my monthly medications off every few months, that I have been prescribed for over 12 years.
Always need prior authorization. How many times do they need this? Take care of the issue.
My claims adjuster Jonathan Accardi should find a real job. I cannot imagine how he sleeps at night knowing what he is doing to people who are injured!
I never had any problems with the other ins. companies, ex.(Kemper, etc.)
They purchased my file, I did not ask them to. Take what you get.
If these guys families had a injury would they treat them that way?
I too had problems with Sedgwick in Houston Texas, samething happened to me what is it with this company, something needs to be done about this.
denied relapse claim
My name is Beverly Anderson .I am a re-hire since 10/2/2011. In December 2012 I had an injury that triggered an underlying medical issue called Degenerative Cervical Disc disorder. It created pain so severe because of 2 damaged spinal discs, my entire upper right extremities, and could not sit, or type for long periods . I was**approved for FMLA on the initial claim # B225012754000-10. In February 2013, I had a relapse and was ** approved for short term disability, claim # B2250127540001-11, and was under Orthopedic care 2 weeks physical therapy. I returned to work, as my Dr said, too soon and had to leave work early on 3/10/13, I was rushed to after hours urgent care . The issue had worsened, a Surgical Nerve Block was ordered, by the same Ortho Physician, for the recurring, worsened issue. . I was ordered to be off work prior to the surgery, , follow-up and PT was ordered for an additional 2weeks, I was not released to return to work until 4/4/13. (documented )ATT IDSC agent advised this would be considered a relapse because it happened within 45 days of the last claim. My claim was denied, stating the Dr did not provide enough clinical evidence that I should be approved for short term disability . I have appealed and included the US Department of Labor Law 29. CFR 825.306 & 29 CFR 825.307 that states: Under regulations issued by the Dept of Labor, an employer cannot require the diagnosis of the employee or covered relative . Furthermore, once medical certification is provided, the employer **may not** request additional information from the healthcare provider. While the employer may contact the employees healthcare provider for purposes of clarifying and authenticating the medical certification, the contact must be made by the healthcare provider representing the employer "only". 29 CFR 825.307. Not only did they deny a claim that was recurring, it was at a more serious level, and they had the case worker contact the hospital staff before I was even out of recovery, the day of the surgery, the agent Monica Brewer, called my phone before the anesthesia wore off and threatened to deny my claim if they did not get the surgeons clinical notes by the end of 3/20/13, ( the same day of the surgery ) I was off 3/10 thru 4/3/13. and my claim is still in denial. I am of again because the surgery failed and I am scheduled for yet another and am afraid I may lose my job now. This is not legal or fair, Please help Beverly Anderson
The complaint has been investigated and resolved to the customer’s satisfaction.
sears tech caused water damage
I had my appliances insured through American Home Shield. My wash machine was making a loud noise and I called American home Shield. They sent a Sears tech out and he stopped the noise but when he left I put a load of clothing in the washer. I turned the wash machine on and left the laundry room and returned a few minutes later to find the kitchen flooded with water. The water ruined my kitchen floor and went down into the basement and ruined my ceiling tiles. I called Sears back and they came out the next day. The tech guy claim that he could not find where the water was coming from. I believed that he did not put the water hose back down in the drain and when he came back the next day he realized it and put it in the drain and pushed the wash machine back up against the wall. He told me that his insurance was with sedgwick CMS. I called Sedgwick many many times and left messages after messages. They never would returned any calls. Finally, I got to speak with someone who asked for pictures and 2 estimates. I sent both and again they would not return any calls . Finally I was able to get a supervisor that was very rude and said that she was not going to pay. I contacted American Home Shield and Sears and both said that Sedgwick CMS should pay.
The complaint has been investigated and resolved to the customer’s satisfaction.
Based on your experience, I believe that American Home Shield hired Sears tech to repair your appliance. Sears tech., screwed up and that screw-up caused you damage to your property. Do I have this right so far? If so, then Sears has Sedgwick CMS to do its dirty work to deny your claim. Sears is trying to sell their home repair service business and they don't not want to payout any money for damages caused by its products or service. So, I would strongly urge you to file a complaint with your contractor's license board and state that Sears did substandard work which caused you damage. Stuart Reed is the overall manager for their home services at Sears. He will likely not respond favorably your complaint. His division is about to be sold and likely there won't be Sears home service much longer. So complaint to your attorney general, contractor's licensee board and every regulatory agencies you can find. Also be sure to include in your complaint American Home Shield as well since they are the one sold you a bill of goods. As far is Sedwick is concerned, they are very dishonest and their only job is to deny legitimate claims on behalf of the companies that here them. So be sure to file a complaint with your department of insurance. Good luck.
denial of claim
I was recently terminated from my job due to my FMLA running out. I was on short term disability with Sedgwick CMS (which Sedgwick denied the claims until my FMLA time ran out, then they back approved them) they approved me for 6 months of long term disability. Now that the 6 months are up, they have denied my claim. I've read things about this company and they find reasons to deny people, without merit. For me, I feel like they are just denying me for the heck of it and just to see if I will appeal. I know these companies think the claimant will just go with the flow and give up. But my condition is serious and I am not giving up. My job basically forced me to go out on FMLA leave. I knew I needed to, but I was pushing myself to work as long as I could not taking into consideration the effects it was having on my family. Recent google searches for Sedgwick has shown up many scams. I do not trust them and feel that they are not taking my claim seriously.
insurance
Been having the same problems as the other complaints posted on here. They do not return phone calls in a prompt reasonable amount of time and are trying everything in their power to not pay up even though it is their responsibility. The only way I been able to get anywhere is leaving a message that I am filing a complaint with the Insurance Commissioners Office. I would recommend anyone else having a problem to file a complaint as well. The more they get the sooner something can be done about their poor service and possible fines for them.
sears home delivery damage claim
Sears Outlet delivered a fridge to my house and in the process there was damage done to my old fridge. This is 6 months ago and Sears fails to respond, fails to do anything other than give me the run around. Apparently there is an insurance company called Sedgwick that handles their claims and no one ever calls back or does anything. It has been months since the claim was filed and I can't even get a call on it, forget the money I am owed! No one speaks english when I call and that makes the process take forever! So annoying! Who has time for that? Sears has really gone downhill! I used to shop there a lot and get all of my appliances from them. Now I've moved to home depot.
The complaint has been investigated and resolved to the customer’s satisfaction.
new fridge delivered december 2019 - floor damaged by crew - have claim w/sedgewick - emailed estimate w/pictures followed by mail registered w/return signature - sev calls no call back - am about to call tv station w/trouble shooter
am aware am not the ONLY property damage on file but a quick courtesy call or email !
Renee Daubenspeck
My dishwasher needed repair and the first Sears repairman cleaned out some glass bits from under the motor cover using his own vacuum. The dishwasher worked for a while but then would not turn on. The second repairman came and sucked out more glass bits but used my central vacuum system. When I went to use the system dark brown water and glass bits poured out of the opening in which you plug the vacuum. I had to call the vacuum company who had to replace the system for over $1, 200.00. I called and called and then was given a number at Sedgwick. They said they had to assign someone to my case. Finally a Delores Holder to whom I sent the vacuum bill, the number of the vacuum company and all the details. I have called her SIX TIMES so far and she has not returned my call. All I get is voicemail. Incidentally, a third repairman had to come and he then replaced the computer system. What do I do? I think I need a lawyer.
From Sedgwick's horrible track record, I agree that you are on track w/thinking that an atty needs to get involved. Who knows, they just might fold w/an atty demand letter if you are lucky.
A few questions:
1. where did the glass bits come from originally? Did glass break in your dishwasher?
2. why did the repairman use your vacuum system the second time and not his?
3. did your vacuum repair company assign blame to the Sears repairman's actions entirely? You need that in writing. Same w/your computer system.
Don't let the SOL expire, BTW (delaying). Sedgwick seems to count on that and/or you just giving up.
Good luck, sorry I didn't have a better suggestion for you.
Let me add to the disappointing comments concerning Sedgwick and how they handled my claim. Sears delivered a dishwasher to my home. It leaked and destroyed my kitchen floor. I let them know and I was told to contact Sedgwich. Everything seemed to be swimming along. I sent the information requested to process my claim. There were some delays on my part and theirs. I was ok with the pace...life happens. However, once they had all of the required information and it was all systems go...nothing. The agent, Walter Mitchell, said he would be out of the office for the holidays and would get back to me afterwards. He finally got back to me on January 29th. Can you believe that? I was so frustrated that I contacted my insurance company and took out the claim weeks before he finally emailed me back that he was ready to process my case. MY INSURANCE COMPANY has sent me the funds needed to take care of my floor and I am on my way...thankfully. Oh...and the defaulted dishwasher that destroyed my floor - it was a GE product, it is still in my home! GE would not even take it back or allow me to return that one and pay the difference for a higher end machine. Run run run from this company and GE products! No one cares or even bothers to think about how your life has been inconvenienced. They got THEIR's and that's all that matters to them! Run. Run. Run. If I could give them a minus star, I would!
My claim is still processing, but I am dealing directly w/the 3rd party carrier that Sears contracted out to deliver my refrigerator. XPO adjuster came back out and re-did their estimate as they failed to figure in the mold damage the first time. Sedgwick is absolutely USELESS but I did finally get a letter out of them disavowing their responsibility for future reference if need be. Anyway, it looks like the 3rd-party (XPO) is offering more than they did at first. Their excuse was that they "didn't know" about the mold at first, even though they had pictures and you could SMELL it (my pantry that buts up next to the fridge can't be used because of it. Actually had to take a crowbar to the baseboards to the baseboards and the shelves in the pantry and remove them so they could SEE the mold up front and personal (Custard adjusters). Crazy.
Anyway, and I'm sure not giving you legal advice, but if I were you I would file a lawsuit. IDK what the cap is in WA for small claims or the amount of your damage...file in small claims or file in limited civil (10k and 25k respectively in my state). You can go to the WA Secretary of State website and find out who exactly accepts service for Sears and/or Sedgwick (service agent). That's who you send your lawsuit to besides your court. Probably pretty easy to DIY, as (I hope) WA uses forms and you primarily check boxes, LOL. The last required form is called a Proof of Service (it's a judicial form) and after you get that back, file that with the court, too. The court will assign you a court date.
You can bring up the forms you need (if WA has them) for free by visiting WA court's website. Hopefully with instructions. Again, IDK about WA, but here you need a cover sheet, too (another form).
Not sure how the bankruptcy thing is going to work out, but you might also need to file in bankruptcy court as a creditor of Sears to protect yourself. Keep ALL your paperwork/photos/(evidence) and attach to your lawsuits. Most importantly, get it in writing that Sedgwick/Sears is "holding" your claim because of the bankruptcy. DON'T MISS YOUR SOL (Statute of Limitations) or else you will have no recourse.
Hope that helps.
L Schaffer, did you settle the claim? My claim is over 2 years old and is for a flood caused by the Sears washer repair person. I immediately gave them pics, estimates, etc— everything they asked for — and the claim dragged on! I was told a month ago (Sept 2018) that the adjuster had closed my claim and then quit her job! I placed many phone calls to Jamie “incompetent” Lesniak and reminded her that a resident of Washington State has 3 years to file a lawsuit for this kind of incident. Jamie then reopened my claim, but they again dragged their feet. On 10/16/18, I received a call from adjuster Brigid Duda that the claim is now on hold due to Sears filed for bankruptcy on 10/15/18! In other words, they aren’t proceeding with my claim! Did anyone else receive a similar call? What can I do? Thanks
Going to add to this list. Bought a refrigerator from Sears Outlet, paid them for delivery and installation. They incorrectly hooked up the ice-maker water line and caused severe water/mold damage, to the tune of 11k+. Sears/Sedgwick has refused to take responsibility and closed my claim while directing me to their 3rd-party delivery service. The 3rd party "XPO" has offered less than half for settlement. Contacted an attorney, was advised that it was SEARS responsibility, not XPO, as I paid Sears for delivery/installation. Re-contacted Beth Rodriguez at Sedgwick, she refused to re-open my claim, said that Sears does not install refrigerators, and said, "that's just too bad for you". When I asked for a letter stating Sedgwick's rationale, she refused to provide one. I then asked to speak with her supervisor, Jamie Losniack. Instead of transferring me, Beth hung up. Have left several messages since to Sedgwick/Jamie. No response. Finally got hold of Beth again and asked for their contact information (service agent) so that they can be served with a legal Complaint. Beth refused and said that they have no contact information, no physical address, no nothing...and asserted that I would need to sue Sears, not Sedgwick. Note: Both/all will be named in the Complaint, plus Does.
I was finally paid! It took over 8 months for Sedgwick to get their act together, me arguing with clerks that don't seem to like their jobs and don't seem to care about what customers are going through. The person dealing with my claim, Ms. Rebecca, was useless and rude. I'm not sure how those people keep their jobs. I'm glad I'm over the aggravation of dealing with Sears and Sedgwick. Good luck to you all
SearsNoMore2
Wow. I was searching for a particular contact from Sedgwick when I came across this page. We had a dishwasher installation issue through Best Buy's Geek Squad which resulted in water damage to two levels in our home, and they use Sedgwick Claims as well. Eventually they sent out another subcontractor for reinstallation, and they damaged our cabinetry and countertop! Sedgwick has been responsive, but they had another subcontractor ("Custard") adjuster come out and they claim to have still not heard back from that adjuster - for the FIRST claim. This was FOUR weeks ago now. Absurd. I'm ready to threaten legal action. We are a family of seven and it has affected our quality of life.
I am having the very same issues people have been describing. I have filed a claim with all supporting documentation more than 2 months ago. A Sears tech came to my house to fix a door issue and broke my dishwasher's drain hose. My house was flooded, walls damaged, and hardwood warped. The Sedgwick representative (Rebecca Suwanski) ignores all emails and phone calls. It seems like their business model is stalling claims, frustrating customers, until the customers give up. Has anyone considered a law suit agains Sears and this insurance company? How have you managed to solve your issues?
I'm having the same issue with Sedgwick. We purchased a GE dishwasher from Sears Hardware in March 2017. It was the floor model that was on clearance. First time I ran the dishwasher the water would not stop running into it. Had to shut off the water and electric to the dishwasher to get it to stop. Water leaked out under and ruined my kitchen/den floor which had to replaced. Been getting the run around from them and Sears for three months.
terrible service
I recently had back surgery Nov. 8th. At first everything seemed fine the first wave of claims were approved and all was good. Then I went to my second Dr. appointment and it went to( H3LL ). My Doctors office made a slight error by saying that “he has been able to return to work” rather than saying “has not” So Sedgwick denied the claim. When I called they said that I was able to return to work. Even though I have a work slip that says return February 4th 2013. After the dr. corrected that error and sent it to Sedgwick they found something else wrong, just trying to keep from paying. At this point the company I work for, said I had to return to work or it’s a voluntary quit. So in other words Sedgwick was trying to force me back to work against dr. orders and the company would be liable if I were to be hurt, that’s if the company would even let me set foot in the place without a dr. slip, cause the dr. has me off until February 4th 2013. Nothing got done about this, until my union got involved and forced Sedgwick to properly evaluate the circumstances. One of the few good things left, about unions I guess. Although I still have not got a check in three weeks.
Citizens need to ban together and bring forth a class action suit against Sedgwick for the harassment and mental anguish they put on people. There are enough people here that someone has to know someone that has connections with an attorney looking to make a name for themselves. Where do I sign up?
my grandauther was ran into by a truck that was owned by a company owned by another bigger co. that this so called. THIRD PARTY ADMINISTRACTOR OF THE BIGGER CO.
SEDGWICK CMS CLAIMS MANAGEMENT INC. BASE OUT KY., CO. AND OTHER CITIES IN THE USA.
after many, many phone calls [15 DAYS ] to there so called liability claim examiner 111, by myself, grandauther, and own ins. adjuster.
and no calls in return i found another way to get some real person. a super.vistor. wow what joke she was. i've send them a police crash report, saying there driver was at fault 100%, two of the parities taken to the [E R] by grandauther going to the doctor. my car at a towing / storage yard, that i had to get removed . that cost me [$1145.00] of borrowed fund. they could care less about me or the injured parities. i just don't unsterstand how they can operate in the***[THE COMMONWEALTH OF PENNSYLVANIA ] AND GET AWAY WITH THESE ACTIONS. still waiting for them to step up and show there a real co. mean while i've got no car, plus i had to get a lawer. more cost they are taking this matter from a minor case to wre i don't know .maybe they like deal with the courts in this [ PA, COMMONWEALTH . MY REAL FEELING ABOUT THEM **THEY S_____ .. [ CHUCK ] 2/16/2013
deception by agent
Tyan Nanka Bruce claims examiner is very deceptive, mean spiritired, combative and not to be trusted. After requesting purchasing documentation she reduced the replacement cost of my families HD television by $1800.00 making it impossible to get the replacement for my set destroyed by AT&T 'S cable wrong equipment installed in my home. No cost for overload strip, electrical outlet and replacement labor of $500.00 were never received. A $2300.00 lost was never paid.
The complaint has been investigated and resolved to the customer’s satisfaction.
Yes I am dealing with them now and they are trying to screw me too.
employer
Sedgwick CMS is one of the worse companies to work for. They will promote people not because of the skills they may have to do the job, but because of popularity. The supervisor was horribly abusive and had even poked me in the shoulder one day while yelling at me. I worked an average of 15-18 hrs per day and at the end of the week I was still told what I had not done. Abusive comments about the way the claim was handled was placed in the actual claim file, which is discoverable by a court of law as well as the client. I pushed to a nervous breakdown. When I filed a formal complaint against the supervisor, she made my life hell and nobody at the corporate office was doing much about getting the problem resolved. Finally I could not take anymore of the abuse and quit.
The complaint has been investigated and resolved to the customer’s satisfaction.
I actually told them I WISH I could work there! Where else can you wait on "hold" for 20+ minutes being repeatedly told by the "professional call screener" that there is NOBODY available to assist you! I said "I've written down the names of FIFTEEN different "managers" of my case..how can SO many people work there while NOBODY is available"?
I want to work where you just leave ONE message and your job is DONE! Wash your hands of the situation and NEXT WEEK somebody ELSE will be assigned to the case! No FOLLOW-UP, and you and your coworkers can LIE LIE LIE! Just tell the MOST ridiculous excuse and apologize for yet ANOTHER mistake while leaving somebody's life in SHAMBLES! Nobody is accountable for SQUAT at Sedgwick. Even the so-called HEAD HONCHOS don't return calls! So, why should those lower on the totem pole bother to return calls. The MOST inefficient and CORRUPT organization I have EVER dealt with!
I work at Sedgwick until I had enough I worked 10-14 hour days and most weekends because the claims representatives would quit or be removed from the account and we had to pick up their work load as they have a hard time getting people to work there. I could not keep up with case load demands and was eventually fired due to" time management" problems . Corporate policy is to ignore the problems and make people's life a living hell while supervisors go home after a 7.5 hour day because it is easy to blame the worker who has to do the actual work they unreasonably promise to the clients.
workmans comp
Search the Department of Insurance or Department of Industrial Relations and file a complaint. Be sure to document every call and message you leave. I've been trying to see a Physician for about 8 months now and all I get is the run around. I've had 3 different adjusters and they never call me back although they do answer their phone most of the time. I've had just about enought and will be filing a complaint. As a person that works for a major insurance company with no relation to Sedgwick we do not like to hear from the DOI and I'm sure it goes the same for Sedgwick. These people propbably count on you to stop calling them and bothering them about the benefits you are entitled to.
Then they try to blame my injury on my current job. What in the world? Shady people, Shady company.
The complaint has been investigated and resolved to the customer’s satisfaction.
I've had a similar issue with Sedgwick. I was injured on the job at the University California Davis Medical Center in Sacramento California and received no proper diagnostics or medical treatment by them. 30 days after my injury, (as allowed by California law) I attempted to see another physician to get the proper medical care, but Sedgwick quickly denied my claim. I then attempted to see my primary care physician but was denied in doing that because it was a work related injury. It's been 2 months now and I still have not received proper medical care for my injury and my employer (UCDMC) will be terminating my employment because of my inability to return to work.
I have 5 operation in 10 years i like to see my dr a cant get true the phone
donna augustynovich/erin hall
I have been treating since 2009 with great respect until a claim rep by the name of Donna augustynovich took hold of my case. For starters she willfully and illegally went and told my doctOr that I was seeking treatment for my injury because "I wanted to get on pain medication"! Can you imagine the amount of gumption and nerve it takes for a RN case manager to come out and say that to a treating physician? Of course this altered thcare I received by my doctor. He became extremely critical and insulted because of her lie. I mention SedgwIck because they are the third party manager for my case and given ms Donna augustynovich comment they have become a thorn in my side. Please know I am angry and wonder how a manager can maintain her position while spreading wanton lies and personal feelings about my case and still be employed. I will write to bunch and associates about this and keep you informed of my progress. Thank You,
The complaint has been investigated and resolved to the customer’s satisfaction.
I was retired from Los Angeles County in 2000. After going through five TPA's in 19 years only one performed with professionalism and empathy (INTERCARE). I was tired of complaining without result, so I had my WC attorney take my issues to the WCAB and had fines imposed on two of the TPA's. So far Sedgwick has not made an effort to advise me who my adjuster will be. If Sedgwick continues to stonewall me I will file a bad faith insurance claim against Sedgwick and the Los Angeles County, which is self insured for Worker's Comp. That's a promise.
There is a "bad faith insurance attorney" in Pasadena, CA. ( a lady) who has never lost a case against insurance companies.
harrassment
Sedgwick is a horrible company. They deliberately harass people that are sick, sending them the same forms over and over. Even my doctor feels harassed by them. I finally got some law advice after they repeatedly denied my case. He said appeal the decision, most times it does overturn, if not we will sue for 'bad faith". So, I called them up and told them that they were not acting in "good faith" and I would appeal their decision, I also told them they were harassing me and when they said they were recording the conversation, I told them that I was too. They changed their minds the next day and approved my claim. Mmmmm. Wonder why?
playing the appeal process
Sedgwick has acquired a mediocre company Bunch & Associates. The entire claims process has been a joke with Donna Augstynovich RN nurse Case manager with a horrible sense of people skills have now joined hands to form a bureaucratic mess. I have obtained authorizations in the past and now that Sedgwick has their dirty claws they are going to contaminate the positivity of my case. They should be disbanded but don't worry a federal inquiry is underway.
The complaint has been investigated and resolved to the customer’s satisfaction.
poor business practices
Hello, I was recently injured at a retail store, well as luck would have it, they retain Sedwick as their third party claims admin. They have a deceptive practice of getting permission for a "statement", but then ask twenty questions. I think there needs to be a class action lawsuit filed against them! They also have the "gift" of turning the injury around to make it seem like it was your fault.
The complaint has been investigated and resolved to the customer’s satisfaction.
ridiculous company
I have been on disability due to a heart attack and two heart sugeries. Sedgwick CMS has been horrible to work with and even though I have tried to jump through all their hoops, even while at death's door, I still can't get my payments properly. My doctors have sent stacks of forms as Sedgwick requested, I have spent hours on the phone, and STILL.. my last 2 payments have been for about 1/5 what they should be. I just now called Sedgwick to see if everything was in order for my August 10 payout so I could pay my rent and bills (all LATE already, penalties on all of course!), and was told again that they are waiting on their nurse to approve it, for another signature from my doctor (he just sent a book size fax a week ago), and all the reasons why I am still probably going to get another tiny check. Every single period has been like this, I am in terrible shape financially thanks to Sedgwick CMS, and besides all this... when a person is close to DEATH, why are they terrorized every few days by this company and asked to do something else, only after which they don't get paid anyway. I am a person who is very slow to anger and slow to complain, but I have had it. I intend to report this company to everyone I can think of to try to get something done so that others don't have to go through this. I am close to returning to work now and am feeling good enough to fight back finally. This has been the most outrageous process. I feel really sorry for the phone reps who have to sit there and tell people these things when it isn't their fault. I bet they don't stay long.
The complaint has been investigated and resolved to the customer’s satisfaction.
I was hit by an Avis car rental, who Sedgwick insures. The party who backed into my car admitted fault as well as 20 witnesses. Sedgwick would not return my calls so after three weeks I had to file on my personal insurance. To date I am out over $2k and their claims adjuster has been incredibly rude the ONE time she returned my call. Almost five weeks later and they still have not paid ONE DIME on my claim, refuse to return calls or acknowledge even receiving information.
Has anyone heard of Sedgwick PAYING a claim? Have you ever wondered why you can't locate a physical address for them? Just a P.O. Box? They claim they have called and left numerous messages, but I believe it was just a stall tactic on their part. I feel sorry for people that don't have the know how to fight back. I'm not giving up and I hope you don't either. This company is nothing but a scam.
Citizens need to ban together and bring forth a class action suit against Sedgwick for the harassment and mental anguish they put on people. There are enough people here that someone has to know someone that has connections with an attorney looking to make a name for themselves. Where do I sign up?
I recently had back surgery Nov. 8th. At first everything seemed fine the first wave of claims were approved and all was good. Then I went to my second Dr. appointment and it went to( H3LL ). My Doctors office made a slight error by saying that “he has been able to return to work” rather than saying “has not” So Sedgwick denied the claim. When I called they said that I was able to return to work. Even though I have a work slip that says return February 4th 2013. After the dr. corrected that error and sent it to Sedgwick they found something else wrong, just trying to keep from paying. At this point the company I work for, said I had to return to work or it’s a voluntary quit. So in other words Sedgwick was trying to force me back to work against dr. orders and the company would be liable if I were to be hurt, that’s if the company would even let me set foot in the place without a dr. slip, cause the dr. has me off until February 4th 2013. Nothing got done about this, until my union got involved and forced Sedgwick to properly evaluate the circumstances. One of the few good things left, about unions I guess. Although I still have not got a check in three weeks.
I wish this wasn't so but this seems to be the norm. I am a 13 yr General Motors employee and have been treated nothing short of a criminal. I have chronic heart problems, 4 yrs ago I had my heart reconstructed yet my problems have returned and I have been prepared for a life long battle. I am the just a statistic and am facing multiple surgeries. My Dr(s) have provided books worth of monthly tests reports and office notes etc AND even gave a return to work date of 2014 at best if not permanent disability. Get this, Sedgwick even reported to my employer I was a voluntary quit until I got the union involved to get this changed and almost a month of terminated health care coverage amiss my treatment etc. This has been nothing short of a nightmare. I've lost everything and this company still manages to find a way monthly to turn what is left of my life completely upside down. I called today and was told payment will be withheld till each surgery so I get paid once a month or every other month at best. I would be more than happy to file suit with anyone willing to tackle this horrible company. We used to have Met-life as our disability admin and I never had this much difficulty. They need to be stopped.
I only had a claim for damages to my vehicle from a company that is insured by sedgwick. After googling them they have multiple attourneys in every state (just another monopoly) However, they are fallable- they became irate when I asked questions and seemed to make multiple mistakes. I would suggest filing a complaint with your *** STATE INSURANCE REGULATOR**** Dial 1800 fed infor for the number in your state and fed info may help you with any orther questions about who to contact. I found it EXTREMELY UNUSUAL that the adjuster that I talked to wasn't even familiar with city codes and statutes. Perhaps some of you with similar cases against this company should consider working together on your complaints. Bullies don't like to be bullied back and this company seems to enjoy dividing and conquering. Also, the BBB is another option. Consumer protection-I'd go all the way. I'd go after their business liscense if possible. The bigger they are the harder they fall.
Now Sedgewick is questioning my doctors integrity. They set up a "peer to peer" appointment so that my doctor (a board certified nephrologist) will speak to their doctor who is board certified in who knows what. They set the appointment for 330 and of course when my doctor called they didnt know what he was talking about. So here I sit and wait. What more does Sedgewick want? What I do believe is that they want to frustrate you so much that you just give up! Well I wont give up. I will be calling the California State Insurance comissioner tomorrow.
Perhaps a HUGE lawsuit against sedgwick for harrassment is in order. It is criminal what they do. Reading all of the above complaints are exactly what I have gone through. I cant add anymore. No check, oops, dont know how that happened, we forgot, changed computer systems, on vacation, overlooked, etc. Does anyone know of any attorneys willing to take this on that are NOT in the insurance companies back pocket or attorneys that are REALLY willing to represent JUSTICE?
same here. I am on kidney dialysis for 10 hours a day 7 days a week. My doctor has faxed them piles of paperwork and they still state they need more! According to the State of California I am 100% disabled but not according to Sedgewick. They call when they need something and you are expected to jump through hoops for them, but it takes them longer than 2 weeks to get back to you! It is a shame that people at deaths door have to fight for what is right! These people have no medical training at all, my caseworker didnt even know what dialysis was and never showed on bit of empathy. I will be getting an attorney!
Totally agree. Segwick has been a nightmare; I would descibe it nothing short of harrassment. My husband works for AT&T and was diagnosed with terminal cancer in April and Segwick refuses to cut us any slack. They have AGAIN denied his claim for this past month saying "there's not enough information" since he only had ONE doctor's ppontment and a CT scan. They demand tons of paperwork, and then claim they don't "read medical-eze" when they get it. Who else can we complain to?
liability for auto damage
The valet attendant damaged my car by driving over a parking block (twice)--in and out of the parking space. We filed a claim with the Embassy Suites hotel and subsequently their claims processor (Sedgwick) determined no liability on their part. Pictures of the damage were sent and pictures of the car "strattling the parking block". There is no doubt that they damaged my vehicle and are liable. I have contacted Embassy suites to dispute this finding by Sedgwick cms.
rude, unprofessional, iars
I have been on workers comp due to a lowes injury I incurred last may while working, and was assigned to claims adjuster Maryanne Morgan. She recently told me on 6/28/12 that she is no longer my claims adjuster, and gave me an email for someone else, which is apparently fake. I am an i/t student who just graduated with my associates, and know when an email comes back as permenatly failed to send that its a phoney. I needed to know how to set up my mileage reimbursement again since its been almost a year, and also to get approval for more physical therapy, but get the same reply, "I'm no longer your claims adj."She is rude, unprofessional, and a huge liar. I contacted her multiple times about stuff, and she never calls back..I always end up calling her boss' boss, and still get no calls back...I end up gettin a call back when I threaten to et a lawyer.
waiting 2 months, following up for physical therapy for broken wrist at work. Sedgwick should be called Sludgewick! I am needing to begin asap to heal and return to work
and they told me I couldn't have phys ther yet with cast on, cast WAS removed-sorry typing with 1 hand!
We have had nothing but heart ache dealing with Sedgwick for the past couple months. My spouses' claim manager name was Jamie and his appeal manager is Beth. They are both incompetent. We can never get a hold of them. We have had some contact with Zachary Bahler who is supposed to be their supervisor. All I know is that I also have Worked in the WC area and a monkey could see my spouses claim is legit. This is just for Short Term. A month's pay is all we are asking for from this company. My spouse pays a portion of the fee his company pays. It is just plain crazy. WE NEED A CLASS ACTION SUITE against Sedgwick.
Jacqueline Ryan - I too have been a victim of SEDGWICK CMS. I was in a work related accident and they have denied numerous claims for no specific reason or the dumbest reasons. I myself have done workers comp claims for another company in the past. I know that as a claims adjuster we can't please all parties involved, but we can try and do the work required to have everyone in good standing. Also, the company I worked for in the past only hired individuals with hands on experience. "I feel that Sedgwick needs to hire actual trained insurance claims adjusters". My adjusters name was ELISA JOHNSON based out of Deerfield Illinois. She is incompetent and plain dumb. She is a class act and not trustworthy. I wonder if this is the same individual? I have heard and experienced the worst with SEDGWICK CMS..
Elisa Johnson is the most incompetent claims agent I have ever dealt with.
I do not believe a word she says, and I do not trust her.
She has denied my claim, for less that $70.00 and will NOT provide me with
evidence that I have requested.
I just wonder if Sedgwick ever pays out a claim for any one?
Sedgwick Insurance Company stinks !
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Sedgwick Claims Management Services emailssedgwick@sedgwick.com100%Confidence score: 100%Supportpatrick.lunn@sedgwick.com94%Confidence score: 94%management
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Sedgwick Claims Management Services addressP.O. Box 171816, Memphis, Tennessee, 38187-1865, United States
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Gregory McPherron is not truthful and lied to get my claim shut down. He does not return phone calls ever and when you do reach him, he acts like an attorney and wants to argue. Do not trust Sedgwick!