Sedgwick Claims Management Services
Reviews and Complaints

I can understand that Sedgwick is the insurance carrier for Walmart employees. They must have a very tight bond assuring with the company. My injury I wouldn’t think is very severe. But you would think I would have to move heaven and earth it’s self to have somebody contact me. Numerous calls and emails to claims adjuster and supervisor even to the office almost every day without a response. When Sedgwick‘s nurse called she stated I’ve seen a neurologist. That’s incorrect. I’ve seen your care physician only on May 10th. That goes first so the doctor can do a referral to the neurologist. When I talk to the claims adjuster. I asked why is the claim not on the accident date April 26th I have not returned to work since then. She had no record of me going to the ER or the paperwork stating from ER doctor not to return to work until primary care physician says so. She goes on to ask me to email her that page. “What’s going on with this company?” After seeing there primary care physician at MayoClinic. He stating not to return to work till after MR and Neurologist evaluation. We made the appointments for those visits. But a week later the claims adjuster said Dr had canceled all the appointments and you may return to work. “That doesn’t make sense.” She said to go back to the physician and see if he would write you another note and start from the beginning again. Really? Ok? Why would the doctor cancel the testing and valuation when he’s the one that wanted me to go? This entire thing sounds sketchy. On the Sedgwick app it been cleared and says no claim. Wow! That was fast… ? It’s been 30 days now without any benefits from Seder. Well, I have all my copied paperwork together with times, dates, and who I spoke with. And I printed out the return to work order from the doctor. Although it has no signature. Let see what he says when I confront him. Along with the cancellation for the MR and Neurologist. Per his request… humm…. Check back for update. Even I want to know what he’s going to say..

Pic-Attached. First reported April 26th

I have a Sears Warranty Plan. My kitchen floor was damaged Dec of 2021. I was given a Sedgwick Liability Clams Associate named Allison Morler. I spoke with her once and she told me what I needed to turn in to her. I sent the pictures as well as 2 itemized estimates for my floor. Then I heard nothing nor did she return my calls. I finally got a hold of an her supervisor (Adrissia) I believe. She said a new person would be assigned to my claim because Allison was terminated. Finally a Shawn Frain left a message on my phone that he had all the information I had sent in and was just waiting on some emails from others to complete my claim. I have called and always get his voicemail. He is not returning my calls. April 28 of 2022I received a letter giving me 3 days he says he contacted me and to call him if I wanted to discuss my claim. It gives me a 14 day window and then he closes the incident. His note said he talked to me Jan 5, Jan 8 and Feb 9of 2022. He wasn't on my case at that time. Allison was. Can you tell me what do to. I can find no other number than his to call. My File # is L2112225012.0001. Thank you Linda Baumgart

CLAIM WAS 723717

I need a letter from Sedgwick stating I no longer am receiving Workmans Compensation benefits as my present administrator The Reed Group shows on their records that I am still receiving Workmans Compensation Payments through Sedgwick. My MMI was in 2009 and the Colorado WCD awarded me $150,000 for 42% whole body disability, those payment have long since expired and any other payments through Sedgwick, but Reed Group's records still show those payments! I need HELP!

Peter Seglem

[protected]

[protected]@me.com

6520 Fredenberg Lake Road

Duluth, MN 55803

Here is an example of the emails from back in the time.

Mr. Seglem,

Per your request attached please find a copy of the payment history for claim 723717.

Should you have any questions, please feel free to call [protected].

Thank you,

Lynn Squire | LTD Case Specialist

Sedgwick Claims Management Services, Inc.

www.sedgwickcms.com | The leader in innovative claims and productivity management solutions

Our truck was hit by a truck insured by Sedgwick on 04/04/22

The claim number is 4A22045T0VV0001.

The person handling the claim is Monica Dickenson @ [protected].

We have put in at least 5 calls and she is not returning the calls. It was clearly the fault of the insured. I tried to speak to anyone in management, but this appears to be an impossibility. It seems the company goes out of it's way to frustrate anybody calling to resolve an issue.

Im Ahmed M Abdelkader, claim# WC20171085853. I have a CA Worker's Comp. SJD Voucher issued by Sedgwick 14450 long beach, claim rep., Eric Rice. I called Mr. Rice to have him send Sedgwick approval to DCE at UCI as my training provider in order to finish my course enrollment. I was told that he isn't and wasn't my claim rep. to begin with.

MY email: [protected]@hotmail.com

Phone# [protected]

I am on medical leave due to my type 2 diabetes being uncontrolled. I am seeing an endocrinologist. I uploaded paper work from my Endo doc and I have been trying to reach my case manager to see if there is anything else she would need and to give me a status update. My endo doc wants me to stay off work until we can get my blood sugars under controlled. I had originally submitted my LOA form from my PCM, but my Endo doc doesn't agree with me returning back to work. I am very upset that I can't get anyone to call me or message me. If you look in the communication box you will see my questions. Cory N did try calling but did not talk to me as it was expressed in his message.

What is the point of having professional case manager Working for you when all they do is call and hangup no conversation with your case manage.

claim # [protected] I was medically retired from L.A.C. Sheriff. I am now having a problem with my back(reason for retirement) At the start of trying to get authorization to see a doctor I had to contact 6 representatives before one would help. I was assigned to rep. fahimie who did not seem to know what to do. She then went on vacation without making anyone aware that things needed to be handled with my claim.. I contacted supervisor bell who stated she would see that the authorization be sent to my doctor on Friday 4/29/2020, she then took time off and also did not make any one aware that the authorization need to be sent. I tried to call Sylvia, bells supervisor, but she was out of the office also. I finally was able to talk to Christian who said the authorization was confirmed on Thursday 4/28/2022 and would be send to the doctor next week. did say he would have the authorization sent to today(4/29/2022)

I had out on sick for my back pain on 3/9/22. Then I had reported short time disability on 9/16/22. I was able to provide completed disability form by my doctor in time to get my pay without interruption because I had five days to provide those documents. In that form clearly stated that the patient needs to be reevaluated after five weeks of physical therapy, and follow up visit day on 4/13/22. In 4/5/22 your company send me email asking for more clinical information which I do not have because my appointment with doctor is on 4/13/22. I send email back to them explaining just that and resend the same forms I had send before. Then your company approved me until 4/13/22 which is the day of my follow up appointment. On the day of that visit, I could only get a return-to-work date form completed because doctor’s office said that they need 2 to 3 days to get the clinical report updated into the system. So, I had uploaded the return work date form. The form said I am returning work on 4/18/22. Now I did not get paid for 4/14 and 4/15. This is my problem. Your examiners are not acting like human. They are acting like robot, repeating the same thing again and again.. Your company said that examiner need five days to review. This is my question; Don’t you think that you have to approve at least five days after the follow up visit day to do the paper work? So I can get pay without interruption? You expect me to get the clinical information on the same day of the visit? Even I did that, you need five days to review. Is that make sense to you? My life depends on every week pay check. Now I have to pay late fee for credit card bills. It seems like your company purposely giving me hard time. You are forcing us not go out on sick. You are forcing us to go back to work without completely heeling our sickness. Your reps do not seem to care. I am not sure who is responsible for this thoughtless practice. This is not the first time your company did this to me. This need to be corrected. Those examiners have to trained to have some common sense. If I could, I really need to speak to someone about this. I am really upset. We do very physical work. We always get hurt. On top of that you want to punish us without paying us. Heatless.

My partner and I are Singapore tourists who went to Canada from 29 Jan to 13 Feb 2022. We bought a 6 day ski pass at Whistler Blackcomb. My partner suffered an injury on Day5 and we stopped the trip, went downtown to see a doctor. We followed up with a Doctor review in SG again. Sedgwick asked for Doctor Memo (in their format), which we requested the doctor to include details as required.

We submitted a claim to refund 1 day cost, and after multiple emails over 3-4 weeks - they finally approved it. But:

1) The amount refunded was different despite the ski pass being the same cost;

2) We asked for a refund on our credit card or a remittance as we are overseas, but they issued a Check instead. (Cost of cheque clearing would eventually almost nett off the claim amount).

I have emailed then about 10 times without any reply.

Claim number 4A21120D0WJ for claimant vehicle 2021 GMC Sierra belonging to Jim Owens. Dawn Alamanza is handling this claim and is not responding to numerous contacts asking for a reply for over three months. Dawn's phone number is [protected] x51084 and her email is dawn.[protected]@sedgewick.com.

The following is copied and pasted directly from my file documentations of the numerous attempts to get a reply. In addition to calling Dawn I have pressed zero to be switched to another representative to handle this - more than 40 times on two phone calls with no answer - either the next person was busy or didn't answer the call at all: [04/19/2022 11:35 AM / PHIL]

Called Dawn Alamanza again - VM LM Hung up - called back - dialed 0 another 20 times - no answer at all.

[04/05/2022 01:45 PM / PHIL]

Called Dawn Alamanza again - got her voice mail - hung up and called back - dialed 0 for the operator - four consecutive extensions were on the phone, hung up and called again - pressed zero at least 20 times - each time the extension was unavailable - called back and dialed Dawn Alamanza's extension and left a firm message to call back. CC'd Jim Owens. Called Jim to let him know what's going on - VM LM

[03/10/2022 09:23 AM / PHIL]

Called Dawn Alamanza [protected] x51084 VM LM - I've left messages and sent emails - what do I need to do to get it paid?

[02/24/2022 12:04 PM / PHIL]

Sent email again to Sedgwick

[02/02/2022 11:34 AM / PHIL]

Called Dawn Alamanza - VM LM

[01/27/2022 10:50 AM / PHIL]

Emailed the final to dawn.[protected]@sedgewick.com for a second time

[01/20/2022 11:35 AM / PHIL]

called owner to let him know the don't pinch your fingers stickers are here. Asked him to come on a warmer day bcz stickers don't stick well to very cold surfaces.

[01/14/2022 05:25 PM / PHIL]

Emailed the final to dawn.[protected]@sedgewick.com

First, I would like to say how appalled I am at the way I have been treated through this claim. My adjuster Rich is very rude and has showed zero empathy at all in my situation. I have suffered through unmeasurable grief and trauma that back in August-February and this claim has not helped at all. I lost my brother and Irish twin to the COVID delta variant, had to identify his body and handle funeral arrangements to only a week later my mother having suffered a stroke and having to have surgery to finding out she has stage 3 cancer. I am a single mother of three kids and have had a hard time keeping composure for them. I have a 12, 13-year-old and 15-month-old. In front of them I try my best to stay strong and do the everyday tasks necessary but even myself is human and I failed at functioning at everyday life. For over two months my family members had to be here full time to assist me in taking care of my kids as I did not want to get out bed, eat or sleep. I still to this day suffer from extreme insomnia and break down in anger and crying in random places and at random times. I hid in the closet to cry so my children wouldn’t see it. I gained 60 lbs., my hair has fallen out in unprecedented rates, and I have zero motivation or joy in much of anything right now. I did not get a chance to say goodbye to my brother. His girlfriend didn’t even tell me or my mother he was even sick or found unresponsive in his bed until two days later and it was already too late to talk to him or see him as he was in covid ward. My whole life we grew up as twins and did almost everything together. His loss has gutted me to my very core. The pain I feel daily is indescribable. No one will ever be able to understand the level of pain and depression I feel on a daily basis.

The timeline of the events is listed below:

- Aug 12 (Taken out of work after Bereavement period expired)

- Aug 11 & 17th called my doctor advised there is no appointment available for Dr. Brown or Davis until Jan or Feb. Advised Kalman available 8/30 (accepted appointment)

- Davis office cancelled and rescheduled appointments several times. I was able to keep up treatment with Kalman as his scheduled permitted. Kalman advised he would take me out of work until I am better and can function at work. (8/30). But would need to make appointment with Psychatrist for medication management and get back on meds.

- Sedgwick: 8/12-8/30 denied due to delay in treatment. 9/1-10/11 approved and paid with on going benefits approved until 2/2022 in portal with updated treatment notes.

- 10/18 filed appeal for Dates 8/12-8/30; First level appeal reviewed and denied due to delay in treatment even though disability papers filled out by MD was back dated to 8/12. When appeal denied for Dates 8/12-8/30 Adjuster denied everything from 10/12 on stating medical did not support disability despite previous approval.

- In late January a ADA claim was filed on my behalf and they approved everything from 8/12- 2/14/2022 advising notes supported disability.

My doctors have attempted to reach out multiple times for peer to peer with no avail as schedules between my doctors and peer adjusters have not been available at the same time. They have filled out the forms several times supporting my need to be on disability while sorting through and dealing with the trauma that I have faced and continue to face. They have submitted treatment notes, formal letters and are just as aggravated as myself as this situation and yall’s inability to understand the large case load they face due to Florida being on of the top states absolutely devastated and turned upside down by the COVID 19 pandemic. I should not be penalized for the fact that your peer adjusters have not made themselves available to my treating physicians when they have attempted to reach out. Not only have yall added stress and caused damage to the progress I was making. You have caused me to not be able to take care of my kids like I should and have caused devastation and financial turmoil delaying this process. This has been unethical and appalling in how little yall care about the well being of people. I pray that one day yall feel the pain and trauma I have suffered through so someone can belittle your mental condition and cause you to lose everything and not be able to take care of your kids basic needs. Shame on you! I have spoke to several attorneys who have advised me I have multiple claims stemming from those actions taken on this claim. I really don’t want to go that route. I just want what is due to me yall have been with holding over 6 months of pay since august of 2021.

I have raised this issue to my HR rep, My supervisor, and my CEO. A copy of this statement will also be published with the EEOC and the department of insurance. My doctors and I have complied with your requests. This is ridiculous.

I would give a 0 if I could. Corrupt is all I can say.

Jan 24th my car was hit by a guy who had a rental car and carried insurance through continental casualty company. Apparently they have Sedgwick manage claims. I have been given the runaround. They called to tell me they have an incorrect e-mail. I spoke to someone from Nationwide appraisals and gave her the correct email which I did. I received no emails from them after the appraiser came by to look at my car. They send me a super low-ball check of about (no break down of what it is covering) that wouldn't cover the damage let alone a rental car for me to get to work and wiped their hands clean of me. Meanwhile, I have had 2 appraisals in my area that are 3 times the dollar amount in repairs. I called Ryan the claims handler twice as he said I would recieve e-mail from him. Nothing. And he will not answer my calls. There is NO WAY to track this claim. I have recieved absolutely no documents or e-mails from the insurance company, Sedgewick or the appraisal company. I will have to contact my attorny and this will cost more in the long run as I will have to take time off work to handle this apparently.

Hi. I had injury at work in December 23/2021. I was talking with a nurse and explained to her that my English is no good and i need the translator so she was asking me about my physician doctor appointment than she told me you have to see a doctor between March 3_15 i was thinking she talked about my physician doctor no segdwick doctor because i had a appointment with a doctor in March 9 and i didn't know she talked about a segdwick doctor so i apologize for my miss understanding and i said can you reschedule a segdwick doctor appointment soon even tomorrow i can come but she was rude and she refused she text me in March 15 and she said i sent you a email but i didn't know that since March 15 because i didn't receive any call or text me message notifie me i had a appointment with a segdwick doctor talking with the adjuster Stacy denied my claim you can found all the proof below. Other way they told me you don't have to pay nothing for your brain test at saint Elizabeth hospital they already take care of that but yesterday i was receiving a letter from the hospital to pay a bills they was liars to me that really illegal and unprofessional so please 🙏🙏 please can you fix this issue for me i need just the insurance cover my spending for visiting doctor and medication and the days i wasn't working thank you for help have a good night

As usual for co workers and myself included the most stressful payment delayed process ever. I have been through 5 terrible experiences with this company in 7 years. This last experience exactly as expected terrible. November 29 total knee replacement. I filed all paperwork 20 days in advance. Doctor clearly states March 1 2022 return to work. Submitted same documents updated notes medical visits half dozen times. Same excuses, fax not legible resubmit. The other excuse not enough supporting documents . They will do this until deadline is missed . Doctors staff will cooperate with everthing asked but its a Sedgwick scam to hold funds long as possible.The month of February and a week of march no pay. I returned to work as usual on due date with no pay. They finally approved my claim then expect me to wait till end of month be compensated. The excuse is i missed deadline . For every surgery by the 30th day they do not pay

The claims manager I have who actually denied a test from April 2020 until Sept 2021. When she finally approved after sending me to the 4th doctor who she contracted with who submitted for the same identical test this claims manager who you obviously value is now doing the same strategy as she has done on the emg test is so wasteful I can't imagine who is watching over her. I would suspect her immediate supervisor needs to be fired along with her.

This case manager didn't like what the doctors recommended which was surgery from the findings of the test. The case manager is doing your company's strategy let's not pay for that service. The thing is your company has no choice you will pay for my surgery all injuries were reported.

This same claims manager hired a IME she didn't like his recommendation, she hired another IME from a well known Institution and his findings were patient not at MMI that patient needs two surgeries if one of the two surgeries possibly a third surgery which is more invasive would have to be done. She has now set an appointment with a Nextcare doctor to do a MMI she will not get away with this for I will tell the doctor what she is doing show him the test.from the Major Medical Center and The Levine Institute and he will tell them he isn't giving them no kind of sign off for I know this doctor personally he will not do anything illegal. This case manager needs to watch her step she is on a slippery slope.

Sedgwick needs to understand you can't continue to run over the little man.

I have ran out of family leave because of her mishandling of my case now I am out of a good paying job thanks to her incompetence. I have broken down her waste on on test she denied that was done anyway here is the calculation just for the time period and waste of 1 TEST that mind you cost $675.00 my wages for 14 months $17647.28, the 2 doctors approximately 3500.00. Plus $615.00 mileage TOTAL $22437.28 that's for 1 test. Again I say that she ultimately approved anyway and wasted 14 months in doing anyway. This claim mgr does one injury at a time this process will take forever Is this what you represent and teach your clerks./employees not sure if they even have to follow any guidelines. I would like to know is she accountable to anyone these actions certainly can't prove profitable nor impressive to a client. She works at home she obviously has a pool for sometimes when I speak with her I can hear the functions of a pool. I lived around a swimming pool all my life I know the sounds.

I do want to make you aware of how bad she has mishandled my case. I only told you of one test. I did have a surgery but it took her six months to approve and for that has probably left me with an issue to my kidney, I only have one as she knows. My store my manager did ask me in a text if I was seeking to file a claim against your company Sedgwick for the mishandling of my case. I ask you if your own client thinks seeking damages against your company would be appropriate then you might ask yourself might I not check out my clerk/ claims mgr.. I found they my employer had know qualms in me filing a suit against your company, therefore I have hired one of the top 25 SUPER LAWYERS in my area.

The only solution I would see fit is for her to be replaced and I am sure that would not be an option you would consider. It appears your company hires this type of employee.

Torn miniscus in my right knee while at work. Been seeing an LPN who put in a request for an MRI, it finally got approved. Went in for an MRI. Had to wait just over a week before I could get in to see the LPN again. He told me the MRI shows that it is a miniscus tear like he suspected. He referred me to NW Orthopedic, to see an orthopedic surgeon.

I waited 2 days, called over to NW Orthopedics, the lady asked me a few questions and said she would call me back. She called me back to inform me that she couldn't schedule the procedure because Sedgwick hasn't approved my claim yet. She also told me that the claims manager told her to tell me that he scheduled an Independent Medical Exam by another Dr for 3/24/2022.

That's over 3 weeks away!

The MRI proves I have an injury that requires a surgery. I am to the point that I've been off work for 6+ weeks no. I'm losing sleep because I wake up to my knee throbbing, I limp around because it hurts to put too much pressure on it.

What is the purpose of the IME appointment, other than dragging out the claim and wasting time? I am considering filing a few complaints with the State of Washington about the handling of this claim by the claims manager.

I had initially called to file a LOA for short term disability which they started the process for. They sent me paperwork to have the doctor fill out. However, after talking with them a day later they decided the injury I had was work related and told me to file for workers comp and not to have my doctor fill out the paperwork as that would be done by worker's comp if needed. I had asked if I get denied would that mean that it isn't work related and I they would switch me back to short term disability, they said yes.

I eventually got denied workers comp. I called back Sedgwick to verify what they needed and was told to just upload the denial letter and have verification that I'm paying Walmart for short term disability benefits sent over from Walmart benefits. I asked if they would need documentation from my doctor, they said no. I asked if they would be the ones I get payment for in regards to short term, they said yes. They said the worker's comp denial letter was all they would need.

After two days I call back to find out the denial letter has no impact on the LOA, they need documentation from my doctor, and my short term benefits wasn't going to be handled by them. So, everything I was told in my previous call to Sedgwick was an false information.

DOES ANYONE EVEN WORK HERE ANYMORE?! Terrible nightmare I wouldn't wish on my worst enemy. Worthless to the nth degree. My husband has lifetime medical workers comp for an incurable cancer. We thought we finally had billing under control as claims were being paid, until he noticed treatments being billed to and paid for by primary insurance. He called his Sedgwick nurse case manager only to be met with a message that stated, "I will be out of the office for an extended period of time." What does that even mean? And why the heck wasn't my husband assigned another nurse to look after his claim?! Looking back through the claims, there hasn't been any correspondence from said nurse case manager for 3 months now. Gross incompetence or willful incompetence to avoid paying claims? Sedgwick, it isn't even your money. It's the state's funds, and they accepted liability. Disgusting, dehumanizing, and insulting to make injured workers jump through hoops. Complaints will be filed with the state worker's comp ombudsman and appropriate federal entities.

All I can say is they will never pay you or answer the phone. Scamming company