Sedgwick Claims Management Services
Reviews and Complaints

I was injured at work 3/13/18 and was deemed unable to work in April due to new restrictions resulting from that injury. It was determined that I had a torn labrum that needed surgery and I would not be able to return to work until that happened. I eventually had surgery on 9/27/18 with Beacon Orthopaedics. From April until September, multiple attempts to contact my case handler were ignored and I had no idea what was going on with my case, until I was sent to see a physician in Lexington, KY in August, followed by approval for surgery that happened on 9/27. Over 5 months elapsed from when I was removed from work until I had surgery; over 6 months since the injury occurred. Since I've had surgery, my situation has not gotten any better with Sedgwick: I quickly used the approved 12 physical therapy visits (orthopaedist ordered 24). I had a routine follow-up with the surgeon on 11/13 and he ordered 6 more weeks of physical therapy- 12 more visits. It is now December and I am still waiting for approval from Sedgwick to have more physical therapy so my recovery is actively being hindered by this company's inability to communicate with me and with Beacon Orthopaedics. Additionally, due to the extreme amount of time it has taken to get approval to proceed with treatment, I have now lost my work benefits and must either purchase COBRA or go without insurance until I can return to work. COBRA is very difficult to afford when I have not had a real paycheck since April. This whole situation is ridiculous and has been excrutiating. I do not understand why I have been treated this way and feel like I have no advocacy or help anywhere in this process. Please, Sedgwick, explain yourself to me and why you have allowed me to suffer and now impede my recovery from a workplace injury.

I have an open claim with Sedgwick insurance, my auto accident was well over a month ago! My car was declared a total loss before I even spoke with my agent. He dragged my claim out for two weeks and claimed he was waiting on the total loss report which occurred two weeks prior to him calling. He also suggested I file a claim with the at fault company (I've never had to do that before. I was more than sure that was his job). The total loss report finally came through and he made me aware that claim would be transferred to a total loss agent who happen to be out the office for an entire week ! I callled Sedgwick direct line 8 days later but was unable to speak with my agent. My accident was over a month ago! This is very frustrating and unprofessional ! Idk if it's the company or my agents but I pray I never have to deal with this company again. Sedgwick insurance has my stress level at 10.

Oh yea they also didn't want to move my car from the tow yard.

My daughter, Patrica- recently got an extended leave approved through Sedgwick. There are some problems going on and she was being harassed by some of an ex employees family members. Her manager Margie - was spreading lies about her and being really rude and nasty with her. So instead of quitting she wanted to go to a different department. When she called Walmart asking for a department change - she was told that Sedgewick didn't update Walmart. I called Susan, personal manager, to see if anything could be done and she told me she would contact sedgewick and call me back. She never did. My daughter did everything right but she still was fired due to points

I'm only giving one star because 0 is not an option. They handle Targets insurance issues, I guess? A target employee hit my car with the cart machine. The agent I have been forced, and I mean forced to deal with Kyle Ewert (I've asked for another one almost every time I talk to them.) refuses to let me talk to a manager. I had to call the actual company twice. Once I called, 3 months after the incident (yes that's how long it took) to speak to a manager, and the operator hung up on me twice. I called again and didn't say who I was and finally got ahold of a manager (I think) Amanda Olson. She was a little more helpful stating she would send me a check for repairs and a rental. I'm under 25 so my rental costs more. Toyota (not some mom and pop shop) has stated its going to take longer than expected to repair my car. I reached back out to the manager and she referred me to the original agent and said she couldn't help me. I have an email from her stating they would cover the rental for any additional repair time needed, but he interrupted me the entire conversation with "ma'am we estimated 6 days of repair time and two weekend days, that's 8 days of a rental and we will not approve anymore time." I don't understand how this is legal at all. No one is replying to my emails anymore and I don't have a clue what to do. I'm hoping that when the shop comes back to say it's going to cost more than they gave (which it will, because they gave the bare minimum) that they answer...

denied claim on a fridge repair job gone wrong by Sears Home. The refrigerator only needed a fan motor replaced on initial inspection. By the time a different technician came back to install the fan motor, he cut the evaporator coil and rendered the entire unit not working. They ordered a coil but when the original Sears tech came to install the evaporator coil I didn't need when he originally came out, he said that the closed system was full of water from humidity in the air and said Sears needed to replace the unit. He assisted in filing the claim with Sedgwick.

I lost meat and other frozen items; at least $400.00 of meat and fish. I was told by Sedwick, Rebecca Morizski, that my fridge was repairable even though It was from July to just a week ago I was informed of this amazing revelation!
I also just received a bill from Sears for a repair that did not occur and had to buy a new fridge altogether.

No One returns your call; they act like you don't exist.

I was off work for 6 months of unpaid medical leave, The screws were twisting in my ankle so my Doctor took me off work till they could do surgery to remove 8 screws and metal plate, they tried therapy to move the screws away from my ankle joint, I had them removed and was down with a staff infection and sedgwick thought i should get up from surgery and go to work

My refrigerator was damaged 6/19/18 when repairman pushed it into my granite countertop. I filed a claim submitted pictures but can't get Jason Torres the adjuster to call back. Can't get anyone to call back supposedly have been transferred to supervisor left 4 messages with a Lisa and one with another still no one calls. I was intiallly told it didn't effect the running of my refrigerator it may not but I don't like seeing a dent and scratch everytime I walk in my kitchen. Sears and evidently Sedgwick don't care about anyone and there's a reason no one shops at Sears.

Their phone system is a nightmare. Prompts are virtually buried under a tidal wave of information that doesn't pertain to what I needed. The automated system is deaf or simply unwilling lol to "hear" the date I needed to report. Used the phone's keypads=NOPE, no luck. Tried to use their website, which is a real joke. No luck either. No way to reach them via email or chat, only call during "business hours, " which is rich as they only give you a 48 hour window to report what you need. Super unhappy with them. Also, their leave approval is quite impersonal. They only approved 6 months so far for a CLOSE family member with CANCER, whose treatment will take 24 months according to the oncologist. Very, very poor service. Very indifferent and very badly put together 1-800 service and webpage. Not at all happy with having to deal with them.

There could not be a more corrupt and unethical insurance company. They denied my claim before the due date saying they had not received proper paperwork when I had 5 more days to send more information. They will "lose" emails and faxes from your health care providers. Their independent physician will say you are not disabled despite multiple doctors recommending you do not go back to work yet. They claim taking muscle relaxers and Valium do not prevent you from working. They will deny any and all claims and put you through months and months of hell to try and fight it.

I went on a short term disability leave which was approved for May 1, 2018 to August 12, 2018. When initiating my class I advised the rep that I did not want to supplement my time due to having of the year left with kids and would never know what may happen. I also had a preplanned vacation that was approved and a trip that was paid for. During my time out I didn't think to question this and did not have access to SunTrust systems to view my check stubs. When returning to work I noticed it & immediately called Sedgwick. I was told the call would be pulled and I will receive a call back. When receiving the return call I was advised that the recording keeping policy is 90 days so the call can not be pulled. This is very stressful and upsetting to me due to either taking the vacation anyway and possibly loosing my job and no pay...or not going and loose the hundreds of dollars I paid out. When discussing it here at SunTrust numerous of coworkers stated they had this same issue with vacation being messed up while on a leave of absence so people are scared to take care of their selves because of this. This is a inconvenience for me & my kids due to someone else mistake. I have spoken with my rep Hattie Helmle and her supervisor and still no resolution. Today when following up due to Mrs. Helmle manager stated she will follow up after speaking with SunTrust I was given different information and the rep was rude and would not even transfer me to Mrs. Helmle.

I Beverly Slater went into store to get my True Metrix Blood Glucase filled. I made it home and check bag with product and had only 1 box of test strips I call pharmacy and inform them I had only 1 box and will be back for the other box. When I arrived back I showed them only box in bag, I was informed by 3 pharmacists they looked and did not see another box and the other box was put into bag, then pharmacist said they would have to run camera, I said go ahead because I only have 1 box and I left with 1 box. I was informed they had check counters and count of product.
While waiting the pharmacist that waited on me came up and I informed her where I was short 1 box of product she said let me check as she went behind counter checking container where other prescriptions was and there it was she gave it to me and said she was sorry and I told her thank you. At that time the pharmacist that had accused me of stealing and lying came up and said only 1 box showed up on camera and she was sorry at that time she was also informed that the other box had been found.
For pharmacist accusing me of stealing and lying have really hurt my pride because I go into the store every other day and use the pharmacy for my medicine I am sueing for $50 Thousand Dollars, I am really hurt by that incident.
I have no interest in the offer $500.00 from Ismas Williams/Claims Representative.

Thanks,
Beverly Slater
119 Alfred Drive
Vicksburg, Ms.39180
[protected]@bellsouth.net
[protected]

Sedgwick CMS refused to cover ongoing treatment of an ankle injury I had sustained at Reyes Holdings LLC. My claims examiner, Cherie Passarella, was almost never available to talk and so I had to communicate with her supervisor, Kasey Weber for most of the time. Kasey said I could go to to any provider of my choice after I go to my initial care provider, Med Center 100. Then a few weeks later she said I have to be evaluated by an orthopedist and that I have to use their panel of orthos. However Cherie had said earlier that all she needed to agree to pay for treatment was the dictated notes from Med Center 100, and that I could continue treatment on my own as long as I present my private insurance in case she denies payment. Additionally, the ortho on the panel Kasey gave me was only for fractures, which I didn't have. Kasey later said she needed notes from the ortho I was seeing on my own, which was Wissahickon Orthopedics. I gave her the contact info to get the notes and she ends up never requesting them. She also falsely stated that my 90 day probation period started over when my claim was re-opened, which is why I couldn't see doctors of my choice. Kasey then reveals to me that I had to go to Med Center 100 per the 90 day rule, though I was past 90 days at that point. Kasey ends up finally authorizing me to go to Wissahickon Ortho. After more frustration from me, she states she's not my examiner and can't handle my claim; though she was the one handling it for three weeks. She also states she hadn't requested any notes from anyone, and that Med Center 100 was the only provider I had been authorized to see, even though she literally authorized me to go to Wissahickon. Cherie finally gets back to me and states I can go anywhere since I'm past 90 days. So I was sent to Med Center 100 for no reason. Cherie then states "Kasey is my supervisor and she doesn't fully understand PA WC case law. She was just trying to help me while I was out of the office."

Sears repaired the motor in my dishwasher, they came back again on 7/13 as the dishwasher was leaking over my wood floors. we called and had them come out as soon as we noticed the leaks, the repair guy confirmed there was a leak and he fixed it. However our wood floors are now ruined. I was told to submit a claim with Sedgwick, which I did, and it has been two weeks and I am still unable to get a hold of my elusive claims agent. I spoke to her once, she told me to get two quotes, which I did, but have no idea who will foot the bill for said quotes, and who to send them too. Additionally, the flooring I have is no longer available, so my entire downstairs will need to be replaced. trying to get ahold of this company is impossible, I think the only person that works there much be the front desk person! she is the only one that picks up.

[protected]-0001 grinnell, tracy pet smart wcb#2073351
I worked for petsmart and had and incident that resulted in a neck injury (2/23/18). The injury to my neck I first thought was a pulled muscle so I didn't seek medical attention until a week after because it was not getting better.

I first had christina daly as my adjuster who would not return messages etc. The minute I started to push into what was going on I was then told you have a new adjuster margaret clemens. I have to constantly message and e-mail before I get 1 response. My doctor's office sent in a request for pain management over 2 weeks ago and now ms. Clemins is saying it has to be on a certain form. The request was sent to sedgwick so why now am I being told that nothing has happened with it and it has to be on a certain form? I am seriously thinking about getting a lawyer because I can't understand why it is so hard to communicate with sedgwick and get answers. I can do none of the things I use to do without cause pain and discomfort. The last 2 nights I have not been able to sleep even with 2 tramadol & a ice pack because I lifted a couple of boxes. If I sit around and do nothing i'm okay but i'm not okay with that. At the moment all I really care about is the medical. I can't keep going this way and it's not fair that I should have too.

On May 8 th I received a double transplant and since then have had nothing but trouble with my claims manager Timothy Pulumbo. I was only given 6 weeks disability for a procedure that is a minimum of 12 weeks I work for Walgreens and my employee number is 1783548 I received my first call from Timothy today even though I have left message with him and with many agents who have left notes. Today's message said that due to me not under the care of the transplant team anymore that he needed a medical record from a local doctor. I am under the care of the transplant team indefinitely and do not have a local doctor that deals with my transplant as my state does not even have a transplant facility. My transplant team has sent three faxes of information but according to Timothy that does not count.
This is unacceptable and I would like my case reviewed and I would like a more responsible case manager He calls me 3 working days before my disability is due to end.

My number is 208.571.7523 and I would like a call from someone that can address this issue. There are plenty of my recorded calls to see that I have done more than what is expected and I should not have to be treated like this.

It is interesting to read how some of the other reviews are identical to my issue

Thank you for your help

Darin Stoddard
06/26/2018
11:15 MST

I have been on Short term disability since January 23rd and I have had nothing but issues with my claim adjuster Patricia Cline. I'm out for pulmonary embolisms which were quite large. My cardiologist put me out originally for 3 months but because I have a heart condition he carried it out til July 8 th. Patricia has been very unprofessional from not returning my primary doctors calls as well as mine I've done everything she has asked me to do but this last situation took the cake. I saw my doctor in May he filled out my paperwork it was faxed and my next appointment was scheduled for June 20th . Patricia approved my disability to June 17th. I called and requested an extension til June 20th which after many phone calls back Patricia finally answered my call and denied my extension telling me it has to be done by the 17th. I harassed my doctors office to please get it done so Patricia received it on the 15th I was soo happy. Only for her to only approve it for a week? ! Telling me she needs more info! I have done everything she's asked and yet it's not enough. I feel like she's very unprofessional and she has even talked to me in a nasty disposition I have had palpitations because of this stress and I've addressed this to my cardiologist. Plus I have to pay for this paperwork.

I am an employee of SkyWest Airlines who had a work injury and had to file a Workman's Comp claim. It has been nothing short of a nightmare. I have been continuously lied to, mishandled and mistreated by your claims adjusters. I started out with Lisa Miller, and was transferred to Jennifer Flower. Jennifer is one of the most condescending and rude people I have ever had to speak with...to the point that I had to resort to emails as my only form of contact with her. I was then assigned a Nurse Case manager LeeAnn Hawker, who was fine until they further assigned a third party nurse from Orchard named Natalie Kodach. I have been ignored, dealt with snide comments and then denied every injury by the assigned IME doctor, Dr. Deborah Mattingly. She was extremely rude. I know she is paid off. I also know that she is being sued for malpractice. She falsified her report and my medical representatives, and I have a doctor who wrote a letter as saying such. I have reported her to the DOPL. The fact that your company uses these types of people to care for people when it comes to their health and livelihood is horrific. I would love to file a formal grievance against your company. I think that there are many lies and mistruths that come from your workers.

Thanks,
Kathryn Brown

I had to go on Short term disability for a heart condition, I was undergoing to undergo surgery and treatment. Sedgwick requested for paperwork to be faxed by my surgician and cardiologist several times; they claimed they never received it any paperwork. After two weeks of going to my doctor to verify if the paperwork was faxed, I decided to take the paperwork to the UPS store had them fax it . Sedgwick, admitted to getting the paperwork, however it was not filled out by the medical doctor the way SEDGEWICK wanted it filled. This took another two weeks, in the meantime, SEDGWICK denied the claim for lack of medical substantiation.
I requested to speak to a supervisor the representative said there is no supervisor or manager that I can speak to that can help me. I wanted a clear answer as to the reasons of denial and appeal process.

Next step,
I called Human Resource for Express Scripts to report the abuse and how its impacting my health. Express Scripts HR supervisor called SEDGEWICK to investigate the delay in the process. SEDGEWICK seemed to be more cooperative towards me, I got answers regarding appeal process and this time the medical documentation was enough for the appeal.

At this point, you might assume that SEDGEWICK started being professional by providing good customer service. NOT! I was told that the denial is final, although the appeal is still pending. In addition, I was told they are doing everything legally within the law. I am still fighting for my benefits 6 weeks later.
I am starting to seek for an attorney to assist me with securing benefits.

The AT&T- owned pole in front of my house is leaning and caused damage to the house I purchased. I filed a claim with Gulf Power who promptly came out, assessed the damage, added slack to the power line connected to the pole, and informed me that the pole belonged to AT&T. I filed the claim with AT&T's 3rd party, Sedgwick, complete with explanation and pictures. After weeks of not hearing anything, I reached out to the rep Tasha Hooper for a status update. She said the "manager" claimed to have called and left a message stating the claim was denied because the pole is not leaning (it is). I checked my phone log and messages but found nothing from the "manager" (I use quotations because I have no proof or interactions that this person truly exists). My general contractor, the second inspector sent by Sedgwick, Gulf Power, neighbors, family members, ALL state- without reservation- that the pole is leaning. Tasha was not allowed to give me the phone number, or even the name, of the "manager" who made these claims. I decided to reach out to Gulf Power. Gulf Power sent me a letter detailing the fact that the pole is leaning and that they had to extend the power line to the riser because the pole is leaning. I provided the letter to Tasha and she said she passed it on to the "manager" and requested he call me to discuss. That was almost 2 weeks and not a word. As a military veteran, I find the lack of integrity and professionalism from this company and unworthy of the compensation it obtains from its corporate contracts. Here's my last email to Tasha, dated 5/11/2018:

11 days and no contact from the "manager". My wife and I could not find any record of a phone call or message sent by the "manager" explaining the pole wasn't leaning and that the claim was denied. I don't appreciate being lied to, nor do I appreciate the lack of integrity displayed by your company. This is a shameful display of cowardice and lack of professionalism. I have no intention of letting this go just because your company feels it can stall its way out of doing what is right.

I can't even get a call from the "manager" whose job it is to deal with this. How about getting me the date and the number this "manager" called so I can verify he isn't a liar or a coward, is that possible? Or, maybe the guy can eek out an email to explain how he decided the pole is not leaning, even though everyone else (my contractor, the second inspector- Patty Clark- hired by your company sent out to look at the pole, Gulf Power, neighbors, family... you get my point) have all stated the pole is clearly leaning away from the house?

Is there anyone in the company above you that I can speak to directly? This firestorm is only beginning if I am to be ignored and dismissed.

I was a icu RN and hurt my back in 1993..I became totally disabled 8 years ago..my medical care is suppose to be covered by Sedgwick cms..What a joke..Iwas awarded future medical but every time my md request anything it is denied by this scum company..I haven't seen a spine specialist at all due to denial from this company..Ihave contacted my state assembly member and Congress rep..Also non MDs are making decisions on my medical care ..which the state of .CA. ( where I live) has fined them only 1.3 million $$, while Sedgwick makes 113.million from our denials..worse company ever..