This page will look at the third party insurance claims adjuster Sedgwick. We will discuss who Sedgwick is and how they get brought in to handle claims adjusting on behalf of many insurance carriers. We will also go over what to expect when dealing with Sedgwick on personal injury claims and how to most effectively deal with this company.
Dealing with Sedgwick in Personal Injury Cases
Sedgwick (formerly Sedgwick CMS) is not an actual insurer company. Rather, Sedgwick is a “third party administrator” (TPA) that gets hired to act as an outside insurance claims adjuster for companies that don’t have their own in-house claims personnel. So Sedgwick is basically a contracted insurance adjuster for self-insured companies and smaller insurance companies that have a small claims department (or have no claims department). We do not think much about third-party adjusters but big business with a market size of $271 billion.
This means Sedgwick handles the claims process on behalf of their client. Sedwick has rapidly expanded over the last 10 years so they are becoming a common player in the personal injury claim world.
Our personal injury lawyers have seen Sedgwick representing companies like Target, LabCorp, Home Depot, Walgreens, Sears, General Electric and Kroger in accident claims. Sedgwick will handle the claims process for everything from car crashes, workers’ comp, premises liability (including slip and falls), other injuries, disability, FMLA, and professional liability (including medical malpractice).
In 2019, the Carlyle Group Global became the majority owner of Sedgwick. Carlyle has an estimated $6.7 billion stake in the company. So this is a huge company that is owned by another huge company. it has nearly 7,000 employees throughout 150 offices in North America and $3.5 million in annual revenue.
Sedgwick Company History
After about 40 years, the company has 10,000 employees and 190 offices in the United States and Canada. What they do is essentially take over the job of the insurer. Field investigations at accident scenes, figuring out how much must be set aside in reserves for injury claims, coordinating with lawyers defending their clients’ claims, and trying to reach a settlement with the victim’s lawyers.
The main difference between TPAs like Sedgwick and dealing directly with the insurer is that Sedgwick competes for its clients’ business. How do they get the business? By helping the negligent party save money by paying out as little as possible. What does this mean to you? Typically, it means they are going to try to get the case settled on the cheap. Sure, all insurance companies do this. But Sedgwicks of the world just have more incentive to attempt to rip off the victim.
For liability claims like automobile accidents, the company notes on its website that it follows these “best practices”:
To make immediate contact with injured third party claimants to ascertain the facts and claimed damages. Statements are taken as appropriate from the claimant and witnesses; police reports are obtained when available and relevant; photographs may also be obtained.
As you might expect, we tell our clients that they refer all requests for dialogue from insurance companies or third-party administrators to us—there is typically no good reason for an automobile accident claimant to speak with the opposing side’s insurance representatives.
Other Third Party Administrators that Compete with Sedgwick
Sedgwick is one of the largest third-party administrators. Business Insurance, ranked these companies by by revenue:
- Sedgwick: $808,152,678
- Gallagher Bassett: $401,900,000
- UMR, Inc.: $393,949,776
- Broadspire: $236,467,690
- ESIS: $195,400,000
- Meritain Health: $193,000,000
- CoreSource, Inc.: $ 86,619,141
- York Risk Services: $ 86,000,000 (which Sedgwick bought in 2019)
- Wells Fargo: $ 74,512,426
- Canon Cochran Management Services: $ 67,500,000
Sedgwick was also the largest third-party administrator for workers’ compensation claims (calculated by revenue paid for claims), with Gallagher Bassett just underneath it.
Sedgwick Claims Processing System
Sedgwick uses a software program known as Juris as a central repository for all of its client information. Juris maintains data on medical bills (“including information such as payment details, service descriptions, procedure codes, methods of calculating fees, provider and vendor contacts, and reasons for review”), and time tracking (for workers’ compensation and disability cases. The purpose to monitor the work statuses of individual claimants while off work or on restricted duty. This function helps users track a claimant’s progress and get the claimant back to work quickly.
Can You Reach a Settlement with Sedgwick Without a Lawsuit?
Sedgwick is a bit harder to predict because they are following their clients’ instructions. Some customers ask Sedgwick to take a tough position and give them very little authority to evaluate and settle claims for fair value. Our car accident lawyers have certainly had our share of problems with these types of Sedgwick clients.
Other Sedgwick clients are looking to get cases resolved and take a very different view. In car accident and slip and fall cases, which is where we generally see Sedgwick, it is difficult to resolve cases before filing suit just because a lawsuit seems to get Sedgwick’s clients to focus on the case.
But Sedgwick appears to be a little more realistic in valuing cases than its chief competitor in third part adjusting, Gallagher Bassett. It seems — just based on the online reviews we get from victims complaining about their dealings with Sedgwick — is that this is a tough company to deal with if you are not represented by an attorney.
Dealing with Sedgwick on Injury Settlement Claims After a Lawsuit is Filed
Like almost all insurance companies and third-party administrators, Sedgwick gets more reasonable after a personal injury lawsuit is filed. Companies using Sedgwick generally have to hire outside attorneys to defend claims. The cost and expenses of defending a case – mostly attorneys’ fees — become an issue when a lawsuit is filed. As a result, Sedgwick’s clients get more serious about evaluating the claim before it goes to the next level. Almost every defendant responds to the pressure of a lawsuit and it often leads to a significant increase in last settlement offer. This logic holds up particularly well in claims that are being handled by Sedgwick.
Hiring a Lawyer to Take on Sedgwick
If you have been hurt in an accident where the at-fault company is self-insured and uses Sedgwick or another third party administrator, call us at 800-553-8082 or click here for a free no obligation consultation. Our firm handles only very serious injury and wrongful death claims.
You can reach Sedgwick in Maryland by calling 800-285-3258. You can contact them by mail at:
PO Box 808
Hunt Valley, MD 21030
Think twice before contacting any insurance company or third party claims adjuster without first speaking to a lawyer. It is usually a mistake.
Is Sedgwick an Insurance Company?
No. Sedgwick is not an insurance carrier. Sedgwick is a third party claims administrator. They get hired to act as a claims administrator or claims adjuster by companies who are self-insured and don’t have their own claims department. For instance, if you bring a slip and fall claim against Target you may end up dealing with Sedgwick as the outside claims adjuster on behalf of Target.
Is Sedgwick Difficult to Deal with on Personal Injury Claims?
Sedgwick tends to take their stance on claims based entirely on directions from their client. They typically have very little discretion or authority to resolve claims on their own. This means that in some cases Sedgwick may be very difficult and aggressive and in other cases they may be very reasonable. It all depends on what instructions they are getting from their client.
Does Sedgwick Make Reasonable Settlement Offers?
The reasonableness of a settlement offer from Sedgwick often depends on the instructions they are getting from their client. However, Sedgwick is generally more reasonable and tends to make better settlement offers than its other major competitor (Gallagher Bassett).
How Long Does it Take to Get a Settlement Check from Sedgwick?
Once the settlement and final release agreement is fully signed and returned, you can expect to get a settlement check from Sedgwick in about 4-6 weeks. This time frame can sometimes be longer depending on certain circumstances.
Who are Some of Sedgwick’s Bigger Clients?
Based on our own experience in dealing with Sedgwick, their major clients appear to be Target, Home Depot, Walgreens, and Kroger. Most of the claims they handle on behalf of these retailers involve premises liability cases (better known as “slip and fall” cases).
More Information on Dealing with Sedgwick in Injury Cases
- Valuing Injury Cases (how much is your case worth?)
- Slip and Fall Claims (an overview)
- Sample Settlement Packages (letter to insurance company for compensation by settlement)
- Handling Injury Claims Without a Lawyer (tips for personal injury victims)
- Getting Your Property Damage Fixed (tips for handling auto accident property damage claims)
- Frequently Asked Questions (handling injury claims against Sedgwick and other insurance companies/third party administrators)
- Help Center (if you want to know how to go after a company like this one, we give you all the tools you need to do it)