Understanding Sedgwick Accident Claims and Settlements
In this post, we’ll explore the role of Sedgwick, a third-party insurance claims adjuster. We’ll discuss what Sedgwick does and how they handle claims, and we will offer guidance on effectively dealing with them in personal injury cases.
Who is Sedgwick?
Sedgwick, previously known as Sedgwick CMS, is a third-party administrator (TPA), not an insurance company. Companies hire them without in-house claims personnel to manage the claims process on their behalf. Sedgwick operates as a contracted insurance adjuster for self-insured companies and smaller insurance firms that lack a dedicated claims department.
This arrangement allows Sedgwick to handle claims for various incidents, including car accidents, workers’ compensation, premises liability (such as slip-and-fall cases), disability, and professional liability. They have grown rapidly over the past decade, becoming a significant player in the personal injury claim sector.
Sedgwick’s clients include well-known companies like Target, LabCorp, Home Depot, Walgreens, Sears, General Electric, and Kroger. In 2019, Carlyle Group Global acquired a majority stake in Sedgwick, further solidifying its position in the industry. Sedgwick plays a crucial role in the insurance claims landscape, with nearly 7,000 employees across 150 offices in North America and significant annual revenue.
The Role of Sedgwick in Personal Injury Cases
Sedgwick essentially steps into the shoes of the insurer. They conduct field investigations, determine reserves for injury claims, coordinate with defense lawyers, and negotiate settlements. As a TPA, Sedgwick competes for business by helping their clients save money, often resulting in attempts to settle claims for less than their fair value. This incentive can make it challenging for claimants to receive adequate compensation without legal representation.
Sedgwick’s best practices for handling liability claims, such as those from automobile accidents, include:
- Making immediate contact with injured third-party claimants to gather facts and assess damages.
- Taking statements from claimants and witnesses.
- Obtaining police reports and relevant photographs.
We advise our clients to direct all communication from insurance companies or TPAs to us, as speaking with the opposing side’s representatives directly typically does not offer any benefit.
Competing Third-Party Administrators
Sedgwick is one of the largest TPAs but faces competition from other major firms. Business Insurance ranked TPAs by revenue, listing Sedgwick at the top:
- 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 (acquired by Sedgwick in 2019)
- Wells Fargo: $74,512,426
- Canon Cochran Management Services: $67,500,000
Sedgwick also leads in workers’ compensation claims by revenue paid for claims, followed closely by Gallagher Bassett.
Sedgwick’s Claims Processing System
Sedgwick uses a software program called Juris as a central repository for all client information. Juris tracks medical bills, including payment details, service descriptions, procedure codes, provider contacts, and more. It also monitors time tracking for workers’ compensation and disability cases, helping manage claimants’ work statuses and facilitating their return to work.
Reaching a Settlement with Sedgwick Without a Lawsuit
Sedgwick’s approach to settlements varies based on their client’s instructions. Some clients direct Sedgwick to take a tough stance and limit settlement authority, while others prefer to resolve cases quickly. Our experience shows that filing a lawsuit often prompts Sedgwick’s clients to take claims more seriously, leading to better settlement offers.
Overall, Sedgwick tends to be more realistic in valuing cases than its main competitor, Gallagher Bassett. However, dealing with Sedgwick without an attorney can be challenging, as numerous online reviews indicate.
Handling Injury Settlement Claims with Sedgwick After Filing a Lawsuit
Like most insurance companies and TPAs, Sedgwick becomes more reasonable after a lawsuit is filed. The cost of defending a case, primarily through attorneys’ fees, incentivizes Sedgwick’s clients to evaluate claims more carefully. This often leads to increased settlement offers.
Contacting Sedgwick
To reach Sedgwick in Maryland, you can call 800-285-3258 or send mail to:
PO Box 808 Hunt Valley, MD 21030 410-773-4221
Before contacting any insurance company or TPA, speaking with a lawyer is advisable to avoid potential pitfalls.
Frequently Asked Questions about Sedgwick
Is Sedgwick an Insurance Company?
No. Sedgwick is a third-party claims administrator hired by self-insured companies to handle claims.
Is Sedgwick Difficult to Deal with on Personal Injury Claims?
Sedgwick’s stance on claims depends on their clients’ instructions, leading to varying difficulty level and aggression.
Does Sedgwick Make Reasonable Settlement Offers?
The reasonableness of Sedgwick’s settlement offers often reflects their clients’ directives. Generally, Sedgwick is more reasonable than its major competitor, Gallagher Bassett.
How Long Does it Take to Get a Settlement Check from Sedgwick?
After signing and returning the settlement and release agreement, expect a check within 4-6 weeks, though this may vary.
Who are Some of Sedgwick’s Bigger Clients?
Sedgwick’s major clients include Target, Home Depot, Walgreens, and Kroger, which mostly handle premises liability cases.
Navigating interactions with Sedgwick can be complex, and seeking legal guidance is often beneficial. At National Injury Attorneys, we are experienced in dealing with Sedgwick and can help you secure the settlement you deserve.
How Can National Injury Attorneys Help?
If you or a loved one experiences a slip and fall accident, Call National Injury Attorneys at 1-800-736-5300 to provide comprehensive legal assistance to ensure you receive the compensation you deserve. Here’s how we can help:
1. Initial Consultation and Case Evaluation
- Free Consultation: We offer a free telephone consultation to discuss the details of your slip and fall accident.
- Case Assessment: Our experienced attorneys will assess the circumstances of your accident to determine the viability of your claim.
2. Investigation
- Evidence Collection: The firm’s team will gather crucial evidence such as accident reports, surveillance footage, witness statements, and medical records.
- Site Inspection: Investigators may visit the accident site to document hazardous conditions and obtain photographic evidence.
3. Establishing Liability
- Proving Negligence: The attorneys will work to prove that the property owner or manager was negligent in maintaining a safe environment.
- Identifying Defendants: They will identify all potentially liable parties, including property owners, management companies, and contractors.
4. Medical Documentation
- Medical Records: The firm will compile all relevant medical records to document the extent of your injuries.
- Expert Testimony: They may consult medical experts to testify about the impact of your injuries.
5. Negotiation with Insurance Companies
- Claim Filing: Our attorneys will file your insurance claim, ensuring all necessary documentation is provided.
- Negotiation: They will negotiate with insurance companies to secure a fair settlement that covers medical expenses, lost wages, pain and suffering, and other damages.
6. Litigation (if needed)
- Filing a Lawsuit: If a fair settlement cannot be reached, the firm is prepared to file a lawsuit and take your case to court.
- Court Representation: Experienced trial lawyers will represent you in court, presenting a strong case to the judge and jury.
7. Client Support
- Communication: The firm ensures clear and regular communication, keeping you informed about the progress of your case.
- Personalized Service: Each case is given personalized attention to address the unique aspects of your situation and needs.
8. Post-Settlement Assistance
- Settlement Disbursement: The firm will assist in the disbursement of settlement funds, ensuring that all medical bills and liens are addressed.
- Continued Support: They offer ongoing support for future legal needs related to your accident.
National Injury Attorneys leverage their extensive experience in personal injury law to provide dedicated and effective representation for slip and fall accident victims. Their goal is to ensure you receive the full compensation you are entitled to for your injuries and suffering.
