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Claims Management

Sedgwick understands the uniqueness of the group captive market and provides customized claims services.

With market-specific focus, nationwide operations, and a reputation for expert adjusters, superior technology and outstanding customer service, Sedgwick is one of the premier third party claims administrators in the country.

Sedgwick offers Third Party Claims Administration services for all lines of business including property, casualty, auto and inland marine. Sedgwick adjusters are seasoned claims professionals, expert negotiators and are focused on providing the very best service and consistent communication to clients. They utilize state-of-the art technology to track the life of every claim. To ensure that each claim receives the individual attention it deserves, they have put together expert resources including:

  • A designated team of adjusters skilled in investigation, evaluation, and negotiation on your behalf and equipped with expertise in the specific types of claims the members face;
  • Experienced litigation specialists who know how to avoid litigation if possible;
  • Experts in handling claims for all line of business ensuring the most effective management of catastrophe or complex claims such as those involving high damages or loss of life.
  • Our designated team with expertise working with group captives.

They understand that the bottom line matters and with group captives, the member insureds are involved and in control. Our client services team is well versed in captives, put the overall interests of the captive ahead of any short-term savings on defense costs, and allow the designated team of adjusters to use their judgment and experience to deliver the best outcome over the long-term based upon the guidelines and priorities.

Managed Care Solutions

Our cost-effective claims services include a comprehensive suite of integrated managed care services to help you reduce costs and maximize savings. We can incorporate our managed care program seamlessly into your overall workers’ compensation claims handling strategies.

This unique approach allows us to leverage the benefits of each component to deliver a result that is, truly, greater than the sum of the parts.

  • Medicare Secondary Payer Compliance
  • National and Specialty PPO Networks
  • Telephonic and Field-based Case Management
  • A Pharmacy Benefit Management Program
  • Utilization Review Services
  • Medical Bill Review Services
  • Return to Work Programs
  • Diagnostic Network and Scheduling Services
  • Certified Networks & Managed Health Plans
  • Claims Reporting: On-line, telephonic or fax
  • Claims Information Access: Online system
  • Bilingual Claim Examiners