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Michael Smith
This has been, without question, the most mismanaged insurance ordeal I have ever encountered. While I am not an attorney, I strongly suspect this could even be classified as insurance fraud. My daughter was involved in a car accident with an individual insured by Falls Lake Insurance. Rather than handling claims directly, Falls Lake outsourced their claims management to Sedgwick Claims Management. The accident occurred at a "T" intersection, with my daughter traveling on the through street while the insured driver approached from the intersecting road. Per the police report, the collision happened in the intersection. My daughter provided her statement just two days after the accident, which was entirely consistent with the police report. However, days turned into weeks without any communication from Sedgwick. I left multiple voicemail messages—about eight in total—and sent several unanswered emails. Frustrated, I began escalating the issue by contacting the claims representative’s supervisor. After a month, I finally received a call from the supervisor, who informed me that the claim was being denied because the two accounts of the incident did not match. She claimed that the other party reported my daughter had rear-ended their vehicle. I sought clarification and asked, "Did the driver say my daughter hit their car from behind?" To my astonishment, the supervisor admitted, "No, we did not speak with the driver. This was a statement made by the dealership." I was floored. I pointed out that a statement from a party who did not witness the accident could not be used as credible evidence. Her response? "The driver will not speak with us." I then inquired whether they had spoken to the second passenger in the vehicle. She admitted they had not but said she would attempt to contact them. A week later, the claims agent called to officially deny the claim, stating that they had now spoken to the second passenger. This time, the story changed completely: they claimed the accident did not occur at the intersection. Instead, they alleged the insured driver was traveling in the opposite direction on the same road as my daughter, and she swerved into their vehicle. This version contradicts the police report entirely. The way this company handled the claim was utterly dishonest and deceptive. Falls Lake Insurance and Sedgwick Claims Management have demonstrated a shocking lack of integrity. My experience with them has been beyond frustrating, and I would strongly advise others to steer clear of both companies.
2 months ago
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Sedgwick Claims Management Services has a 1.1 average rating from 808 reviews

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