When an accident or workplace injury occurs, most people expect to deal directly with an insurance company. In many cases, personal injury attorneys become involved early in the process to help injured individuals protect their rights and pursue fair compensation. But sometimes, a third-party entity, such as Sedgwick Claims Management Services, steps in to manage the process.
Sedgwick is not an insurance carrier. Instead, it acts as a third-party administrator (TPA). This distinction often leads to confusion, particularly when you’re trying to recover compensation after an injury.
How Is Sedgwick Different from an Insurance Company?
Sedgwick doesn’t sell insurance policies or collect premiums. Additionally, it does not carry financial risk for the claims it manages. Instead, it operates behind the scenes on behalf of employers, insurers, and large corporations.
Sedgwick’s job is to administer claims, such as those involving workers’ compensation, injury liability, or property damage. It investigates incidents and either recommends or directly authorizes settlements, depending on the authority granted by the insurer or employer.
For instance, suppose you’re injured in a car accident and the at-fault party’s insurance company uses Sedgwick to manage claims. Sedgwick will be your main point of contact. However, the money for any settlement or award will still come from the insurer, not Sedgwick.
This arrangement can blur the lines for claimants. Many people mistakenly assume Sedgwick is the insurer, which can lead to frustration when there are delays or poor communication.
Common Challenges When Dealing with Sedgwick
If Sedgwick is involved in your injury claim, you may face a process that may not always feel fair or straightforward.
Because Sedgwick works for the insurer or employer, their goal is typically to protect their client’s bottom line. That often means minimizing payouts, delaying claims, or using tactics that downplay the severity of your injuries.
Here are some common issues you may encounter:
- Lowball settlement offers that don’t account for your true medical expenses or long-term needs
- Use recorded statements to reduce your credibility or claim value
- Delays in processing paperwork, scheduling evaluations, or issuing decisions
- Denials of legitimate claims
Sedgwick’s adjusters are focused on managing claims efficiently in service to their clients’ interests, which may not always align with your needs.
Accordingly, you should keep a detailed record of every interaction with Sedgwick, including dates, names, and summaries of phone calls or emails. This documentation may be critical if you need to challenge delays, denials, or bad faith conduct.
Overview of Third-Party Claims in Workers’ Compensation Cases
If you were injured on the job and Sedgwick is managing your workers’ compensation claim, it’s essential to consider whether a third-party claim might also apply.
In workers’ compensation cases, third-party claims can be filed against someone other than your employer who contributed to your injury, such as:
- A negligent driver who hit you while you were performing job duties
- A contractor who created an unsafe work condition on a shared job site
- A manufacturer of defective equipment used in your role
While Sedgwick may only process your workers’ compensation benefits, a Baton Rouge personal injury attorney can evaluate whether you also have grounds for a separate third-party lawsuit.
This second claim could help you recover damages not available under workers’ compensation, including pain and suffering, loss of enjoyment of life, and full wage replacement beyond statutory limits.
Contact a Baton Rouge Personal Injury Lawyer if Sedgwick Is Handling Your Claim
Dealing with Sedgwick after an accident or workplace injury can be confusing and stressful, especially when your recovery depends on timely financial support. You don’t have to face the process alone.
For more information, please contact Mansfield Melancon Car Accident and Personal Injury Lawyers to schedule a free consultation with a personal injury lawyer in Baton Rouge, LA today. We have three convenient locations in Louisiana, including Baton Rouge, New Orleans, and Lafayette.
We proudly serve East Baton Rouge Parish, Lafayette Parish, Orleans Parish, and its surrounding areas:
Mansfield Melancon Car Accident and Personal Injury Lawyers – Baton Rouge Office
404 Europe Street
Baton Rouge, Louisiana, 70124
(225) 263-4787
Mansfield Melancon Car Accident and Personal Injury Lawyers – New Orleans Office
365 Canal Street, Suite 415
New Orleans, Louisiana, 70130
(504) 294-3804
Mansfield Melancon Car Accident and Personal Injury Lawyers – Lafayette Office
1318 Camellia Boulevard Suite 206
Lafayette, Louisiana, 70508
(337) 473-2991
Mansfield Melancon Car Accident and Personal Injury Lawyers – Metairie Office
111 Veterans Memorial Blvd, Suite 255
Metairie, Louisiana, 70005
(888) 601-0127