Q. Outside of claims handling, I’m looking for someone to explain in
layman’s terms, what kind of services Sedgwick provides.
Sedgwick is the leading provider of technology-enabled claims and productivity
management solutions. We have evolved our offerings over time to cover a wide
range of services to meet the current and future needs of our clients. In workers’
compensation our clients are self-insured employers and insurance companies.
Our initial role as a third party administrator for workers’ compensation claims has
steadily grown to encompass other services tailored to clients’ specific needs –
including disability, leave, absence management, liability, property and specialty
market services – giving us a depth of expertise as well as distinctive synergies
unparalleled in our industry. A complete list of services can be found on
www.sedgwick.com

Q. What is the benefit Sedgwick brings to the workers’ comp system
and to employers and injured workers?
Sedgwick’s goal is to help injured employees obtain the best possible medical care
and every benefit to which they are legally entitled with the aim of returning them
to health and productivity as quickly and safely as possible.
Regardless of whether injured workers’ care is covered through the traditional
workers’ compensation system or an alternative option, Sedgwick’s focus remains
on taking care of employees while supporting the unique service needs of the
employers we serve.

Q. Sedgwick was acquired by two private equity firms in 2010 for
$1.1 billion and then sold for $2.4 billion in early 2014. That’s a
huge increase in a short amount of time. To what do you attribute
that growth?
Over our history, we have grown primarily through significant, organic business
development, and, at times, through strategic, key acquisitions. In addition, we are
fortunate to partner with clients that continue to choose Sedgwick and grow along
with us over the long term. This combination of growth plus a stable client base has
steadily increased our value.
Every year, nearly three million people contact Sedgwick when they are injured or
ill, have a disability or encounter a loss of property. We are responsible for $13
billion in claim payments to these people annually across many lines of business. Of
these three million new claims we handle, workers’ compensation claims equate
approximately one third of the volume of our activity.

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 Q. Some people have criticized TPAs for receiving fees,
commissions, rebates, etc. from vendors for selling their services to
employers and not being transparent about it. How does Sedgwick
disclose this? How do you respond to the suggestion that it creates
an incentive to sell unneeded services that increase the price for
employers and draw out claims?
One of Sedgwick’s differentiators in the marketplace is that we provide
employers with an integrated approach to handling all aspects of claims through
our own in-house resources, including comprehensive managed care, return to
work and structured settlements services customized to meet their individual
goals. When clients choose these solutions from Sedgwick, there is not a need
to rely on outside vendors.
If a client elects to use a vendor, or if a program requires a service that Sedgwick
does not provide directly, we will enter into a subcontractor arrangement. Sedgwick
does not receive fees, commissions or rebates from vendor partnerships. Invoices
for these services are paid as associated direct expenses on individual claims. There
is no profit sharing or bonus program associated with Sedgwick’s vendor
agreements. Vendors share expenses with Sedgwick, as the cost of doing business,
for Sedgwick’s program oversight, quality audits, customer service, technology
interfaces and state reporting on behalf of the respective vendor partners.

Q. A group of injured workers whose claims have been processed by
Sedgwick have created a community on Facebook accusing
Sedgwick of using “dirty tactics.” As of this writing, it has 957 likes.
I’ve heard Dave North speak at several conferences and it’s clear he
believes Sedgwick’s role is to do good and help injured workers.
How does he respond that so many people report having opposite
experiences from what he describes?
The vast majority of workers’ compensation claims Sedgwick receives are accepted
and successfully resolved. However, issues and disputes do arise in a very small
number of cases that must be managed through the processes prescribed. We are
responsible for following state and federal laws as well as workers’ compensation
regulations. As a result of following these legal and regulatory guidelines, some
claims are denied – however, these situations equate to a very small percent of the
volume of claims Sedgwick handles each year. As an independent third party
administrator - not an insurance company - there is no financial benefit to Sedgwick
in denying claims.
We have the utmost concern for the injured workers and the clients we serve; our
goal is to handle every claim professionally and in compliance with all applicable
laws and regulations. We wholly respect the privacy of our customers and their
employees and as a matter of policy do not discuss the specifics of individual cases
and therefore are unable to respond to posts on social media. We implore anyone
who has an issue relative to his or her specific case to contact us for immediate
review.
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