- 209
- Insurers graded
- 51
- States covered
- 206
- Denial-rate records
- 37
- Medicare Advantage plans
According to published National Association of Insurance Commissioners complaint data and the U.S. Centers for Medicare & Medicaid Services Transparency in Coverage Public Use File (PY2025), data as of July 2026, PlainInsurer grades more than 1,000 insurer records across all 51 United States jurisdictions. See our methodology for how every figure is sourced and computed.
The national picture
Across 209 insurers and 51 states, complaint records and claim-denial rates vary enormously - marketplace insurers in Alabama deny 36% of claims, while top-graded carriers draw far fewer complaints than their size predicts.
- 209
- insurers graded
- 41
- F-grade carriers
- 21%
- avg claims denied (CMS)
- 51
- states covered
How we calculate: complaint grades are peer-relative, each insurer's complaint index is ranked against every other insurer in the same dataset, not against an absolute external scale. Denial rates are measured directly from CMS marketplace filings, not estimated. Data as of July 2026.
Claim denials across the country
Marketplace claim-denial rate by state (CMS PY2025). States running their own exchange aren't in the federal file and show blank.
Where insurers deny the most claims
Marketplace claim-denial rate by state (states with ≥50,000 claims on file)
- AL
Alabama: 35.5% of marketplace claims denied (15.3M claims)
35.5 % of claims denied
- AK
Alaska: 27.0% of marketplace claims denied (0.8M claims)
27 % of claims denied
- AZ
Arizona: 24.5% of marketplace claims denied (10.1M claims)
24.5 % of claims denied
- IN
Indiana: 24.2% of marketplace claims denied (4.7M claims)
24.2 % of claims denied
- OK
Oklahoma: 23.8% of marketplace claims denied (11.0M claims)
23.8 % of claims denied
- HI
Hawaii: 23.8% of marketplace claims denied (0.7M claims)
23.8 % of claims denied
- OH
Ohio: 22.1% of marketplace claims denied (13.6M claims)
22.1 % of claims denied
- TN
Tennessee: 22.0% of marketplace claims denied (17.6M claims)
22 % of claims denied
- FL
Florida: 21.9% of marketplace claims denied (114.1M claims)
21.9 % of claims denied
- TX
Texas: 21.9% of marketplace claims denied (111.9M claims)
21.9 % of claims denied
What this shows Claim-denial rates reflect plan design, network rules and state regulation. These are aggregate marketplace rates across all reporting issuers, individual carriers vary widely within each state.
Cost vs. denials, state by state
Each bubble is a state, placed by its marketplace claim-denial rate and its average auto premium (bubble size = claim volume). The bottom-left is best for consumers: lower denials and lower cost.
Marketplace claim-denial rate (CMS PY2025) vs average auto expenditure (NAIC 2023)
Top 10 states by claim-denial rate
States ranked by aggregate marketplace claim-denial rate (CMS TiC PY2025, states with ≥100,000 claims)
Highest-complaint insurers
All rankings →These carriers received an F grade on PlainInsurer's peer-relative composite of complaint index, denial rate and prior-authorization data. A high complaint ratio is a signal to investigate, not proof of wrongdoing.
SafeAuto (Kemper)
FKemper
Infinity P&C (Kemper)
FKemper
Direct General (Allstate)
FAllstate
Root Insurance
FRoot
Gainsco Insurance
FGainsco
Universal Property & Casualty
FUniversal Insurance
Worst & best insurers by coverage line
Complaint index rankings for the exact line you carry, auto, home, health, or life, each normalized against its own market median (2026 NAIC MCAS data).
Auto insurance rates by state
NAIC 2023, average premiums & expenditures across all 51 states
Highly rated insurers
All →These carriers earned an A or B grade on PlainInsurer's peer-relative composite of complaint index, denial rate and prior-authorization data, not a personalized recommendation. Coverage needs, state availability and price still vary, compare quotes before you buy.
Insurance guides
Understanding Complaint Ratios
What NAIC data reveals about your insurer
Evaluate Health Insurers
Using government data beyond star ratings
Claim Denial Rates Explained
Why rates vary and what it means for you
How to Appeal a Claim Denial
Step-by-step process for fighting denials
Choosing Auto Insurance
Data-driven approach to auto coverage
Frequently Asked Questions
What is a complaint ratio?
A complaint ratio (or complaint index) measures confirmed complaints filed against an insurer relative to its premium volume. A value above 1.0 means more complaints than the market average for a company of that size; below 1.0 is better than average.
Where does this data come from?
Published NAIC complaint-index data (2024), the CMS Transparency in Coverage PUF PY2025 (per-state claim denial rates), and CMS Medicare Advantage analysis. All are public-domain federal sources.
What do the letter grades mean?
Grades (A–F) are assigned on a curve relative to the carriers in our dataset, combining the NAIC complaint index, claim denial rates, and prior-authorization data. A = far fewer consumer problems than peers; F = significantly worse. The grade is a relative ranking, not a legal certification.
Is a high complaint ratio illegal?
No. A high complaint ratio is a signal worth investigating, not proof of wrongdoing. Larger insurers receive more complaints by volume; the complaint index normalizes for premium size. Claim complexity and state regulation also affect complaint rates.
Start here
Three ways to use PlainInsurer's data before you buy or appeal.
- Look up your carrier's complaint index and grade. Browse insurers
- See how insurers rank in your state on complaints and denials. Browse by state
- Denied a claim? Walk through the appeal process step by step. Appeal a denial
PlainInsurer is informational and not affiliated with NAIC or CMS. It is not financial, legal, or insurance advice.