Reputation grade
D
Peer-relative, A–F
Insurer profile · NAIC + CMS
Oscar Insurance Company's complaint record, claim-denial rate and reputation grade, drawn from published NAIC complaint data and CMS Transparency in Coverage.
The verdict
Oscar Insurance Company earns a D reputation grade — a worse-than-average record versus peers, CMS records show 23.0% of its marketplace claims denied across 8 states.
Grades are peer-relative within PlainInsurer's dataset. A high complaint ratio is not proof of wrongdoing — larger insurers draw more complaints by volume, which the index normalises.
Reputation grade
D
Peer-relative, A–F
NAIC complaint index
N/A
1.0 = market average; lower is better
Claim denial rate
23.0%
CMS, 8 states
Marketplace claims denied, by state (states with ≥100 claims on file)
MO: 26.7% denied (27,222 of 101,961 claims)
26.7 % of claims denied
TN: 26.5% denied (31,529 of 118,815 claims)
26.5 % of claims denied
IA: 24.9% denied (51,685 of 207,959 claims)
24.9 % of claims denied
MI: 24.4% denied (5,494 of 22,475 claims)
24.4 % of claims denied
OK: 23.3% denied (73,742 of 316,490 claims)
23.3 % of claims denied
KS: 22.8% denied (9,514 of 41,772 claims)
22.8 % of claims denied
TX: 22.5% denied (479,462 of 2,134,298 claims)
22.5 % of claims denied
NE: 21.4% denied (5,358 of 24,997 claims)
21.4 % of claims denied
What this shows Denial rates vary by state plan and network. Across 8 reporting states, Oscar Insurance Company denied 23.0% of marketplace claims on average.
Oscar Insurance Company carries a D reputation grade in PlainInsurer's dataset, with a composite score of 35.6 (higher means more consumer friction relative to size). It does not yet carry enough NAIC complaint history for a normalized complaint index.
On the claims side, CMS Transparency-in-Coverage filings show Oscar Insurance Company denied 23.0% of marketplace claims across 8 reporting states — an elevated rate that warrants checking the plan's appeal-success record before enrolling.
The practical implication: complaint and denial data give a comparative view of how Oscar Insurance Company treats policyholders relative to peers, but they cannot predict your individual claim experience. Compare the grade against named alternatives in your state, and weigh price, coverage terms and state licensing before any purchase. Source: NAIC Consumer Information Source complaint data (2024). Source: CMS Transparency in Coverage PUF (PY2025), cms.gov.
What to do with this
How to act on Oscar Insurance Company's complaint and denial record.
Complaint ratios normalise by premium volume so larger carriers are not penalised for writing more policies.
Source: NAIC published complaint index + CMS Transparency in Coverage PY2025 Complaint index, reputation grade and per-state claim denial rates for Oscar Insurance Company · 2024 NAIC complaint index aggregates state-DOI consumer complaints, normalized against premium volume (1.0 = market average). Denial rates from CMS Transparency in Coverage PY2025. Reputation grade is PlainInsurer's peer-relative methodology applied to this public data.
Data: NAIC published complaint index (2024) · CMS Transparency in Coverage PUF PY2025. Not affiliated with NAIC or CMS. Read our methodology.