Insurer profile · UnitedHealth Group · NAIC + CMS
UnitedHealthcare Insurance Company
UnitedHealthcare Insurance Company's complaint record, claim-denial rate and reputation grade, drawn from published NAIC complaint data and CMS Transparency in Coverage.
- F
- Reputation grade
- 27.2%
- Claims denied
- 5
- States (CMS data)
The verdict
UnitedHealthcare Insurance Company earns a F reputation grade - a significantly worse record than peers, according to CMS Transparency in Coverage filings, 27.2% of its marketplace claims were denied across 5 states.
- F
- reputation grade
- 27.2%
- claims denied (CMS)
Graded on 1 of 3 measures: claim denials. The score is rescaled across the measures available, so it is not directly comparable with a carrier graded on more of them.
How we calculated this grade →NAIC CIS filing desk
NAIC NAIC F · 18.9
GRADE-F · INDEX-UNK · DENIAL-HOT · RANK-UNK · PHOTO-SOLO · LINES-0 · BOOK-MID
- GRADE-F F · 18.9
- INDEX-UNK Index blank
- DENIAL-HOT 27.2% denied
- RANK-UNK Rank pending
- PHOTO-SOLO No peer gap
- LINES-0 No lines
- BOOK-MID 3/7 fields
Instrument codes from this carrier’s NAIC Consumer Information Source filing: grade band, complaint index, CMS denial band, corpus rank, photo-finish peer, line book, and field completeness. Not an official NAIC rating.
UnitedHealthcare Insurance Company - claim denial rate by state
- LA
LA: 35.4% denied (549,914 of 1,553,306 claims)
35 % of claims denied
- MO
MO: 30.7% denied (448,480 of 1,458,708 claims)
31 % of claims denied
- TN
TN: 26.7% denied (693,284 of 2,595,620 claims)
27 % of claims denied
- KS
KS: 26.0% denied (298,019 of 1,145,267 claims)
26 % of claims denied
- AL
AL: 25.2% denied (1,867,378 of 7,407,082 claims)
25 % of claims denied
What this shows Denial rates vary by state plan and network. Across 5 reporting states, UnitedHealthcare Insurance Company denied 27.2% of marketplace claims on average.
Among states with enough reported claims to compare, UnitedHealthcare Insurance Company's highest marketplace denial rates in this dataset are in Louisiana (35.4%), Missouri (30.7%), and Tennessee (26.7%). State-level rates reflect the specific plans UnitedHealthcare Insurance Company offers there and how each state's regulators and utilization-review rules apply, not necessarily the carrier's national practice.
CMS marketplace filing
Reported appeal outcomes for UnitedHealthcare Insurance Company
The largest state samples are Alabama (2,741 filed, 1,054 overturned), Tennessee (1,483 filed, 470 overturned), and Missouri (1,119 filed, 386 overturned); 5 states contribute to the profile total.
CMS reports an overturn outcome for 6,779 of these 6,779 filed appeals; missing outcomes are excluded from the percentage. These filing totals are not a prediction for an individual appeal. View the CMS source ↗
What the NAIC filing desk shows for UnitedHealthcare Insurance Company
UnitedHealthcare Insurance Company's filing desk summarizes the NAIC complaint record and any CMS marketplace denial data on file.
See where UnitedHealthcare Insurance Company sits against every reporting carrier in the claim-denial rate ranking. Appeal notes for UnitedHealthcare Insurance.
Nationwide insurers with similar scores or complaint volume
Two corpus-wide peer sets for UnitedHealthcare Insurance Company: nearest national-scale carriers by composite score and by NAIC complaint volume. These are cross-market neighborhoods, not the corporate-family list or same-grade chips above.
Similar composite score
Nearest carriers by composite score (18.9 here). Floored at 50+ complaints and 5+ states.
UnitedHealthcare Insurance Company is part of the UnitedHealth Group family, alongside UnitedHealthcare, UnitedHealthcare of South Carolina, Inc., UnitedHealthcare of Ohio, Inc., UnitedHealthcare of Texas, Inc., and 2 more in PlainInsurer's dataset -- a shared parent doesn't mean shared performance, so check each subsidiary's own record before assuming they behave alike.
Questions about UnitedHealthcare Insurance Company
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Source: NAIC published complaint index + CMS Transparency in Coverage PY2026 Complaint index, reputation grade and per-state claim denial rates for UnitedHealthcare Insurance Company · 2024
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Download the data behind this page
The full PlainInsurer extract, covering every insurer including UnitedHealthcare Insurance Company, is available as CSV and JSON. Underlying federal data is public domain; see our methodology for the compilation and grading method.
Data: NAIC published complaint index (2024) · CMS Transparency in Coverage PUF PY2026. Not affiliated with NAIC or CMS.
Every figure on PlainInsurer comes directly from NAIC MCAS and CMS Transparency in Coverage data; no editor types in numbers. See our editorial standards or methodology, or report an error. Data current as of 2026-08-11. Grades measure only the published complaint/denial data; we don't recommend any insurer or policy.