State profile · IA · CMS + NAIC
Iowa marketplace insurers denied 22.4% of claims (7th of 30 states); drivers average $869/yr for auto cover, #48 nationally by cost.
The verdict
Marketplace insurers in Iowa deny 22.4% of claims - above the 20% national average, the 7th-highest of 30 states, and drivers pay an average $869 a year for auto cover, less than the $1191 national average (the 48th-most-expensive of 51 states).
2019: $709 average expenditure
$709 avg expenditure
2020: $708 average expenditure
$708 avg expenditure
2021: $726 average expenditure
$726 avg expenditure
2022: $777 average expenditure
$777 avg expenditure
2023: $869 average expenditure
$869 avg expenditure
What this shows Iowa drivers' average auto cost rose 23% between 2019 and 2023.
Year over year, Iowa's average auto expenditure rose 11.9% from 2022 to 2023, part of a 23% increase (+$160) since 2019. See the full 5-year state-by-state comparison.
Iowa auto rates in detail →Iowa: $869/yr average auto expenditure (this state)
$869 avg expenditure
Vermont: $893/yr average auto expenditure
$893 avg expenditure
Hawaii: $888/yr average auto expenditure
$888 avg expenditure
Idaho: $864/yr average auto expenditure
$864 avg expenditure
Maine: $856/yr average auto expenditure
$856 avg expenditure
Oscar Insurance Company: 34.4% denied (225,302 of 655,352)
34 % of claims denied
Medica Insurance Company: 27.6% denied (127,452 of 461,507)
28 % of claims denied
Wellmark Health Plan of Iowa, Inc.: 19.9% denied (812,696 of 4,086,062)
20 % of claims denied
What this shows These carriers deny the largest share of marketplace claims filed in Iowa. Denial rates reflect plan design and network rules as much as carrier behaviour.
3 insurers reporting marketplace claims in Iowa
| # | Insurer | Claims | |
|---|---|---|---|
| 1 | Oscar Insurance Company F | 655,352 | |
| 2 | Medica Insurance Company D | 461,507 | |
| 3 | Wellmark Health Plan of Iowa, Inc. C | 4,086,062 |
Among carriers with enough reported claims to compare, Iowa's highest marketplace denial rates in this dataset belong to Oscar Insurance Company (34.4%), Medica Insurance Company (27.6%), and Wellmark Health Plan of Iowa, Inc. (19.9%). A high rate often reflects utilization-review intensity and network design, not just claim legitimacy -- check the carrier's own profile before drawing conclusions.
The reported-claims sample is highly concentrated: the 3 largest insurers account for 100% of the 5,202,921 claims represented here. That makes the statewide rate especially sensitive to the mix and experience of a few reporting carriers. Only insurers with at least 1,000 claims in the CMS filing are included, so this is a description of the available dataset rather than the full insurance market.
Oscar Insurance Company: 2,167 of 7,284 reported appeals overturned
30 appeals overturned (%)
Wellmark Health Plan of Iowa, Inc.: 221 of 674 reported appeals overturned
33 appeals overturned (%)
Medica Insurance Company: 98 of 195 reported appeals overturned
50 appeals overturned (%)
What this shows Across the 3 carriers with at least 100 reported appeals in Iowa, 30.5% of reported appeals were overturned (2,486 of 8,153). This filing field describes reported outcomes, not the likelihood that an individual claim will change.
Evidence map
The order below follows the evidence with the greatest bearing on this state record, while keeping the CMS claims filing, NAIC cost series, and state-rule context distinct.
Reporting-sample shape
The 3 largest reporting insurers represent 100% of the 5,202,921 claims in this page's CMS sample. That concentration means the statewide rate can be strongly affected by a few carriers and their plan mix.
Marketplace claims filing
Iowa's reporting insurers denied 22.4% of submitted marketplace claims, ranking 7th among the 30 states with a comparable federal filing. This is a carrier-reported claims measure, not a consumer-complaint rate or a prediction of how an individual claim will be resolved.
Auto-cost position
Iowa's 2023 average auto expenditure was $869, 48th of 51 jurisdictions by cost and 27.0% below the national average. The figure reflects the coverage mix recorded by NAIC, not an individual driver's quote.
State insurance rules
Iowa uses an at-fault (tort) auto-insurance system: the driver responsible for an accident, or their insurer, is liable for the other party's damages -- unlike the 12 no-fault states. Iowa's insurance commissioner is an appointed office (in most states, by the governor), not an elected position -- one of 39 states structured this way.
Nearest expenditure peers. By average auto expenditure, Iowa's closest peers in PlainInsurer's dataset are Idaho ($864/yr) and Maine ($856/yr) -- both within a few dollars of Iowa's own $869/yr.
Border comparison. Iowa borders Illinois, Minnesota, Missouri, Nebraska, South Dakota, and Wisconsin. Iowa's auto costs run lower than all of them, by average auto expenditure -- geography is one of several factors (alongside regulation and risk pool) that shapes these differences, not a direct cause.
Rate regulation and guaranty-fund coverage are state-specific, so a state record can differ from an insurer's national average. Sources: CMS Transparency in Coverage PUF PY2026; NAIC 2023 Auto Insurance Database; Insurance Information Institute; Ballotpedia.
State insurance-department directory links come from NAIC. PlainInsurer is 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.