State profile · NC · CMS + NAIC
North Carolina marketplace insurers denied 20.5% of claims (12th of 30 states); drivers average $925/yr for auto cover, #44 nationally by cost.
The verdict
Marketplace insurers in North Carolina deny 20.5% of claims - near the 20% national average, the 12th-highest of 30 states, and drivers pay an average $925 a year for auto cover, less than the $1191 national average (the 44th-most-expensive of 51 states).
2019: $754 average expenditure
$754 avg expenditure
2020: $766 average expenditure
$766 avg expenditure
2021: $789 average expenditure
$789 avg expenditure
2022: $839 average expenditure
$839 avg expenditure
2023: $925 average expenditure
$925 avg expenditure
What this shows North Carolina drivers' average auto cost rose 23% between 2019 and 2023.
Year over year, North Carolina's average auto expenditure rose 10.2% from 2022 to 2023, part of a 23% increase (+$171) since 2019. See the full 5-year state-by-state comparison.
North Carolina auto rates in detail →North Carolina: $925/yr average auto expenditure (this state)
$925 avg expenditure
South Dakota: $936/yr average auto expenditure
$936 avg expenditure
Indiana: $926/yr average auto expenditure
$926 avg expenditure
Wisconsin: $922/yr average auto expenditure
$922 avg expenditure
Vermont: $893/yr average auto expenditure
$893 avg expenditure
Same 1,000-claim floor as the table, ordered by rate
CareSource North Carolina Co.: 37.0% denied (76,854 of 207,708)
37 % of claims denied
Oscar Health Plan of North Carolina, Inc: 31.2% denied (33,542 of 107,392)
31 % of claims denied
AmeriHealth Caritas North Carolina, Inc.: 30.6% denied (139,608 of 456,084)
31 % of claims denied
UnitedHealthcare of North Carolina, Inc: 27.7% denied (515,982 of 1,863,541)
28 % of claims denied
Ambetter of North Carolina Inc.: 21.0% denied (1,082,702 of 5,146,068)
21 % of claims denied
Cigna HealthCare of North Carolina, Inc.: 21.0% denied (226,995 of 1,079,077)
21 % of claims denied
Blue Cross and Blue Shield of NC: 19.0% denied (3,217,713 of 16,959,958)
19 % of claims denied
What this shows A high rate on a smaller book is not evidence of the most denied claims in North Carolina.
Same filing sample, ordered by denied count rather than rate
Blue Cross and Blue Shield of NC: 3,217,713 denied of 16,959,958 (19.0%)
3,217,713 denied claims
Ambetter of North Carolina Inc.: 1,082,702 denied of 5,146,068 (21.0%)
1,082,702 denied claims
UnitedHealthcare of North Carolina, Inc: 515,982 denied of 1,863,541 (27.7%)
515,982 denied claims
Cigna HealthCare of North Carolina, Inc.: 226,995 denied of 1,079,077 (21.0%)
226,995 denied claims
AmeriHealth Caritas North Carolina, Inc.: 139,608 denied of 456,084 (30.6%)
139,608 denied claims
CareSource North Carolina Co.: 76,854 denied of 207,708 (37.0%)
76,854 denied claims
Oscar Health Plan of North Carolina, Inc: 33,542 denied of 107,392 (31.2%)
33,542 denied claims
What this shows Denied-claim count is a volume rank. It is not a restatement of the rate ranking.
CareSource North Carolina Co. reports the highest marketplace denial rate in North Carolina at 37.0% on 207,708 received claims. Blue Cross and Blue Shield of NC reports the most denied claims (3,217,713) at 19.0% - a different rank, not a second reading of the same list.
7 insurers reporting marketplace claims in North Carolina
| # | Insurer | Claims | Denied | |
|---|---|---|---|---|
| 1 | CareSource North Carolina Co. F | 207,708 | 76,854 | |
| 2 | Oscar Health Plan of North Carolina, Inc F | 107,392 | 33,542 | |
| 3 | AmeriHealth Caritas North Carolina, Inc. F | 456,084 | 139,608 | |
| 4 | UnitedHealthcare of North Carolina, Inc D | 1,863,541 | 515,982 | |
| 5 | Ambetter of North Carolina Inc. C | 5,146,068 | 1,082,702 | |
| 6 | Cigna HealthCare of North Carolina, Inc. C | 1,079,077 | 226,995 | |
| 7 | Blue Cross and Blue Shield of NC C | 16,959,958 | 3,217,713 |
Among carriers with enough reported claims to compare, North Carolina's highest marketplace denial rates in this dataset belong to CareSource North Carolina Co. (37.0%), Oscar Health Plan of North Carolina, Inc (31.2%), and AmeriHealth Caritas North Carolina, Inc. (30.6%).
The reported-claims sample is highly concentrated: the 3 largest insurers account for 93% of the 25,819,828 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.
Blue Cross and Blue Shield of NC: 779 of 2,160 reported appeals overturned
36 appeals overturned (%)
UnitedHealthcare of North Carolina, Inc: 526 of 1,407 reported appeals overturned
37 appeals overturned (%)
Oscar Health Plan of North Carolina, Inc: 320 of 875 reported appeals overturned
37 appeals overturned (%)
CareSource North Carolina Co.: 95 of 728 reported appeals overturned
13 appeals overturned (%)
Cigna HealthCare of North Carolina, Inc.: 39 of 150 reported appeals overturned
26 appeals overturned (%)
What this shows Across the 5 carriers with at least 100 reported appeals in North Carolina, 33.1% of reported appeals were overturned (1,759 of 5,320). 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 93% of the 25,819,828 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
North Carolina's reporting insurers denied 20.5% of submitted marketplace claims, ranking 12th 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
North Carolina's 2023 average auto expenditure was $925, 44th of 51 jurisdictions by cost and 22.3% below the national average. The figure reflects the coverage mix recorded by NAIC, not an individual driver's quote.
State insurance rules
North Carolina 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. North Carolina's insurance commissioner is a directly elected statewide office, one of 11 states where voters choose this role rather than a governor.
Nearest expenditure peers. By average auto expenditure, North Carolina's closest peers in PlainInsurer's dataset are Indiana ($926/yr) and Wisconsin ($922/yr) -- both within a few dollars of North Carolina's own $925/yr.
Border comparison. North Carolina borders Georgia, South Carolina, Tennessee, and Virginia. North Carolina'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.