State profile · NC · CMS + NAIC
Insurance in North Carolina
How health insurers handle claims in North Carolina, and what drivers pay for auto cover — measured from CMS Transparency-in-Coverage and NAIC data.
- 19.7%
- Avg claims denied
- #15
- denial rank of 31
- $925
- Avg auto / yr
- +23%
- Auto, 5-yr
- 9
- Insurers w/ data
The verdict
Marketplace insurers in North Carolina deny 19.7% of claims — near the 21% national average, the 15th-highest of 31 states, and drivers pay an average $925 a year for auto cover, less than the $1191 national average.
- 19.7%
- avg claims denied
- #15
- of 31 states
- $925
- avg auto / yr
- 46%
- highest (CareSource North C)
Denial rates are aggregate marketplace figures from CMS filings; auto figures are NAIC average expenditures. State regulation, risk pool and plan design all shape these numbers.
Highest claim-denial rates in North Carolina
Health insurers by share of marketplace claims denied (≥1,000 claims on file)
- CareSource North Carolin
CareSource North Carolina Co.: 45.7% denied (4,891 of 10,705)
45.7 % of claims denied
- AmeriHealth Caritas Nort
AmeriHealth Caritas North Carolina, Inc.: 43.0% denied (106,857 of 248,740)
43 % of claims denied
- Oscar Health Plan of Nor
Oscar Health Plan of North Carolina, Inc: 38.3% denied (2,890 of 7,541)
38.3 % of claims denied
- UnitedHealthcare of Nort
UnitedHealthcare of North Carolina, Inc: 34.8% denied (570,269 of 1,637,927)
34.8 % of claims denied
- Cigna HealthCare of Nort
Cigna HealthCare of North Carolina, Inc.: 21.5% denied (238,678 of 1,112,498)
21.5 % of claims denied
- Celtic
Celtic Insurance Company: 20.7% denied (1,861 of 9,006)
20.7 % of claims denied
- Blue Cross and Blue Shie
Blue Cross and Blue Shield of NC: 19.6% denied (3,731,867 of 19,086,297)
19.6 % of claims denied
- Aetna Health Inc. (a PA
Aetna Health Inc. (a PA corp.): 18.3% denied (1,693,812 of 9,237,233)
18.3 % of claims denied
- Ambetter of North Caroli 15.3
Ambetter of North Carolina Inc.: 15.3% denied (648,469 of 4,224,662)
15.3 % of claims denied
What this shows These carriers deny the largest share of marketplace claims filed in North Carolina. Denial rates reflect plan design and network rules as much as carrier behaviour.
Health insurers in North Carolina, by denial rate
9 insurers reporting marketplace claims in North Carolina
| # | Insurer | Claim denial rate | Claims |
|---|---|---|---|
| 1 | CareSource North Carolina Co. F | 10,705 | |
| 2 | AmeriHealth Caritas North Carolina, Inc. F | 248,740 | |
| 3 | Oscar Health Plan of North Carolina, Inc F | 7,541 | |
| 4 | UnitedHealthcare of North Carolina, Inc F | 1,637,927 | |
| 5 | Cigna HealthCare of North Carolina, Inc. D | 1,112,498 | |
| 6 | Celtic Insurance Company B | 9,006 | |
| 7 | Blue Cross and Blue Shield of NC C | 19,086,297 | |
| 8 | Aetna Health Inc. (a PA corp.) D | 9,237,233 | |
| 9 | Ambetter of North Carolina Inc. B | 4,224,662 |
Auto insurance in North Carolina
Auto premiums in North Carolina are climbing
Average annual auto-insurance expenditure by year (NAIC)
- 2019
2019: $754 average expenditure
$754 avg expenditure
- 2020
2020: $766 average expenditure
$766 avg expenditure
- 2021
2021: $789 average expenditure
$789 avg expenditure
- 2022
2022: $839 average expenditure
$839 avg expenditure
- 2023
2023: $925 average expenditure
$925 avg expenditure
What this shows North Carolina drivers' average auto cost rose 23% between 2019 and 2023.
What the data shows for North Carolina
North Carolina's marketplace insurers denied 19.7% of submitted claims in the CMS data, the 15th-highest rate of the 31 states with federal marketplace filings. Denial rates this far below the 21% national average usually reflect the state's mix of plan types and risk pool rather than any single carrier — Medicaid managed-care and narrow-network plans route more claims through utilization review.
On the auto side, drivers in North Carolina pay an average $925 a year — less than the $1191 national average — split across $448 liability, $441 collision and $208 comprehensive premiums. That figure has moved up 23% since 2019, tracking the national surge in repair and medical-claim costs.
Because rate regulation, licensing and guaranty-fund coverage are set state by state, an insurer's record in North Carolina can differ from its national average — which is why the state view matters for local consumers. Source: CMS Transparency in Coverage PUF PY2025, cms.gov. Source: NAIC 2023 Auto Insurance Database; state commissioner registry, NAIC member directory.
For North Carolina residents
Use the state view before you buy or appeal a denial here.
- Check a specific carrier's full national and per-state record. Browse insurers
- Compare North Carolina's auto costs against the rest of the country. Auto rankings
- Denied a claim in this state? Walk through the appeal process. Appeal a denial
Verify coverage availability and terms directly with any insurer or a licensed agent. Informational only — not insurance advice.
Data: CMS Transparency in Coverage PUF PY2025 (per-state claim denials) · NAIC 2023 Auto Insurance Database. State commissioner links from the NAIC member directory. Not affiliated with NAIC or CMS. Read our methodology.