State profile · ND · CMS + NAIC
Insurance in North Dakota
How health insurers handle claims in North Dakota, and what drivers pay for auto cover — measured from CMS Transparency-in-Coverage and NAIC data.
- 13.5%
- Avg claims denied
- #29
- denial rank of 31
- $808
- Avg auto / yr
- +15%
- Auto, 5-yr
- 3
- Insurers w/ data
The verdict
Marketplace insurers in North Dakota deny 13.5% of claims — below the 21% national average, the 29th-highest of 31 states, and drivers pay an average $808 a year for auto cover, less than the $1191 national average.
- 13.5%
- avg claims denied
- #29
- of 31 states
- $808
- avg auto / yr
- 23%
- highest (Medica Health Plan)
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 Dakota
Health insurers by share of marketplace claims denied (≥1,000 claims on file)
- Medica Health Plans
Medica Health Plans: 22.8% denied (12,876 of 56,382)
22.8 % of claims denied
- Blue Cross Blue Shield o
Blue Cross Blue Shield of North Dakota: 17.6% denied (107,878 of 611,353)
17.6 % of claims denied
- Sanford Health Plan 6.6
Sanford Health Plan: 6.6% denied (28,935 of 437,822)
6.6 % of claims denied
What this shows These carriers deny the largest share of marketplace claims filed in North Dakota. Denial rates reflect plan design and network rules as much as carrier behaviour.
Health insurers in North Dakota, by denial rate
3 insurers reporting marketplace claims in North Dakota
| # | Insurer | Claim denial rate | Claims |
|---|---|---|---|
| 1 | Medica Health Plans C | 56,382 | |
| 2 | Blue Cross Blue Shield of North Dakota C | 611,353 | |
| 3 | Sanford Health Plan A | 437,822 |
Auto insurance in North Dakota
Auto premiums in North Dakota are climbing
Average annual auto-insurance expenditure by year (NAIC)
- 2019
2019: $704 average expenditure
$704 avg expenditure
- 2020
2020: $691 average expenditure
$691 avg expenditure
- 2021
2021: $691 average expenditure
$691 avg expenditure
- 2022
2022: $729 average expenditure
$729 avg expenditure
- 2023
2023: $808 average expenditure
$808 avg expenditure
What this shows North Dakota drivers' average auto cost rose 15% between 2019 and 2023.
What the data shows for North Dakota
North Dakota's marketplace insurers denied 13.5% of submitted claims in the CMS data, the 29th-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 Dakota pay an average $808 a year — less than the $1191 national average — split across $331 liability, $320 collision and $309 comprehensive premiums. That figure has moved up 15% 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 Dakota 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 Dakota 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 Dakota'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.