State profile · ND · CMS + NAIC
North Dakota marketplace insurers denied 11.4% of claims (28th of 30 states); drivers average $808/yr for auto cover, #51 nationally by cost.
The verdict
Marketplace insurers in North Dakota deny 11.4% of claims - below the 20% national average, the 28th-highest of 30 states, and drivers pay an average $808 a year for auto cover, less than the $1191 national average (the 51st-most-expensive of 51 states).
Medica Health Plans: 23.5% denied (17,561 of 74,787)
24 % of claims denied
Blue Cross Blue Shield of North Dakota: 15.1% denied (109,326 of 724,618)
15 % of claims denied
Sanford Health Plan: 5.9% denied (39,306 of 663,600)
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.
3 insurers reporting marketplace claims in North Dakota
| # | Insurer | Claims | |
|---|---|---|---|
| 1 | Medica Health Plans C | 74,787 | |
| 2 | Blue Cross Blue Shield of North Dakota A | 724,618 | |
| 3 | Sanford Health Plan A | 663,600 |
Among carriers with enough reported claims to compare, North Dakota's highest marketplace denial rates in this dataset belong to Medica Health Plans (23.5%), Blue Cross Blue Shield of North Dakota (15.1%), and Sanford Health Plan (5.9%). 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 1,463,005 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 Blue Shield of North Dakota: 79 of 177 reported appeals overturned
45 appeals overturned (%)
Sanford Health Plan: 96 of 147 reported appeals overturned
65 appeals overturned (%)
What this shows Across the 2 carriers with at least 100 reported appeals in North Dakota, 54.0% of reported appeals were overturned (175 of 324). This filing field describes reported outcomes, not the likelihood that an individual claim will change.
2019: $704 average expenditure
$704 avg expenditure
2020: $691 average expenditure
$691 avg expenditure
2021: $691 average expenditure
$691 avg expenditure
2022: $729 average expenditure
$729 avg expenditure
2023: $808 average expenditure
$808 avg expenditure
What this shows North Dakota drivers' average auto cost rose 15% between 2019 and 2023.
Year over year, North Dakota's average auto expenditure rose 10.8% from 2022 to 2023, part of a 15% increase (+$104) since 2019. See the full 5-year state-by-state comparison.
North Dakota auto rates in detail →North Dakota: $808/yr average auto expenditure (this state)
$808 avg expenditure
Idaho: $864/yr average auto expenditure
$864 avg expenditure
Maine: $856/yr average auto expenditure
$856 avg expenditure
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 1,463,005 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 Dakota's reporting insurers denied 11.4% of submitted marketplace claims, ranking 28th 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 Dakota's 2023 average auto expenditure was $808, 51st of 51 jurisdictions by cost and 32.2% below the national average. The figure reflects the coverage mix recorded by NAIC, not an individual driver's quote.
State insurance rules
North Dakota is one of 12 no-fault auto-insurance states: drivers file injury claims with their own insurer's Personal Injury Protection coverage regardless of who caused the accident, rather than suing the at-fault driver. North Dakota'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 Dakota's closest peers in PlainInsurer's dataset are Maine ($856/yr) and Idaho ($864/yr) -- both within a few dollars of North Dakota's own $808/yr.
Border comparison. North Dakota borders Minnesota, Montana, and South Dakota. North Dakota'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.