State profile · SD · CMS + NAIC
South Dakota marketplace insurers denied 7.9% of claims (30th of 30 states); drivers average $936/yr for auto cover, #42 nationally by cost.
The verdict
Marketplace insurers in South Dakota deny 7.9% of claims - below the 20% national average, the 30th-highest of 30 states, and drivers pay an average $936 a year for auto cover, less than the $1191 national average (the 42nd-most-expensive of 51 states).
Wellmark of South Dakota: 17.5% denied (77,973 of 446,393)
18 % of claims denied
Sanford Health Plan: 5.2% denied (45,897 of 879,472)
5 % of claims denied
Avera Health Plans, Inc.: 3.5% denied (15,405 of 440,684)
4 % of claims denied
What this shows These carriers deny the largest share of marketplace claims filed in South Dakota. Denial rates reflect plan design and network rules as much as carrier behaviour.
3 insurers reporting marketplace claims in South Dakota
| # | Insurer | Claims | |
|---|---|---|---|
| 1 | Wellmark of South Dakota B | 446,393 | |
| 2 | Sanford Health Plan A | 879,472 | |
| 3 | Avera Health Plans, Inc. A | 440,684 |
Among carriers with enough reported claims to compare, South Dakota's highest marketplace denial rates in this dataset belong to Wellmark of South Dakota (17.5%), Sanford Health Plan (5.2%), and Avera Health Plans, Inc. (3.5%). 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 1,766,549 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.
Sanford Health Plan: 218 of 365 reported appeals overturned
60 appeals overturned (%)
Avera Health Plans, Inc.: 69 of 154 reported appeals overturned
45 appeals overturned (%)
Wellmark of South Dakota: 43 of 152 reported appeals overturned
28 appeals overturned (%)
What this shows Across the 3 carriers with at least 100 reported appeals in South Dakota, 49.2% of reported appeals were overturned (330 of 671). This filing field describes reported outcomes, not the likelihood that an individual claim will change.
2019: $745 average expenditure
$745 avg expenditure
2020: $738 average expenditure
$738 avg expenditure
2021: $770 average expenditure
$770 avg expenditure
2022: $823 average expenditure
$823 avg expenditure
2023: $936 average expenditure
$936 avg expenditure
What this shows South Dakota drivers' average auto cost rose 26% between 2019 and 2023.
Year over year, South Dakota's average auto expenditure rose 13.7% from 2022 to 2023, part of a 26% increase (+$191) since 2019. See the full 5-year state-by-state comparison.
South Dakota auto rates in detail →South Dakota: $936/yr average auto expenditure (this state)
$936 avg expenditure
Wyoming: $948/yr average auto expenditure
$948 avg expenditure
Ohio: $947/yr average auto expenditure
$947 avg expenditure
Indiana: $926/yr average auto expenditure
$926 avg expenditure
North Carolina: $925/yr average auto expenditure
$925 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 1,766,549 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
South Dakota's reporting insurers denied 7.9% of submitted marketplace claims, ranking 30th 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
South Dakota's 2023 average auto expenditure was $936, 42nd of 51 jurisdictions by cost and 21.4% below the national average. The figure reflects the coverage mix recorded by NAIC, not an individual driver's quote.
State insurance rules
South Dakota 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. South Dakota'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, South Dakota's closest peers in PlainInsurer's dataset are Indiana ($926/yr) and North Carolina ($925/yr) -- both within a few dollars of South Dakota's own $936/yr.
Border comparison. South Dakota borders Iowa, Minnesota, Montana, North Dakota, Nebraska, and Wyoming. South Dakota's auto costs run higher than 4 of them and lower than 2, 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.