Key statistics · NAIC + CMS
U.S. insurance statistics
The headline numbers on insurance complaints and claim denials in the United States, free to cite, measured from public NAIC and CMS data.
- 20%
- Avg claims denied
- 215
- Insurers graded
- 51
- States covered
- $1191
- Avg auto / yr
According to the U.S. Centers for Medicare & Medicaid Services Transparency in Coverage Public Use File (plan year 2026) and published National Association of Insurance Commissioners data, PlainInsurer compiled these statistics from more than 1,000,000 marketplace claims across 51 states. See our methodology.
Key findings
- • PlainInsurer grades 215 U.S. insurance companies using public NAIC complaint and CMS claim-denial data.
- • The national average marketplace claim-denial rate is 20.4%, measured across 495,646,850 submitted claims.
- • Alaska has the highest average marketplace claim-denial rate of any state at 32.0%.
- • South Dakota has the lowest average marketplace claim-denial rate of any state at 7.9%.
- • CareSource North Carolina Co. has the highest claim-denial rate among large marketplace health insurers, at 37.0%.
- • Only 21% of the 215 insurers PlainInsurer grades earn an A reputation rating.
- • The national average annual auto-insurance expenditure is $1191.
- • Florida has the highest average auto-insurance expenditure of any state, at $1864 a year.
The headline numbers
Across U.S. marketplace insurers, 20% of claims are denied on average - but the range is enormous: Alaska insurers deny 32% of claims, South Dakota just 8%.
- 20%
- avg claims denied (CMS)
- 32%
- highest state (Alaska)
- 8%
- lowest state (South Dakota)
- 215
- insurers graded
Denial rates are aggregate marketplace figures; states running their own exchange aren't in the federal file.
Claim-denial rate by state
% of marketplace claims denied, by state (CMS PY2026). Blank = state-run exchange, not in the federal file.
View all 30 states as a list
- Alaska: 32
- Hawaii: 27
- West Virginia: 23
- Arizona: 23
- Tennessee: 23
- Florida: 23
- Iowa: 22
- Indiana: 22
- Alabama: 22
- Ohio: 22
- Nebraska: 22
- North Carolina: 21
- Kansas: 21
- Delaware: 20
- Texas: 20
- Louisiana: 20
- Utah: 20
- Oklahoma: 20
- Mississippi: 19
- Michigan: 19
- Missouri: 18
- South Carolina: 18
- Wyoming: 18
- Arkansas: 16
- Wisconsin: 15
- Oregon: 13
- Montana: 13
- North Dakota: 11
- New Hampshire: 11
- South Dakota: 8
Highest claim-denial states
Top 12 states by marketplace denial rate
- ALA
Alaska: 32.0% denied
32 % denied
- HAW
Hawaii: 27.0% denied
27 % denied
- WES
West Virginia: 23.3% denied
23 % denied
- ARI
Arizona: 23.2% denied
23 % denied
- TEN
Tennessee: 22.8% denied
23 % denied
- FLO
Florida: 22.7% denied
23 % denied
- IOW
Iowa: 22.4% denied
22 % denied
- IND
Indiana: 22.3% denied
22 % denied
- ALA
Alabama: 22.1% denied
22 % denied
- OHI
Ohio: 22.0% denied
22 % denied
- NEB
Nebraska: 21.8% denied
22 % denied
- NOR
North Carolina: 20.5% denied
21 % denied
Highest-denial insurers
Top 12 insurers by marketplace denial rate
- CareSource North Carolin
CareSource North Carolina Co.: 37.0% denied
37 % denied
- Select Health of South C
Select Health of South Carolina: 36.5% denied
37 % denied
- Oscar Buckeye State Insu
Oscar Buckeye State Insurance Corp.: 36.4% denied
36 % denied
- UnitedHealthcare Communi
UnitedHealthcare Community Plan, Inc.: 35.6% denied
36 % denied
- Oscar Health Plan
Oscar Health Plan, Inc.: 34.6% denied
35 % denied
- UnitedHealthcare of Okla
UnitedHealthcare of Oklahoma, Inc.: 33.7% denied
34 % denied
- UnitedHealthcare of Ohio
UnitedHealthcare of Ohio, Inc.: 33.2% denied
33 % denied
- Community First Insuranc
Community First Insurance Plans: 32.5% denied
33 % denied
- Oscar Health Plan of Nor
Oscar Health Plan of North Carolina, Inc: 31.2% denied
31 % denied
- AmeriHealth Caritas Nort
AmeriHealth Caritas North Carolina, Inc.: 30.6% denied
31 % denied
- AmeriHealth Caritas Flor
AmeriHealth Caritas Florida, Inc.: 30.5% denied
31 % denied
- CareSource West Virginia
CareSource West Virginia Co.: 30.5% denied
31 % denied
Download the source extracts
Get the documented company-and-line complaint-index data or the state-level marketplace claim-denial extract. The state extract includes only states with at least 50,000 reported marketplace claims, matching the denominator used in these comparisons.
Data: CMS Transparency in Coverage PUF PY2026 · NAIC published complaint index (2024) · NAIC Auto Insurance Database (2023). Not affiliated with NAIC or CMS.