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.
- 21%
- Avg claims denied
- 229
- 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 (PY2025, published March 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.
The headline numbers
Across U.S. marketplace insurers, 21% of claims are denied on average — but the range is enormous: Alabama insurers deny 36% of claims, South Dakota just 7%.
- 21%
- avg claims denied (CMS)
- 36%
- highest state (Alabama)
- 7%
- lowest state (South Dakota)
- 229
- 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 PY2025). Blank = state-run exchange, not in the federal file.
Highest claim-denial states
Top 12 states by marketplace denial rate
- ALA
Alabama: 35.5% denied
35.5 % denied
- ALA
Alaska: 27.0% denied
27 % denied
- ARI
Arizona: 24.5% denied
24.5 % denied
- IND
Indiana: 24.2% denied
24.2 % denied
- OKL
Oklahoma: 23.8% denied
23.8 % denied
- HAW
Hawaii: 23.8% denied
23.8 % denied
- OHI
Ohio: 22.1% denied
22.1 % denied
- TEN
Tennessee: 22.0% denied
22 % denied
- FLO
Florida: 21.9% denied
21.9 % denied
- TEX
Texas: 21.9% denied
21.9 % denied
- ILL
Illinois: 20.5% denied
20.5 % denied
- IOW
Iowa: 20.3% denied
20.3 % denied
Highest-denial insurers
Top 12 insurers by marketplace denial rate
- UnitedHealthcare Communi
UnitedHealthcare Community Plan, Inc.: 45.5% denied
45.5 % denied
- Select Health of South C
Select Health of South Carolina: 45.5% denied
45.5 % denied
- UnitedHealthcare of Ohio
UnitedHealthcare of Ohio, Inc.: 43.5% denied
43.5 % denied
- UnitedHealthcare of Illi
UnitedHealthcare of Illinois, Inc.: 43.1% denied
43.1 % denied
- AmeriHealth Caritas Nort
AmeriHealth Caritas North Carolina, Inc.: 43.0% denied
43 % denied
- UnitedHealthcare of Ariz
UnitedHealthcare of Arizona, Inc.: 41.8% denied
41.8 % denied
- UnitedHealthcare
UnitedHealthcare Insurance Company: 41.4% denied
41.4 % denied
- UnitedHealthcare of Okla
UnitedHealthcare of Oklahoma, Inc.: 40.3% denied
40.3 % denied
- Blue Cross and Blue Shie
Blue Cross and Blue Shield of Montana: 38.7% denied
38.7 % denied
- UnitedHealthcare of Texa
UnitedHealthcare of Texas, Inc.: 38.3% denied
38.3 % denied
- UnitedHealthcare of Flor
UnitedHealthcare of Florida, Inc.: 38.2% denied
38.2 % denied
- UnitedHealthcare of Miss
UnitedHealthcare of Mississippi, Inc.: 37.1% denied
37.1 % denied
Cost vs. denials, state by state
Each bubble is a state, placed by marketplace claim-denial rate and average auto premium (size = claim volume). Bottom-left is best for consumers.
Claim-denial rate (CMS PY2025) vs auto expenditure (NAIC 2023)
Cite these statistics
Free to reference with attribution. Suggested citation:
PlainInsurer, "U.S. Insurance Statistics — Complaints & Claim Denials" (2026), https://plaininsurer.com/statistics/. Source data: CMS Transparency in Coverage PUF (PY2025); NAIC published complaint index (2024).
Underlying federal data is public domain. PlainInsurer's compilation and grading methodology are described on our methodology page.
Data: CMS Transparency in Coverage PUF PY2025 · NAIC published complaint index (2024) · NAIC Auto Insurance Database (2023). Not affiliated with NAIC or CMS.