Which health insurance company denies the most claims?

Asked by: Ludie Shanahan I  |  Last update: January 20, 2025
Score: 4.1/5 (34 votes)

According to the analysis, AvMed and UnitedHealthcare tied for the highest denial rate, with both companies denying about a third of in-network claims for plans sold on the Marketplace in 2023, respectively.

Which insurance company has the most complaints?

The auto insurance company with the most complaints is United Automobile Insurance, which receives roughly 40 times more complaints than the average insurer its size, according to the latest NAIC complaint index.

How often do health insurance claims get denied?

Yet while close to 17% of claims were denied, rates varied drastically among plan issuers, ranging from 2% to 49%. A separate KFF survey also found that people with private insurance are more likely to have denied claims than those with public coverage.

Which health insurance company denies the least claims?

Kaiser Permanente has the lowest claim denial rate among major health insurance companies, which the analysis defined as brands offering Marketplace plans in seven states or more during the 2025 plan year. The California-based healthcare company denied just 6% of claims based on the available 2023 data.

What is the denial rate for Aetna?

A review of 2023 data from the state's Insurance Department found the three companies deny claims at rates above the statewide average for both HMO and indemnity plans. Aetna had the highest denial rates for HMO plans, at 39.4%, followed closely by Harvard Pilgrim, at 38.8%, and Connecticare, at 33.6%.

Which Health Insurance Company Denies The Most Claims? - InsuranceGuide360.com

22 related questions found

Who is the most trusted insurance company?

Key takeaways

Amica and USAA tied in Bankrate's analysis as the two best auto insurance companies overall. Geico ranks as the best car insurance company for high-risk drivers. Nationwide and Liberty Mutual are some of the best auto insurance companies for discounts and bundling.

Which health insurance company is best at paying claims?

Reliable: Kaiser Permanente is the best major insurance company for paying its medical bills, with less than half as many claim denials as average.
  • Limited network of doctors: In most cases, you can only use your plan at Kaiser's medical offices. ...
  • Few plan choices: Most of Kaiser's plans are HMOs.

Which health insurance company has the highest customer satisfaction?

Kaiser Permanente is the top health insurer in the nation for affordability, customer satisfaction, and trustworthiness, according to Insure.com. Insure.com uses industry data and consumer feedback to rate health insurance companies.

Is Cigna a good health insurance?

Is Cigna good insurance? Cigna is a good insurance company, but it isn't usually the best option for most people. Even in the states where its rates are cheaper than the state average, Cigna usually isn't the cheapest health insurance. And its customer satisfaction is typically lower than average.

Which state has 100% of their complaints come from claims?

While 100% of complaints in Vermont were about claims, 79% of the complaints lodged in Maryland were related to policy cost and cancellations. California was the state with the most home and auto insurance complaints, recording 772 complaints in 2019 – most of which were related to unsatisfactory settlements or offers.

What do insurance companies fear the most?

Plus, insurance companies fear litigation; they would rather pay your claim than risk losing even more money in a lawsuit. Keep reading to learn about the top nine tricks insurance companies use to avoid paying you a fair settlement and how a legal professional can help you get the compensation you deserve.

Is $200 a month good for health insurance?

Health insurance that costs $200 per month is a good deal in California. Silver plans typically cost $513 per month for a 21-year-old or $656 per month for a 40-year-old. The best way to get cheap rates is to use health insurance subsidies, which lower the cost of an insurance plan based on your income.

Is hmo or PPO better?

HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.

Who is the number one healthcare company in the USA?

1. UnitedHealth Group (UNH) UnitedHealth Group holds its position at the forefront of the healthcare sector, pushing the boundaries of digital and personalized care.

Which health insurance company has best claim settlement?

Tata AIG, The New India Assurance and HDFC Ergo are the top three general insurers in terms of settling health claims, shows the draft red herring of Niva Bupa Health Insurance. Tata AIG achieved a 100% claim settlement ratio in FY 2024. This means that every claim filed with Tata AIG in FY 2024 was settled.

What is the absolute best health insurance?

Investopedia's analysis ranks Kaiser Permanente as the best health insurance company for 2025 because of its blend of affordability and low customer complaints. UnitedHealthcare and Aetna also earned top marks. We evaluated nine insurers using dozens of criteria, such as customer satisfaction, plan types, and costs.

What insurance company has the least complaints?

Why it's the best: American Family received the lowest number of customer complaints to state regulators relative to a company of its size among the companies in this list. This insurer stands out thanks to its wide variety of coverage options and discounts, as well as its accident forgiveness offerings.

Is it best to have all your insurances with one company?

In fact, having your home, auto and business policies with one company can help you save – time, money and a whole lot of trouble. Here's how: Save time: You may be a homeowner. You may own your own business.

What insurance companies do billionaires use?

A small number of premier insurance companies offer these products tailored to the unique needs of high net worth families. Chubb, PURE Insurance, Cincinnati Insurance, AIG Private Client, VAULT, and National General are all highly regarded insurance companies with products reserved for high net worth homeowners.

Why is Aetna not paying claims?

If your health or disability benefits have been denied, Aetna may have claimed the following: The procedure is merely cosmetic and not medically necessary. The treating physician is out of network or out of plan. The claim filed was for a medical condition that isn't authorized or covered.

How often are health insurance claims denied?

38% of survey respondents said that at least one in ten claims is denied. Some organizations see claims denied more than 15% of the time.

Does Aetna have a good reputation?

Aetna is one of the largest health insurers in the US, and is highly rated by AM Best and the BBB. The company offers a variety of health plans for employer groups, and a limited number of plans (Medicare supplements, dental plans) for individuals and families.