AETNA LIFE INSURANCE COMPANY — health Complaints in Texas
Detailed analysis of 11,458 health insurance complaints filed against AETNA LIFE INSURANCE COMPANY by consumers in Texas, based on public NAIC and state DOI data.
Key Statistics
- health Complaints in Texas: 11,458
- Total health Complaints (All States): 11,533
- Texas Share: 99.3%
- NAIC Complaint Ratio: 65.82
- AI Risk Score: 85/100
Analysis: AETNA LIFE INSURANCE COMPANY health in Texas
AETNA LIFE INSURANCE COMPANY has accumulated 11,458 health insurance complaints from consumers in Texas. Across all states, AETNA LIFE INSURANCE COMPANY has 11,533 total health complaints, making Texas responsible for 99.3% of the volume.
The most frequent complaint sub-type is Claim denial with 3444 complaints. Other common issues include Premium or billing dispute (2357), Delayed payment (2243), Unsatisfactory Settle/Offer | No Jurisdiction (669).
The most active year was 2026 with 54 complaints filed.
Consumers in Texas who have health disputes with AETNA LIFE INSURANCE COMPANY can file a complaint with the Texas Department of Insurance.
health Complaint Issues in Texas
| Issue Type | Complaints | % |
|---|---|---|
| Claim denial | 3,444 | 30.1% |
| Premium or billing dispute | 2,357 | 20.6% |
| Delayed payment | 2,243 | 19.6% |
| Unsatisfactory Settle/Offer | No Jurisdiction | 669 | 5.8% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue | 141 | 1.2% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 125 | 1.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction | 124 | 1.1% |
| Usual And Customary | Contract Language/Legal Issue | 121 | 1.1% |
| Provider or network dispute | 120 | 1.0% |
| Usual And Customary | No Jurisdiction | 60 | 0.5% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction | 55 | 0.5% |
| Recoupment Of Claims Payment | No Jurisdiction | 52 | 0.5% |
| Prompt Pay; SB418 Rule Violation | No Jurisdiction | 51 | 0.4% |
| Policy cancellation | 49 | 0.4% |
| Not Within TDI Jurisdiction | No Jurisdiction | 48 | 0.4% |
| Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction | 38 | 0.3% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue | 34 | 0.3% |
| Other | Information Furnished | 33 | 0.3% |
| Coverage dispute | 33 | 0.3% |
| Unsatisfactory Settle/Offer | Information Furnished | 33 | 0.3% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 32 | 0.3% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Contract Language/Legal Issue | 31 | 0.3% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 30 | 0.3% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 28 | 0.2% |
| Prompt Pay | No Jurisdiction | 27 | 0.2% |
| Prompt Pay | Contract Language/Legal Issue | 26 | 0.2% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; No Jurisdiction | 22 | 0.2% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction | 21 | 0.2% |
| Other | No Jurisdiction | 20 | 0.2% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 18 | 0.2% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 17 | 0.1% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | No Jurisdiction | 16 | 0.1% |
| Unfair settlement | 14 | 0.1% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction | 14 | 0.1% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Referred To | 13 | 0.1% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue | 13 | 0.1% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction | 13 | 0.1% |
| Other | Contract Language/Legal Issue | 12 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Information Furnished | 12 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished | 11 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer | No Jurisdiction | 11 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue | 11 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 11 | 0.1% |
| Unsatisfactory Settle/Offer | Claim Settled | 10 | 0.1% |
| Cust Service Claim Handling | Contract Language/Legal Issue | 10 | 0.1% |
| Coordination of Benefits; Unsatisfactory Settle/Offer | No Jurisdiction | 10 | 0.1% |
| Access to Care | No Jurisdiction | 10 | 0.1% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue | 10 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Company Position Upheld | 10 | 0.1% |
| Misleading sales | 8 | 0.1% |
| Unsatisfactory Settle/Offer | Referred To; No Jurisdiction | 8 | 0.1% |
| Unsatisfactory Settle/Offer | Insufficient Information | 8 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 7 | 0.1% |
| Cust Service Claim Handling | Information Furnished | 7 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Referred To | 7 | 0.1% |
| Other | Insufficient Information | 7 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received | 7 | 0.1% |
| Unsatisfactory Settle/Offer | Record Only | 7 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction; Contract Language/Legal Issue | 7 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 6 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken | 6 | 0.1% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue | 6 | 0.1% |
| Cust Service Claim Handling | No Jurisdiction | 6 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue | 6 | 0.1% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received | 6 | 0.1% |
| Unsatisfactory Settle/Offer | Company Position Upheld | 6 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 6 | 0.1% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 5 | 0.0% |
| Other | Information Furnished; Contract Language/Legal Issue | 5 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld | 5 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished | 5 | 0.0% |
| Other | Corrective Action Taken; Information Furnished | 5 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Insufficient Information | 5 | 0.0% |
| Usual And Customary | No Jurisdiction; Contract Language/Legal Issue | 5 | 0.0% |
| Usual And Customary | Contract Language/Legal Issue; No Jurisdiction | 5 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction | 5 | 0.0% |
| Recoupment Of Claims Payment; Usual And Customary | Contract Language/Legal Issue | 5 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue | 5 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; SB418 Rule Violation; Unsatisfactory Settle/Offer | Contract Language/Legal Is | 5 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer | No Jurisdiction | 5 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished | 5 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Additional Monies Received; Stat Pen Pd-Up To 45 Dys Late; Corrective Action Taken | 5 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received | 5 | 0.0% |
| Recoupment Of Claims Payment | Insufficient Information | 5 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Company Position Upheld | 5 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected | 5 | 0.0% |
| Cust Service Claim Handling | Information Furnished; Contract Language/Legal Issue | 4 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received | 4 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 4 | 0.0% |
| Other | Contract Language/Legal Issue; Information Furnished | 4 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Referred To; No Jurisdiction | 4 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; No Jurisdiction | 4 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue | 4 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Up To 45 Dys Late; Additional Monies Received; Corrective Action Taken | 4 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Over 90 Dys Late; Additional Monies Received; Corrective Action Taken | 4 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction | 4 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld | 4 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Contract Language/Legal Issue | 4 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 4 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction | 4 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Language/Legal Issue | 4 | 0.0% |
| Recoupment Of Claims Payment; SB418 Rule Violation | No Jurisdiction | 4 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Referred To; No Jurisdiction | 4 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue; Information Furnished | 4 | 0.0% |
| Overcharges | No Jurisdiction | 4 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg | No Jurisdiction | 4 | 0.0% |
| Maximum Out of Pocket | Information Furnished; Contract Language/Legal Issue | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 3 | 0.0% |
| Other | Corrective Action Taken | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken | 3 | 0.0% |
| Other | Record Only | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue | 3 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken | 3 | 0.0% |
| Prompt Pay | Contract Language/Legal Issue; Corrective Action Taken | 3 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue; Information Furnished | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received | 3 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; No Jurisdiction | 3 | 0.0% |
| Prompt Pay | Additional Monies Received; Stat Pen Pd-Up To 45 Dys Late; Corrective Action Taken | 3 | 0.0% |
| Prompt Pay | Information Furnished; No Jurisdiction | 3 | 0.0% |
| Prompt Pay | Claim Settled; Contract Language/Legal Issue | 3 | 0.0% |
| Access to Care; Continuity of Treatment | No Jurisdiction | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 3 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished | 3 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Clean Claims Violation; Stat Pen Pd-Up To 45 Dys Late; Additional Monies Received | 3 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Up To 45 Dys Late; Corrective Action Taken; Additional Monies Received | 3 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; No Jurisdiction | 3 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; No Jurisdiction | 3 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Referred To; No Jurisdiction; Contract Language/Legal Issue | 3 | 0.0% |
| Den/N-Pymt MD Nec RX | Information Furnished; Contract Language/Legal Issue | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished | 3 | 0.0% |
| Continuity Of Treatment | No Jurisdiction | 3 | 0.0% |
| Declination Of Verification; SB418 Rule Violation; Timely Filing Deficiency | No Jurisdiction | 3 | 0.0% |
| Prior Authorization | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 2 | 0.0% |
| Cust Srvc Policy Holder Srvcs | Information Furnished; Corrective Action Taken | 2 | 0.0% |
| Prior Authorization | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 2 | 0.0% |
| Prior Authorization | Information Furnished; Contract Language/Legal Issue | 2 | 0.0% |
| Prior Authorization | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Corrective Action Taken; Additional Monies Received | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Claim Settled | 2 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Payment Expected; Corrective Action Taken | 2 | 0.0% |
| Cust Srvc Policy Holder Srvcs | Information Furnished | 2 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 2 | 0.0% |
| Other | 2 | 0.0% |
| Misrepresentation | Information Furnished | 2 | 0.0% |
| Access to Care | Referred To; No Jurisdiction | 2 | 0.0% |
| Recoupment Of Claims Payment | Referred To; No Jurisdiction | 2 | 0.0% |
| Not Within TDI Jurisdiction; Other | No Jurisdiction; Information Furnished | 2 | 0.0% |
| Other | Information Furnished; Corrective Action Taken | 2 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Referred To; No Jurisdiction | 2 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Corrective Action Taken | 2 | 0.0% |
| Prompt Pay; Timely Filing Deficiency | Contract Language/Legal Issue | 2 | 0.0% |
| Usual And Customary | Record Only | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Corrective Action Taken | 2 | 0.0% |
| Recoupment Of Claims Payment; Usual And Customary | No Jurisdiction; Record Only | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Insufficient Information; Record Only | 2 | 0.0% |
| Claimant Fraud; Unsatisfactory Settle/Offer | Mediation Paid Amount; Mediation Billed Amount | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation | No Jurisdiction; Contract Language/Legal Issue | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Referred To | 2 | 0.0% |
| Recoupment Of Claims Payment | No Jurisdiction; Record Only | 2 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Claim Not Clean | 2 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue; Company Position Upheld | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Not Eligible; Mediation Billed Amount | 2 | 0.0% |
| Coordination of Benefits | No Jurisdiction | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Billed Amount; Mediation Paid Amount | 2 | 0.0% |
| Coordination of Benefits | Contract Language/Legal Issue | 2 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue | 2 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Stat Pen Pd-46 To 90 Dys Late; Additional Monies Received | 2 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | No Jurisdiction | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Corrective Action Taken; Clean Claims Violation; Stat Pen Pd-46 To 90 Dys Late | 2 | 0.0% |
| Not Within TDI Jurisdiction; Recoupment Of Claims Payment | No Jurisdiction | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Information Furnished; No Jurisdiction | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Corrective Action Taken; Contract Language/ | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late; Corrective Action Taken | 2 | 0.0% |
| Prompt Pay | Contract Language/Legal Issue; Claim Not Clean | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Corrective Action Taken; Additional Monies Received; Stat Pen Pd-Up To 45 Dys Late | 2 | 0.0% |
| Prompt Pay | Corrective Action Taken; Additional Monies Received; Information Furnished | 2 | 0.0% |
| Prompt Pay | Additional Monies Received; Corrective Action Taken; Stat Pen Pd-Up To 45 Dys Late | 2 | 0.0% |
| Cust Service Claim Handling; Disclosure Of Benefits; Unsatisfactory Settle/Offer | No Jurisdiction | 2 | 0.0% |
| Closed-Lack Of Info Cmplainant | Insufficient Information | 2 | 0.0% |
| Prompt Pay | Stat Pen Pd-Up To 45 Dys Late; Additional Monies Received; Corrective Action Taken | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Information Furnished; Contract Language/Leg | 2 | 0.0% |
| Unfair Discrim-Clms Handling; Usual And Customary | Contract Language/Legal Issue | 2 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Contract Language/Legal | 2 | 0.0% |
| Recoupment Of Claims Payment | No Jurisdiction; Contract Language/Legal Issue | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Up To 45 Dys Late; Additional Monies Received; Clean Claims Violation | 2 | 0.0% |
| Prompt Pay | Additional Monies Received; Clean Claims Violation; Stat Pen Pd-Up To 45 Dys Late | 2 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; No Jurisd | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue; Question of Fact | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Question of Fact; Contract Language/Legal Issue | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Information Furnished | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Clean Claims Violation; Additional Monies Received; Stat | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-46 To 90 Dys Late; Corrective Action Taken | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; No Jurisdiction; Referred To | 2 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished; Contract Language/Legal Issue | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Clean Claims Violation; Additional Monies Received; Stat Pen Pd-Up To 45 Dys Late | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished; No Jurisdiction | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Company Position Upheld | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished; Company Positio | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Payment Expected; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; Corrective Action Taken; Claim Settled | 2 | 0.0% |
| Continuation of Benefits | No Jurisdiction | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Question of Fact | 2 | 0.0% |
| Den/N-Pymt MD Nec RX | No Jurisdiction | 2 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Additional Monies Received | 2 | 0.0% |
| Access to Care; Continuity of Treatment; Den/N-Pymt MD Nec Trmt N-Emrg | No Jurisdiction | 2 | 0.0% |
| Other | Contract Language/Legal Issue; Information Furnished; Question of Fact | 2 | 0.0% |
| Recoupment Of Claims Payment; SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction | 2 | 0.0% |
| Unsatisfactory Settle/Offer | 2 | 0.0% |
| Refusal to Insure | Contract Language/Legal Issue | 2 | 0.0% |
| Other | Information Furnished; No Jurisdiction | 2 | 0.0% |
| Usual And Customary | Information Furnished | 2 | 0.0% |
| COBRA | Information Furnished; No Jurisdiction | 2 | 0.0% |
| Prior Authorization | Claim Settled; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Coordination of Benefits | No Jurisdiction; Record Only | 1 | 0.0% |
| Prior Authorization | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling | Referred To; Record Only; No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Maximum Out of Pocket | Claim Settled; Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Maximum Out of Pocket | Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Cust Service Claim Handling; Maximum Out of Pocket | Contract Language/Legal Issue; Question of Fact; Company Position U | 1 | 0.0% |
| Prior Authorization | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Disclosure Of Benefits; Identification Card Issue | Information Furnished | 1 | 0.0% |
| Prior Authorization | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Insufficient Information | 1 | 0.0% |
| Prior Authorization | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Claim Settled; Corrective Action Taken | 1 | 0.0% |
| Assignment of Benefits; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Posi | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Prior Authorization | Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Claim Settled; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Claim Settled; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Payment Expected; Corrective Action Taken | 1 | 0.0% |
| Access to Care; Prior Authorization | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Additional Payment Expected | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Payment Expected | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken; Claim Settled | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled; Additional Monies Received | 1 | 0.0% |
| Hlth Care Svcs Covg/Copay/Lmts | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Company | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Contract | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs; Prior Authorization | Information Furnished; Company Position Upheld; Contract Language/L | 1 | 0.0% |
| Other | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Cust Service Claim Handling | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Payment Expected; Information Furnished | 1 | 0.0% |
| Authorization Dispute; Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Additional Monies R | 1 | 0.0% |
| Prior Authorization | Corrective Action Taken; Information Furnished; Additional Payment Expected | 1 | 0.0% |
| Cust Service Claim Handling | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Other | Referred To; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Payment Expected; Corrective Action Taken; Informa | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Material Change To Contract | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Maximum Out of Pocket | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Claim Settled | 1 | 0.0% |
| Prompt Pay | Record Only; Insufficient Information | 1 | 0.0% |
| Unauthorized Acts | Insufficient Information | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Additional Payment Expected; Correctiv | 1 | 0.0% |
| Other | Corrective Action Taken; Information Furnished; Claim Settled | 1 | 0.0% |
| Other | Information Furnished; Corrective Action Taken; Additional Payment Expected | 1 | 0.0% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Claim Settl | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling; Unsatisfactory Settle/Offer | Corrective Action Taken; Informatio | 1 | 0.0% |
| Recoupment Of Claims Payment | Corrective Action Taken; Information Furnished; Claim Settled | 1 | 0.0% |
| Coordination of Benefits; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Other | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Pediatric Care; Unsatisfactory Settle/Offer | Additional Payment Expected; Information Furnished; Corrective Action Take | 1 | 0.0% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Language/L | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Payment Expected; Information Furnished; Correctiv | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Access to Care | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Payment Expected; Co | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Claim Settled | 1 | 0.0% |
| Access to Care | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Referred To; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Access to Care | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Claim Se | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; Claim Settled; Corrective Action Taken | 1 | 0.0% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Record Only; No Jurisdiction; Referred To | 1 | 0.0% |
| Maternity and Newborn Care; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Information Furnished; Company Position | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Info | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Additional Payment Expected; Additional Monies Received; Stat Pen Pd-Over 90 D | 1 | 0.0% |
| Maximum Out of Pocket | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling | Contract Language/Legal Issue; Information Furnished; Company Po | 1 | 0.0% |
| Maximum Out of Pocket; Mental Health Parity | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Essential Health Benefit; Pediatric Care; Unsatisfactory Settle/Offer | Information Furnish | 1 | 0.0% |
| Cust Service Claim Handling; External Review; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information F | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Language/Legal Issue; Information F | 1 | 0.0% |
| Other | Referred To; Company Position Upheld; No Jurisdiction | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contr | 1 | 0.0% |
| Recoupment Of Claims Payment | No Jurisdiction; Information Furnished; Referred To | 1 | 0.0% |
| Claim Recoding/Bundling; Essential Health Benefit; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Payment Expected; Corrective Action Taken | 1 | 0.0% |
| Not Within TDI Jurisdiction | Complaint Withdrawn | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Policy Not In Force; Information Furnished; Contract Languag | 1 | 0.0% |
| Cust Service Claim Handling | No Jurisdiction; Referred To | 1 | 0.0% |
| Cust Service Claim Handling | Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Fraud | Referred To; Information Furnished | 1 | 0.0% |
| Not Within TDI Jurisdiction | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Not Within TDI Jurisdiction | No Jurisdiction; Referred To | 1 | 0.0% |
| Other | Corrective Action Taken; Information Furnished; No Jurisdiction | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | No Jurisdiction; Referred To | 1 | 0.0% |
| Coordination of Benefits; Unsatisfactory Settle/Offer | Record Only; Referred To; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Referred To; Information Furnished | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Stat Pen Pd-Up To 45 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Access to Care; Disclosure Of Benefits | Referred To; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Claim Settled | 1 | 0.0% |
| Misrepresentation | No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling; Unsatisfactory Settle/Offer | Record Only; No Jurisdiction | 1 | 0.0% |
| Prompt Pay | Referred To; No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Additional Payment Expected | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Referred To; No Jurisdiction | 1 | 0.0% |
| Other | Contract Language/Legal Issue; Information Furnished; Referred To | 1 | 0.0% |
| Timely Filing Deficiency; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Retaliation By Mgd Care Plans | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment | No Jurisdiction | 1 | 0.0% |
| Other | Complaint Withdrawn | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Access to Care; Not Within TDI Jurisdiction | No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling | Corrective Action Taken | 1 | 0.0% |
| Identification Card Issue | Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Corrective Action Taken; Additional Payment Expected | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling; Not Within TDI Jurisdiction; Other; Unsatisfactory Settle/Offer | | 1 | 0.0% |
| Usual And Customary | Contract Language/Legal Issue; Record Only | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Corrective Action Taken; Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment | Insufficient Information; Contract Language/Legal Issue | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Record Only | 1 | 0.0% |
| Other | Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Cash Value | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Other | Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Additional Monies Received; No Jurisdiction | 1 | 0.0% |
| Continuity of Treatment; Den/N-Pymt MD Nec Trmt N-Emrg | Failure to Timely Respond; No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Stat Pen Pd-46 To 90 Dys Late; Additional Monies Received; Corrective Action T | 1 | 0.0% |
| Den/N-Pymt MD Nec DME/Supplies | Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Additional Monies Received; Stat Pen Pd-46 To 90 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Den/N-Pymt MD Nec DME/Supplies; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Inform | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Record Only; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Record Only | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Usual And Customary | Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Access to Care; Den/N-Pymt MD Nec Trmt N-Emrg; PPACA-Access To OB/GYN | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Referred To; No Jurisdiction; Claim Settled | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Insufficient Information; Record Only | 1 | 0.0% |
| Access to Care | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Stat Pen Pd-Up To 45 Dys Late; Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Correcti | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Timely Filing Deficiency; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Access to Care; Continuity of Treatment | Insufficient Information; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Record Only; Insufficient Information | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Company Position Upheld; Information F | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Record Only; No Jurisdiction | 1 | 0.0% |
| Claimant Fraud; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| SB418 Rule Violation | Additional Monies Received; Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay | Additional Monies Received; Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Record Only; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late; Referred for Disciplinary Actn | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | No Jurisdiction; Company Position Upheld; Information Furnis | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Stat Pen Pd-Over 90 Dys Late; Clean Claims Viol | 1 | 0.0% |
| Prompt Pay | Stat Pen Pd-Over 90 Dys Late; Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Claim Not Clean; Contract Language/Legal Issue | 1 | 0.0% |
| Summary of Benefits | No Jurisdiction | 1 | 0.0% |
| Claimant Fraud; Unsatisfactory Settle/Offer | Mediation Not Eligible; Mediation Billed Amount; Insufficient Information | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Billed Amount; Mediation Not Eligible | 1 | 0.0% |
| Not Within TDI Jurisdiction; SB418 Rule Violation | No Jurisdiction | 1 | 0.0% |
| SB418 Rule Violation | Corrective Action Taken; Contract Language/Legal Issue; Additional Monies Received | 1 | 0.0% |
| Prompt Pay | Clean Claims Violation; Stat Pen Pd-Over 90 Dys Late; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Stat Pen Pd-Up To 45 Dys Late; Corrective Action Taken; Additional Monies Rece | 1 | 0.0% |
| Not Within TDI Jurisdiction; Prompt Pay; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Not Within TDI Jurisdiction | Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Cust Service Claim Handling | Contract Language/Legal Issue; Additional Monies Received; No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Mediation Not Eligible; Mediation Billed Amount | 1 | 0.0% |
| SB418 Rule Violation | Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Corrective Action Taken; Contract Language/Legal Issue; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Referred To; Company Position Upheld | 1 | 0.0% |
| Access to Care; Continuity of Treatment | Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Mediation Billed Amount | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Mediation Billed Amount | 1 | 0.0% |
| Coordination of Benefits; Recoupment Of Claims Payment; Rehabilitative/habilitative ; Unsatisfactory Settle/Offer | No J | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction | 1 | 0.0% |
| Coordination of Benefits; Not Within TDI Jurisdiction; Usual And Customary | No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Stat Pen Pd-46 To 90 Dys Late; Corrective Action Taken; | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Record Only | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Corrective Action T | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Referred for Disciplinary Actn | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Not Eligible; Mediation Billed Amount; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Billed Amount | 1 | 0.0% |
| Coordination of Benefits; Prompt Pay | Contract Language/Legal Issue | 1 | 0.0% |
| Coordination of Benefits; Usual And Customary | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Not Eligible; No Jurisdiction; Mediation Billed Amount | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Record Only | 1 | 0.0% |
| Cust Service Claim Handling; Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer | No Jurisdiction; Information Fur | 1 | 0.0% |
| Claimant Fraud; Fraud | No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Company Position Upheld; Information Furnished | 1 | 0.0% |
| Closed-Lack Of Info Cmplainant | Record Only | 1 | 0.0% |
| Cust Service Claim Handling; Insurer Fraud; Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling | Contract Language/Legal Issue; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Cash Value; Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Is | 1 | 0.0% |
| Recoupment Of Claims Payment; Usual And Customary | Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; Usual And Customary | No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Maximum Out of Pocket; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Clean Claims Violation; Contract Language/Legal | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Record Only; Insufficient Information; No Jurisdiction | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; SB418 Rule Violation; Unsatisfactory Settle/Offer | Additional Monies Received | 1 | 0.0% |
| Other | Insufficient Information; Record Only | 1 | 0.0% |
| Prompt Pay | No Jurisdiction; Record Only | 1 | 0.0% |
| Prompt Pay | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Prompt Pay | Additional Monies Received; Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Corrective Action Taken; Stat Pen Pd-46 To 90 Dys Late; Clean Claims Violation | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Clean Claims Violation; Stat Pen Pd-Up To 45 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Up To 45 Dys Late; Clean Claims Violation; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Corrective Action Taken; A | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Corrective Action Taken; Stat Pen Pd-Over 90 Dys Late; C | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Corrective Action Taken; Stat Pen Pd-Up To 45 Dys Late; Clean Claims Violation | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Consumer Withdraw | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Corrective Action Taken; Clean Claims Violation | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Up To 45 Dys Late; Corrective Action Taken; Clean Claims Violation | 1 | 0.0% |
| Not Within TDI Jurisdiction; Other | No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Notice Requirements | Insufficient Information | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-46 To 90 Dys Late; Corrective Action Taken; Clean Claims Violation | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Corrective Action Taken; Stat Pen Pd-Up To 45 Dys Late; | 1 | 0.0% |
| Cash Value | Information Furnished; Policy Not In Force | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Contract | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Question of Fact | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Corrective Action Taken; Stat Pen Pd-Over 90 Dys Late; Clean Claims Violation | 1 | 0.0% |
| PPACA-Preventive Health Svcs; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Clean Claims Violation; Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Record Only; Additional Monies Received; Stat Pen Pd-46 | 1 | 0.0% |
| Coordination of Benefits; Rehabilitative/habilitative ; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furni | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Record Only | 1 | 0.0% |
| Cust Service Claim Handling; Misrepresentation | No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Record Only | 1 | 0.0% |
| Prompt Pay | Information Furnished | 1 | 0.0% |
| Assignment of Benefits; Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Policy Not In Force | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Corrective Action Taken; Stat Pen Pd-Up To 45 Dys Late; Additional Monies Received | 1 | 0.0% |
| Misrepresentation | Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Stat Pen Pd-Over 90 Dys Late; Information Furnished; Additional Monies Received | 1 | 0.0% |
| Ambulatory Patient Services; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Prompt Pay | Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Sta | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Prompt Pay | Contract Language/Legal Issue; Claim Settled | 1 | 0.0% |
| Overcharges; Recoupment Of Claims Payment | Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Maternity and Newborn Care; Unsatisfactory Settle/Offer | Information Furnished; No Jurisdi | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Over 90 Dys Late; Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Additional Monies Received; Stat Pen Pd-46 To 90 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay | Company Position Upheld | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Disclosure Of Benefits; Other | Information Furnished | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Over 90 Dys Late; Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Corrective Action Taken; Additional Monies Received; Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Additional Monies Received; Corrective Action Taken; Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Claim Settled; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Corrective Action Taken; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Corrective Action Taken; Stat Pen Pd-Up To 45 Dys Late; Claim Settled | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Additional Monies Received; Corrective Action Taken; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Cust Service Claim Handling | Insufficient Information; No Jurisdiction | 1 | 0.0% |
| Prompt Pay | Additional Monies Received; Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Prompt Pay | Clean Claims Violation; Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Policy Not In Force | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Stat Pen Pd-Over 90 | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Clean Claims Violation; Additional Monies Received; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Up To 45 Dys Late; Clean Claims Violation; Additional Monies Received | 1 | 0.0% |
| Prompt Pay | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Misrepresentation; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Over 90 Dys Late; Clean Claims Violation | 1 | 0.0% |
| Prompt Pay | Additional Monies Received; Corrective Action Taken; Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Recoupment Of Claims Payment; Usual And Customary | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late; Information Furnished | 1 | 0.0% |
| Not Within TDI Jurisdiction; Recoupment Of Claims Payment | No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Claim Settled; Information Furnished | 1 | 0.0% |
| Prompt Pay | Information Furnished; Claim Settled | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Mediation Not Eligible | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Overpaid Claim Recouped | 1 | 0.0% |
| Prompt Pay | Contract Language/Legal Issue; Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Prompt Pay | Contract Language/Legal Issue; Question of Fact | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Contract Language/Lega | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Stat Pen Pd-Up To 45 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Misrepresentation | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay | Stat Pen Pd-46 To 90 Dys Late; Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Unfair Discrim-Clms Handling | No Jurisdiction | 1 | 0.0% |
| Prompt Pay | Corrective Action Taken; Stat Pen Pd-Over 90 Dys Late; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received; Claim Settled | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Company Position Upheld; Contract Language/Legal Iss | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Corrective Action Taken; Clean Claims Violation; Stat Pen Pd-Up To 45 Dys Late | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Additional Monies Received; Corrective Action Taken; Stat Pen Pd-Up To 45 Dys Late | 1 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; No | 1 | 0.0% |
| Hospitalization; Unsatisfactory Settle/Offer | Policy Not In Force; Company Position Upheld | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Prompt Pay | Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| SB418 Rule Violation; Timely Filing Deficiency | Information Furnished; Stat Pen Pd-Up To 45 Dys Late | 1 | 0.0% |
| Prompt Pay | Corrective Action Taken; Stat Pen Pd-Up To 45 Dys Late; Additional Monies Received | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Prohibited PHI Disclosure | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Other; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Other | No Jurisdiction; Policy Not In Force | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Information Furnished; Company Position Upheld | 1 | 0.0% |
| Prompt Pay | Stat Pen Pd-46 To 90 Dys Late; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Referred To; No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Disclosure Of Benefits; Material Change To Contract; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Lan | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Referre | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Insufficient Information | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue; Referred To | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Contract Language/Legal Issue; Referred To | 1 | 0.0% |
| Deficient Claim Notice; Unsatisfactory Settle/Offer | Clean Claims Violation; Additional Monies Received; Stat Pen Pd-Up | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Claim Settled; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Company Position Upheld; No Jurisdi | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Unfair Discrim-Clms Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Clean Claims Violation; Additional Monies Received; Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Hospitalization; Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Language/Legal Iss | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Clean Claims Violation; Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Company | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken; Addit | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Clean Claims Violation; Stat Pen Pd-Over 90 Dys Late; Additional Monies Received | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Claim Not Clean; Information Furnished | 1 | 0.0% |
| Disclosure Of Benefits; Material Change To Contract; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Fraud | Record Only; No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Up To 45 Dys Late; Clean Claims Violation; Information Furnished | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Information Furnished; Additional Monies Received; Stat Pen Pd-Up To 45 Dys Late | 1 | 0.0% |
| Commissions | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Up To 45 Dys Late; Information Furnished; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Information Furnished; Stat Pen Pd-Up To 45 Dys Late; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Referred To; No Jurisdiction | 1 | 0.0% |
| Discl-Fee Schd/Clms Proc Gdlns; Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Lan | 1 | 0.0% |
| Prompt Pay | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; No Jurisdiction; Contract Language/ | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Company Position Upheld | 1 | 0.0% |
| Hospitalization; Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Corrective Action Taken; | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; No | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Overpaid Claim Recouped | 1 | 0.0% |
| Cust Service Claim Handling; Discl-Fee Schd/Clms Proc Gdlns; Other | Information Furnished | 1 | 0.0% |
| Material Change To Contract | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Continuation of Benefits; Grp Conversion/Continuation | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Other | Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Additional Payment Expected; Information Furnished | 1 | 0.0% |
| Notice Requirements | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue; Additional M | 1 | 0.0% |
| Assignment of Benefits; COBRA; Continuation of Benefits; Disclosure Of Benefits; Lifetime/Annual Limits; Material Change | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Contract Language/Legal Issue; No Jurisdi | 1 | 0.0% |
| Access to Care; Continuity of Treatment | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Referred To | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; No Jurisdiction; Additional Monies Rec | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Contract Language/Legal Issue; Additional Moni | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Information Furnished; Insufficient Information | 1 | 0.0% |
| Disclosure Of Benefits; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received; Contract Langua | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; No Jurisdiction; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Clean Claims Violation; Stat Pen Pd-Up To 45 Dys Late; Contract Langu | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Closed-Lack Of Info Cmplainant; Unsatisfactory Settle/Offer; Usual And Customary | Record Only; Insufficient Information | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Referred To; Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Payment Expected; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Question of Fact; Company Position Upheld | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Corrective Action Taken; Contract Languag | 1 | 0.0% |
| Material Change To Contract | Contract Language/Legal Issue | 1 | 0.0% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken; Additional | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Language/Legal Issue; No Jurisdicti | 1 | 0.0% |
| Prompt Pay | Corrective Action Taken; Stat Pen Pd-46 To 90 Dys Late; Additional Monies Received | 1 | 0.0% |
| Not Within TDI Jurisdiction | Contract Language/Legal Issue | 1 | 0.0% |
| Den/N-Pymt MD Nec DME/Supplies | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Company Position Upheld | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 1 | 0.0% |
| COBRA; Continuation of Benefits; Cust Service Claim Handling | No Jurisdiction | 1 | 0.0% |
| Disclosure Of Benefits; Material Change To Contract; Misrepresentation | Information Furnished; Contract Language/Legal | 1 | 0.0% |
| Access to Care; Other | Information Furnished | 1 | 0.0% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Fur | 1 | 0.0% |
| Disclosure Of Benefits; Material Change To Contract | No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; SB418 Rule Violation; Timely Filing Deficiency | No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Complainant Retained Attorney | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Claim Settled | 1 | 0.0% |
| Assignment of Benefits | No Jurisdiction | 1 | 0.0% |
| Coordination of Benefits; Recoupment Of Claims Payment | No Jurisdiction | 1 | 0.0% |
| Not Within TDI Jurisdiction | 1 | 0.0% |
| Disclosure Of Benefits; Material Change To Contract; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld; No Jurisdiction; Contract Language/ | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Poli | 1 | 0.0% |
| Cust Service Claim Handling | Insufficient Information | 1 | 0.0% |
| Cust Service Claim Handling; Timely Filing Deficiency | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Insufficient Information; Contract Language/Legal Issue | 1 | 0.0% |
| Other | Information Furnished; Company Position Upheld; Corrective Action Taken | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| COBRA; Continuation of Benefits; Grp Conversion/Continuation | Information Furnished; Additional Payment Expected; Contr | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Overpaid Claim Recouped; No Jurisdiction; Company Position U | 1 | 0.0% |
| Ambulatory Patient Services; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Fraud; Laboratory Services | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction; Company Position Upheld | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Failure to Timely Respond; Contract Language/Legal Issue | 1 | 0.0% |
| Commissions | Question of Fact | 1 | 0.0% |
| Other | Other; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Other | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Contract Language/Legal Issue; Claim Settled | 1 | 0.0% |
| Disclosure Of Benefits; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company Posi | 1 | 0.0% |
| Closed-Lack Of Info Cmplainant; Other; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Other; Insufficient I | 1 | 0.0% |
| Maximum Out of Pocket | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled; Information Furnished | 1 | 0.0% |
| Agent Handling | Question of Fact; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Agent Handling | Information Furnished | 1 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer | Corrective Action Taken; No Jurisdiction | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received; C | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Disclosure Of Benefits; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Closed-Lack Of Info Cmplainant; Cust Service Claim Handling; Other; Rehabilitative/habilitative ; Unsatisfactory Settle/ | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Question of Fact | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received; Claim Settled | 1 | 0.0% |
| Not Within TDI Jurisdiction | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Question of Fact; Company Position Upheld; No Jurisdiction | 1 | 0.0% |
| Commissions | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished; Additional Monies Received | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling | Information Furnished | 1 | 0.0% |
| Unfair Discrim-Clms Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Misrepresentation; Unsatisfactory Settle/Offer | Additional Payment Expected; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Additional Monies Received; Contract Languag | 1 | 0.0% |
| Prompt Pay | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Attorney Fraud; Cust Service Claim Handling; Disclosure Of Benefits; Material Change To Contract | Contract Language/Leg | 1 | 0.0% |
| Liability Dispute; Maternity and Newborn Care; Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; | 1 | 0.0% |
| Other | Additional Payment Expected; Information Furnished | 1 | 0.0% |
| Disclosure Of Benefits; Material Change To Contract; Unsatisfactory Settle/Offer | Additional Payment Expected; Informat | 1 | 0.0% |
| Overcharges; Unfair Discrim-Clms Handling | No Jurisdiction | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled | 1 | 0.0% |
| COBRA | No Jurisdiction | 1 | 0.0% |
| Misrepresentation; Recoupment Of Claims Payment | Insufficient Information | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| IRO Failed To Obtn Med Rcrds; IRO Report Incomplete; Inaccurate Info In IRO Decsn | Contract Language/Legal Issue | 1 | 0.0% |
| Disclosure Of Benefits | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Access to Care; Other | Information Furnished; Company Position Upheld | 1 | 0.0% |
| Access to Care; Continuity of Treatment | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Continuation of Benefits | Information Furnished | 1 | 0.0% |
| Agent/Agency Contrct Termin; Unfair Discrimination | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Policy Not In Force; Additional Monies Received | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 1 | 0.0% |
| Other; Refusal to Insure | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Overcharges | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Payment Expected | 1 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Company Position Upheld; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Question of Fact; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; No Jurisdiction; Information Furnished | 1 | 0.0% |
| Access to Care; Primary Care Providr Selection | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Question of Fact | 1 | 0.0% |
| Laboratory Services; Unsatisfactory Settle/Offer | Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Additional Monies Received; Clean Claims Violation | 1 | 0.0% |
| Identification Card Issue | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Ad | 1 | 0.0% |
| Access to Care; Continuity of Treatment; Other | Information Furnished | 1 | 0.0% |
| Coordination of Benefits; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction; Referred To | 1 | 0.0% |
| Maternity and Newborn Care; Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Clean Claims Violation; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Other | No Jurisdiction; Insufficient Information | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Additional Monies Received; Clean Claims Violation; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg; Not Within TDI Jurisdiction; PPACA-Preventive Health Svcs | No Jurisdiction; Information | 1 | 0.0% |
| URA Failed To Prov Pr-To-Pr Rv; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Access to Care; Continuity Of Treatment | Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled | 1 | 0.0% |
| Physician Ranking Programs | Information Furnished | 1 | 0.0% |
| Other | Information Furnished; Referred for Disciplinary Actn; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Not Clean; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Claim Not Clean | 1 | 0.0% |
| Coordination of Benefits; SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Failure to Timely Respond; Additional Monies Received | 1 | 0.0% |
| Deficient Claim Notice; SB418 Rule Violation | No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Other | Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| Assignment of Benefits; Deficient Claim Notice | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Other | Policy Not In Force | 1 | 0.0% |
| Access to Care; Den/N-Pymt MD Nec Trmt N-Emrg | Contract Language/Legal Issue | 1 | 0.0% |
| COBRA | No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; SB418 Rule Violation | Additional Monies Received; Overpaid Claim Recouped; Contract Langu | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Clean Claims Violation; Stat Pen Pd-46 To 90 Dys Late; Additional Monies Recei | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue | 1 | 0.0% |
| Access to Care; Den/N-Pymt MD Nec Trmt N-Emrg; PPACA-Preventive Health Svcs; Unsatisfactory Settle/Offer | No Jurisdicti | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg; SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Contract Language | 1 | 0.0% |
| Access to Care; Agent Handling; Misrepresentation | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; No Jurisdiction | 1 | 0.0% |
| Access to Care; Den/N-Pymt MD Nec RX; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling | No Jurisdiction | 1 | 0.0% |
| Disclosure Of Benefits | No Jurisdiction | 1 | 0.0% |
| Agent Handling; Misrepresentation | No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Not Clean; No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Cash Value | Additional Payment Expected | 1 | 0.0% |
| Coordination of Benefits; SB418 Rule Violation | Insufficient Information | 1 | 0.0% |
| Deficient Claim Notice; SB418 Rule Violation; Timely Filing Deficiency | No Jurisdiction | 1 | 0.0% |
| Not Within TDI Jurisdiction | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling | Information Furnished; Other | 1 | 0.0% |
| Continuation of Benefits | Record Only | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Claim Not Clean | 1 | 0.0% |
| Access to Care; Out Of Ntwk Referral | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction; Additional Payment Expected; Information Furnished | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; SB418 Rule Violation; Unsatisfactory Settle/Offer; Usual And Customary | Information Furni | 1 | 0.0% |
| Improper Inducements; Misrepresentation | No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| Prompt Pay; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| SB418 Rule Violation; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Information Furnished; Clean Claims Violat | 1 | 0.0% |
| Prompt Pay; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| SB418 Rule Violation; Timely Filing Deficiency; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Overcharges | No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unfair Discrim-Clms Handling | Information Furnished | 1 | 0.0% |
| Disclosure Of Benefits | Question of Fact | 1 | 0.0% |
| Fraud | Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment; SB418 Rule Violation | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction; Claim Settled | 1 | 0.0% |
| Discl-Fee Schd/Clms Proc Gdlns; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Timely Filing Deficiency | No Jurisdiction | 1 | 0.0% |
| Overcharges | Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment | Corrective Action Taken; Overpaid Claim Recouped; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Additional Monies Received | 1 | 0.0% |
| Other | Policy Issued/Restored | 1 | 0.0% |
| Other | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Other | Other | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction; Information Furnished | 1 | 0.0% |
| Den/N-Pymt MD Nec DME/Supplies; Timely Filing Deficiency | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Additional Monies Received | 1 | 0.0% |
| Timely Filing Deficiency; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 1 | 0.0% |
| SB418 Rule Violation | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Not Clean; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; XX-Recoupment | No Jurisdiction | 1 | 0.0% |
| Assignment of Benefits | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Other | Policy Issued/Restored; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Payment Expected | 1 | 0.0% |
| Claim Recoding/Bundling; XX-Recoupment | Information Furnished; Claim Settled; Additional Monies Received | 1 | 0.0% |
| Coordination of Benefits | Information Furnished; No Jurisdiction | 1 | 0.0% |
Complaints by Year
- 2026: 54 complaints
- 2025: 118 complaints
- 2024: 99 complaints
- 2023: 178 complaints
- 2022: 144 complaints
- 2021: 254 complaints
- 2020: 296 complaints
- 2019: 1,193 complaints
- 2018: 2,429 complaints
- 2017: 1,441 complaints
- 2016: 1,691 complaints
- 2015: 956 complaints
- 2014: 1,041 complaints
- 2013: 1,016 complaints
- 2012: 548 complaints
Recent health Complaints Against AETNA LIFE INSURANCE COMPANY in Texas
- health Complaint #TX-454456-8fb88435 (2026-04-23) — Prior Authorization | Information Furnished; Company Position Upheld; Contract Language/Legal Issue
- health Complaint #TX-453654-b68827a7 (2026-04-15) — Premium or billing dispute
- health Complaint #TX-453541-b16199c4 (2026-04-14) — Cust Srvc Policy Holder Srvcs | Information Furnished; Corrective Action Taken
- health Complaint #TX-453405-1e7d6075 (2026-04-13) — Unfair settlement
- health Complaint #TX-453176-b6c62210 (2026-04-10) — Claim denial
- health Complaint #TX-452346-d5e08050 (2026-04-02) — Unfair settlement
- health Complaint #TX-452035-8fb88435 (2026-03-30) — Prior Authorization | Claim Settled; Information Furnished; Contract Language/Legal Issue
- health Complaint #TX-451945-1fe37908 (2026-03-30) — Coordination of Benefits | No Jurisdiction; Record Only
- health Complaint #TX-451759-d5e08050 (2026-03-27) — Unfair settlement
- health Complaint #TX-451598-d5e08050 (2026-03-26) — Unfair settlement
Frequently Asked Questions
How many health complaints does AETNA LIFE INSURANCE COMPANY have in Texas?
AETNA LIFE INSURANCE COMPANY has 11458 health insurance complaints on file from consumers in Texas, according to NAIC and state DOI data.
What are the most common health complaint issues with AETNA LIFE INSURANCE COMPANY in Texas?
The most common issues are: Claim denial (3444), Premium or billing dispute (2357), Delayed payment (2243), Unsatisfactory Settle/Offer | No Jurisdiction (669), Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue (141).
How does AETNA LIFE INSURANCE COMPANY's health record in Texas compare to other states?
AETNA LIFE INSURANCE COMPANY has 11458 health complaints in Texas out of 11533 total health complaints nationwide. That is 99.3% of their health volume.
Where can I file a health complaint against AETNA LIFE INSURANCE COMPANY in Texas?
You can file a complaint with the Texas Department of Insurance. The NAIC Consumer Information Source at https://content.naic.org/cis_consumer.htm also accepts complaints.
Related Pages
AETNA LIFE INSURANCE COMPANY health Complaints in Other States
- AETNA LIFE INSURANCE COMPANY health in California
- AETNA LIFE INSURANCE COMPANY health in New York
- AETNA LIFE INSURANCE COMPANY health in Florida
- AETNA LIFE INSURANCE COMPANY health in Illinois
- AETNA LIFE INSURANCE COMPANY health in Pennsylvania
- AETNA LIFE INSURANCE COMPANY health in Ohio
- AETNA LIFE INSURANCE COMPANY health in Georgia
- AETNA LIFE INSURANCE COMPANY health in North Carolina
- AETNA LIFE INSURANCE COMPANY health in New Jersey