InsuranceComplaintCheck

GOLDEN RULE INSURANCE COMPANY — health Insurance Complaints

Analysis of 526 health insurance complaints filed against GOLDEN RULE INSURANCE COMPANY, based on public NAIC and state DOI data.

Key Statistics

  • health Complaints: 526
  • Total Complaints (All Types): 529
  • health Share: 99.4%
  • NAIC Complaint Ratio: 2.46
  • AI Risk Score: 83/100

health Complaint Issues

Issue TypeComplaints% of Total
Claim denial14327.2%
Premium or billing dispute13124.9%
Delayed payment10620.2%
Policy cancellation193.6%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue112.1%
Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue81.5%
Prompt Pay; Timely Filing Deficiency | Contract Language/Legal Issue40.8%
Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue30.6%
Refusal to Insure | Information Furnished; Contract Language/Legal Issue30.6%
Usual And Customary | Contract Language/Legal Issue30.6%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished30.6%
Unfair settlement20.4%
Coverage dispute20.4%
Refusal to Insure | Company Position Upheld; Information Furnished; Contract Language/Legal Issue20.4%
Refusal to Insure | Company Position Upheld; Information Furnished20.4%
Misleading sales20.4%
Refusal to Insure | Policy Not In Force; Contract Language/Legal Issue20.4%
Refusal to Insure | Contract Language/Legal Issue20.4%
Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Contract Language/Legal Issue; Company Positio20.4%
Unsatisfactory Settle/Offer | Additional Payment Expected; Information Furnished20.4%
Endorsement / Rider | Contract Language/Legal Issue20.4%
Unsatisfactory Settle/Offer | Information Furnished20.4%
Cust Service Claim Handling | Information Furnished20.4%
Other | Information Furnished20.4%
Cust Service Claim Handling | Contract Language/Legal Issue; Information Furnished; Company Position Upheld10.2%
Recoupment Of Claims Payment | Contract Language/Legal Issue; Company Position Upheld; Information Furnished10.2%
Provider or network dispute10.2%
Maximum Out of Pocket | Information Furnished; Company Position Upheld; Contract Language/Legal Issue10.2%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken; Company Position Upheld10.2%
Cust Service Claim Handling; Pediatric Care; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Fu10.2%
Assignment of Benefits; Coordination of Benefits; Cust Service Claim Handling; Unsatisfactory Settle/Offer | Claim Settl10.2%
Prior Authorization | Information Furnished; Corrective Action Taken10.2%
Recoupment Of Claims Payment | Company Position Upheld; Information Furnished; Contract Language/Legal Issue10.2%
Waiting Periods | Underwriting | Company Position Substantiated10.2%
Refusal to Insure | Contract Language/Legal Issue; Information Furnished10.2%
Claim Procedure | Claim Handling10.2%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Information Furnished10.2%
Bad Faith Participation | Information Furnished10.2%
Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Company Position Upheld10.2%
Recoupment Of Claims Payment | Information Furnished; Company Position Upheld; Contract Language/Legal Issue10.2%
Recoupment Of Claims Payment | Information Furnished; Contract Language/Legal Issue; Policy Not In Force10.2%
Access to Care; Misrepresentation | Information Furnished; Contract Language/Legal Issue10.2%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Claim Settled; Contract Language/Legal10.2%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Claim Settled10.2%
Claim Recoding/Bundling | Contract Language/Legal Issue10.2%
Misrepresentation | Corrective Action Taken; Information Furnished; Contract Language/Legal Issue10.2%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Contract L10.2%
Refusal to Insure | Company Position Upheld; Contract Language/Legal Issue; Information Furnished10.2%
Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Policy Not In Force; Contract Language/Legal Issue10.2%
Refusal to Insure | Contract Language/Legal Issue; No Jurisdiction; Policy Not In Force10.2%
Refusal to Insure | Referred To; Contract Language/Legal Issue; No Jurisdiction10.2%
Refusal to Insure | No Jurisdiction; Contract Language/Legal Issue; Company Position Upheld10.2%
Refusal to Insure | Information Furnished; Referred To; No Jurisdiction10.2%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue10.2%
Continuation of Benefits; Not Within TDI Jurisdiction | No Jurisdiction; Information Furnished10.2%
Misrepresentation | No Jurisdiction10.2%
Refusal to Insure | Contract Language/Legal Issue; Company Position Upheld10.2%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Lang10.2%
Refusal to Insure | Contract Language/Legal Issue; No Jurisdiction10.2%
Refusal to Insure | Referred To; No Jurisdiction; Contract Language/Legal Issue10.2%
Continuation of Benefits; Refusal to Insure | Information Furnished; Contract Language/Legal Issue10.2%
Commissions | Contract Language/Legal Issue10.2%
Refusal to Insure | Contract Language/Legal Issue; Company Position Upheld; Policy Not In Force10.2%
Refusal to Insure | No Jurisdiction; Company Position Upheld; Policy Not In Force10.2%
Refusal to Insure | Contract Language/Legal Issue; Information Furnished; Company Position Upheld10.2%
Fraud; Unsatisfactory Settle/Offer | Claim Settled; Information Furnished10.2%
Access to Care | Contract Language/Legal Issue; Company Position Upheld10.2%
Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Language/Legal Issue10.2%
PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Additional Payme10.2%
Unsatisfactory Settle/Offer; Usual And Customary | Claim Settled; Contract Language/Legal Issue10.2%
Closed-Lack Of Info Cmplainant; Unsatisfactory Settle/Offer; Usual And Customary | Insufficient Information10.2%
Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction10.2%
Unsatisfactory Settle/Offer | Company Position Upheld10.2%
Fraud; Laboratory Services; Maximum Out of Pocket; Overcharges | Contract Language/Legal Issue10.2%
Access to Care; Other | Information Furnished; Contract Language/Legal Issue10.2%
Material Change To Contract | Contract Language/Legal Issue; Company Position Upheld10.2%
Other | Company Position Upheld; Contract Language/Legal Issue10.2%
Disclosure Of Benefits; Material Change To Contract | Contract Language/Legal Issue; Information Furnished10.2%
Not Within TDI Jurisdiction10.2%
Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction; Contract Language/Legal Issue10.2%
Other | Information Furnished; Contract Language/Legal Issue10.2%
Access to Care | Policy Not In Force10.2%
Refusal to Insure | Policy Not In Force10.2%
Continuation of Benefits | Information Furnished10.2%
Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Claim Settled10.2%
Refusal to Insure | No Jurisdiction10.2%
Unsatisfactory Settle/Offer | No Jurisdiction10.2%
Unsatisfactory Settle/Offer | Additional Payment Expected10.2%
Continuity Of Treatment | Claim Settled10.2%
Claim Recoding/Bundling | Information Furnished10.2%

health Complaints by State

StateComplaints
Texas521
Connecticut5

Recent health Complaints Against GOLDEN RULE INSURANCE COMPANY

Frequently Asked Questions

How many health complaints does GOLDEN RULE INSURANCE COMPANY have?

GOLDEN RULE INSURANCE COMPANY has 526 health insurance complaints on file, according to NAIC and state DOI data.

What are the most common health complaint issues with GOLDEN RULE INSURANCE COMPANY?

The most common health complaint issues for GOLDEN RULE INSURANCE COMPANY are: Claim denial (143), Premium or billing dispute (131), Delayed payment (106), Policy cancellation (19), Unsatisfactory Settle/Offer | Contract Language/Legal Issue (11).

Which states have the most health complaints against GOLDEN RULE INSURANCE COMPANY?

The states with the most health complaints against GOLDEN RULE INSURANCE COMPANY are: Texas (521), Connecticut (5).

health Complaints by State

GOLDEN RULE INSURANCE COMPANY Complaints by State

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