Health Care Service Corporation, a Mutual Legal Reserve Company — health Insurance Complaints
Analysis of 1,260 health insurance complaints filed against Health Care Service Corporation, a Mutual Legal Reserve Company, based on public NAIC and state DOI data.
Key Statistics
- health Complaints: 1,260
- Total Complaints (All Types): 1,261
- health Share: 99.9%
- NAIC Complaint Ratio: 13.44
- AI Risk Score: 97/100
health Complaint Issues
| Issue Type | Complaints | % of Total |
|---|---|---|
| Claim denial | 507 | 40.2% |
| Delayed payment | 175 | 13.9% |
| Premium or billing dispute | 107 | 8.5% |
| Unfair settlement | 44 | 3.5% |
| Policy cancellation | 29 | 2.3% |
| Provider or network dispute | 21 | 1.7% |
| Cust Srvc Policy Holder Srvcs | Information Furnished | 7 | 0.6% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 6 | 0.5% |
| Cust Srvc Policy Holder Srvcs | Information Furnished; Corrective Action Taken | 5 | 0.4% |
| Other | Information Furnished | 5 | 0.4% |
| Cust Srvc Policy Holder Srvcs | Contract Language/Legal Issue; Information Furnished | 5 | 0.4% |
| Prior Authorization | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 5 | 0.4% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled; Additional Monies Received | 5 | 0.4% |
| Prior Authorization | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 4 | 0.3% |
| Prior Authorization | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 4 | 0.3% |
| Cust Srvc Policy Holder Srvcs | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 4 | 0.3% |
| Prior Authorization | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 4 | 0.3% |
| Cust Srvc Policy Holder Srvcs | Company Position Upheld; Information Furnished | 4 | 0.3% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 4 | 0.3% |
| Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 4 | 0.3% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 4 | 0.3% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 4 | 0.3% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished | 4 | 0.3% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received; Corrective Action Taken | 4 | 0.3% |
| Delivery of Policy | PolicyHolder Service | 3 | 0.2% |
| Prior Authorization | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 3 | 0.2% |
| Prior Authorization | Information Furnished; Corrective Action Taken | 3 | 0.2% |
| Cust Srvc Policy Holder Srvcs; Prior Authorization | Contract Language/Legal Issue; Information Furnished; Company Posit | 3 | 0.2% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Language/L | 3 | 0.2% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 3 | 0.2% |
| Maximum Out of Pocket | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 3 | 0.2% |
| Cust Service Claim Handling | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 3 | 0.2% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Infor | 3 | 0.2% |
| Coverage dispute | 3 | 0.2% |
| Authorization Dispute; Recoupment Of Claims Payment | Corrective Action Taken; Information Furnished; Claim Settled | 3 | 0.2% |
| Commissions | Contract Language/Legal Issue; Information Furnished | 2 | 0.2% |
| Prior Authorization | Information Furnished | 2 | 0.2% |
| Cust Srvc Policy Holder Srvcs; Prior Authorization | Information Furnished; Contract Language/Legal Issue; Company Posit | 2 | 0.2% |
| Cust Srvc Policy Holder Srvcs; Prior Authorization | Information Furnished; Company Position Upheld; Contract Language/L | 2 | 0.2% |
| Prior Authorization | Corrective Action Taken; Information Furnished | 2 | 0.2% |
| Delivery of Policy | PolicyHolder Service | Company Position Overturned | 2 | 0.2% |
| Cust Srvc Policy Holder Srvcs | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 2 | 0.2% |
| Cust Srvc Policy Holder Srvcs | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 2 | 0.2% |
| Prior Authorization | Information Furnished; Contract Language/Legal Issue | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled | 2 | 0.2% |
| Cust Service Claim Handling; Maximum Out of Pocket | Company Position Upheld; Contract Language/Legal Issue; Information | 2 | 0.2% |
| Cust Service Claim Handling | Company Position Upheld | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished | 2 | 0.2% |
| Bad Faith Participation | Information Furnished | 2 | 0.2% |
| Prompt Pay | Information Furnished | 2 | 0.2% |
| Access to Care | Information Furnished; Question of Fact | 2 | 0.2% |
| Other | Contract Language/Legal Issue; Information Furnished | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 2 | 0.2% |
| Cust Srvc Policy Holder Srvcs; Prior Authorization | Contract Language/Legal Issue; Information Furnished | 2 | 0.2% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Infor | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Claim Settled; Information Furnished; Corrective Action Taken | 2 | 0.2% |
| Prior Authorization | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 2 | 0.2% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Lang | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Claim Settled; Corrective Action Taken; Additional Monies Received | 2 | 0.2% |
| Cust Service Claim Handling; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Informa | 2 | 0.2% |
| Cust Srvc Policy Holder Srvcs | Corrective Action Taken; Information Furnished | 2 | 0.2% |
| Recoupment Of Claims Payment | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Information Furnished | 2 | 0.2% |
| Other | Information Furnished; Contract Language/Legal Issue | 2 | 0.2% |
| Commissions | Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Cust Service Claim Handling | Question of Fact; Insufficient Information | 1 | 0.1% |
| Cust Service Claim Handling | Information Furnished | 1 | 0.1% |
| Maximum Out of Pocket; Misrepresentation | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.1% |
| Prior Authorization | Company Position Upheld | 1 | 0.1% |
| Cust Service Claim Handling; Maternity and Newborn Care; Unsatisfactory Settle/Offer | Company Position Upheld; Referred | 1 | 0.1% |
| Access to Care | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.1% |
| Cust Service Claim Handling | Claim Settled; Corrective Action Taken; Information Furnished | 1 | 0.1% |
| Cust Service Claim Handling | Information Furnished; Corrective Action Taken | 1 | 0.1% |
| Cust Service Claim Handling | Record Only; No Jurisdiction; Referred To | 1 | 0.1% |
| Access to Care; Prior Authorization | Corrective Action Taken; Information Furnished | 1 | 0.1% |
| Cust Service Claim Handling | No Jurisdiction; Company Position Upheld | 1 | 0.1% |
| Cust Service Claim Handling | Corrective Action Taken | 1 | 0.1% |
| Cust Service Claim Handling; Recoupment Of Claims Payment | Company Position Upheld | 1 | 0.1% |
| Cust Service Claim Handling | Information Furnished; Question of Fact | 1 | 0.1% |
| Continuation of Benefits; Coordination of Benefits; Cust Service Claim Handling | Contract Language/Legal Issue; Company | 1 | 0.1% |
| Lapsed | PolicyHolder Service | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs | Question of Fact; Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Recoupment Of Claims Payment | Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Misrepresentation | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.1% |
| Access to Care; Cust Srvc Policy Holder Srvcs | Information Furnished; Referred To | 1 | 0.1% |
| Misrepresentation | Information Furnished; Question of Fact | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Prior Authorization | Contract Language/Legal Issue; Information Furnished; Question of F | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Disclosure Of Benefits | Information Furnished; Company Position Upheld; Contract Languag | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Maximum Out of Pocket | Contract Language/Legal Issue; Information Furnished; Company Pos | 1 | 0.1% |
| Health Privacy | Information Furnished; Question of Fact; Contract Language/Legal Issue | 1 | 0.1% |
| Cust Service Claim Handling; Recoupment Of Claims Payment | Corrective Action Taken; Claim Settled; Claim Not Clean | 1 | 0.1% |
| Prior Authorization | Company Position Upheld; Contract Language/Legal Issue | 1 | 0.1% |
| Coordination of Benefits; Pediatric Care; Recoupment Of Claims Payment | Claim Settled; Information Furnished; Correctiv | 1 | 0.1% |
| Cust Service Claim Handling | Information Furnished; Claim Settled; Corrective Action Taken | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Enrllmt/Canc/Rnwl Of Enrollee | Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Other | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.1% |
| Cust Service Claim Handling; Maximum Out of Pocket | Complaint Withdrawn; Information Furnished | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Misrepresentation | Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Access to Care; Cust Srvc Policy Holder Srvcs; Prior Authorization | Information Furnished; Contract Language/Legal Issu | 1 | 0.1% |
| Cust Service Claim Handling; Fraud | Information Furnished | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs | Contract Language/Legal Issue; Referred To; Information Furnished | 1 | 0.1% |
| Authorization Dispute; Cust Service Claim Handling | Information Furnished; Company Position Upheld; Contract Language/L | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Identification Card Issue | Information Furnished; Contract Language/Legal Issue; Correct | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Enrllmt/Canc/Rnwl Of Enrollee | Question of Fact; Information Furnished; Company Position | 1 | 0.1% |
| Maximum Out of Pocket | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Disclosure Of Benefits | Contract Language/Legal Issue; Question of Fact; Company Positio | 1 | 0.1% |
| Maximum Out of Pocket | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 1 | 0.1% |
| Prompt Pay | Information Furnished; Contract Language/Legal Issue; Claim Settled | 1 | 0.1% |
| Prior Authorization | Information Furnished; Corrective Action Taken; Claim Settled | 1 | 0.1% |
| Not Within TDI Jurisdiction | Information Furnished; Referred To | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Not Within TDI Jurisdiction | Information Furnished; Company Position Upheld | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld | 1 | 0.1% |
| Not Within TDI Jurisdiction; Other | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Company Position Upheld | 1 | 0.1% |
| Maximum Out of Pocket | Contract Language/Legal Issue | 1 | 0.1% |
| Prompt Pay; Recoupment Of Claims Payment | Information Furnished; Corrective Action Taken | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Corrective Action Taken | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Prior Authorization | Company Position Upheld; Contract Language/Legal Issue; Information | 1 | 0.1% |
| Maximum Out of Pocket | Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Continuation of Benefits; Cust Service Claim Handling; Recoupment Of Claims Payment | Additional Monies Received; Correc | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs | Question of Fact; Information Furnished | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs | Information Furnished; Referred To | 1 | 0.1% |
| Continuation of Benefits | Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Claim Settled; Corrective Action Taken | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Claim Not Clean | 1 | 0.1% |
| Other | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.1% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 1 | 0.1% |
| Fraud; Other | Information Furnished; Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.1% |
| Authorization Dispute; Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Company Positio | 1 | 0.1% |
| Prior Authorization; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Information F | 1 | 0.1% |
| Policy Service | PolicyHolder Service | 1 | 0.1% |
| Other; Unauthorized Acts | Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Other | Information Furnished; Claim Settled; Question of Fact | 1 | 0.1% |
| Other | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Referred To; Additional Monies Received; Corrective Action Taken | 1 | 0.1% |
| Recoupment Of Claims Payment | Information Furnished; Corrective Action Taken | 1 | 0.1% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled; Contract Language/Legal Iss | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Claim Settled; Information Furnished | 1 | 0.1% |
| Ambulatory Patient Services; Maximum Out of Pocket | Information Furnished; Contract Language/Legal Issue; Company Posit | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Additional Monies Received | 1 | 0.1% |
| Authorization Dispute; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Language/L | 1 | 0.1% |
| Cust Service Claim Handling | Information Furnished; Claim Settled | 1 | 0.1% |
| Access to Care; Cust Srvc Policy Holder Srvcs | Contract Language/Legal Issue; Corrective Action Taken; Information Furn | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.1% |
| Pediatric Care | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Cust Service Claim Handling | No Jurisdiction; Record Only; Referred To | 1 | 0.1% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Information | 1 | 0.1% |
| Maximum Out of Pocket | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.1% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Referred To; No Jurisdiction; Record Only | 1 | 0.1% |
| Unauthorized Acts | Additional Payment Expected; Information Furnished | 1 | 0.1% |
| Authorization Dispute; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Information Fu | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 1 | 0.1% |
| Maximum Out of Pocket | Claim Settled; Corrective Action Taken; Information Furnished | 1 | 0.1% |
| Cust Service Claim Handling | Corrective Action Taken; Additional Monies Received | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Prior Authorization | Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Prior Authorization | Corrective Action Taken; Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Cust Service Claim Handling; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Information Furnished; Corrective Acti | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Prior Authorization | Company Position Upheld; Information Furnished; Contract Language/L | 1 | 0.1% |
| Prior Authorization | Record Only; Insufficient Information | 1 | 0.1% |
| Enrllmt/Canc/Rnwl Of Enrollee | Information Furnished; Contract Language/Legal Issue; Policy Issued/Restored | 1 | 0.1% |
| Maximum Out of Pocket | Corrective Action Taken; Information Furnished | 1 | 0.1% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Referred To; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.1% |
| Cust Service Claim Handling; Maximum Out of Pocket | Information Furnished; Company Position Upheld | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Stat Pen Pd-Up To 45 Dys Late; Company Position Upheld | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken; Claim Settled | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs | Information Furnished; Company Position Upheld | 1 | 0.1% |
| Cust Service Claim Handling | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.1% |
| Cust Service Claim Handling | Additional Monies Received | 1 | 0.1% |
| Prior Authorization | Question of Fact; Information Furnished; Company Position Upheld | 1 | 0.1% |
| Prior Authorization; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company Positio | 1 | 0.1% |
| Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Question of Fact; Company Posit | 1 | 0.1% |
| Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Company | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Information Furnished | 1 | 0.1% |
| Prior Authorization | Company Position Upheld; Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.1% |
| Cust Service Claim Handling | Corrective Action Taken; Information Furnished | 1 | 0.1% |
| Cust Service Claim Handling; Maximum Out of Pocket | Company Position Upheld; Information Furnished; Contract Language/L | 1 | 0.1% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Company Position | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 1 | 0.1% |
| Authorization Dispute; Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Corrective Acti | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Record Only; Insufficient Information | 1 | 0.1% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Claim Procedure | Claim Handling | 1 | 0.1% |
| Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld | 1 | 0.1% |
| Cust Service Claim Handling; Maximum Out of Pocket | Contract Language/Legal Issue; Information Furnished; Corrective Ac | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Claim Settled | 1 | 0.1% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Claim Settled; Corrective Action Taken; Information Furnished | 1 | 0.1% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken | 1 | 0.1% |
| Coordination of Benefits; Recoupment Of Claims Payment | Company Position Upheld; Contract Language/Legal Issue; Informa | 1 | 0.1% |
| Access to Care; Cust Srvc Policy Holder Srvcs; Identification Card Issue; Unsatisfactory Settle/Offer | Contract Languag | 1 | 0.1% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Insufficient Information | 1 | 0.1% |
| Prior Authorization | Corrective Action Taken; Claim Settled; Information Furnished | 1 | 0.1% |
| Cust Service Claim Handling; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Information Furnished; Contract Langua | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; Company Position Upheld; Information Furnished | 1 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Corrective Action Taken; Information Furn | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Claim Settled | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken | 1 | 0.1% |
| Recoupment Of Claims Payment | Corrective Action Taken; Information Furnished | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.1% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Enrllmt/Canc/Rnwl Of Enrollee | Additional Payment Expected; Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Continuation of Benefits; Cust Srvc Policy Holder Srvcs; Notice Requirements | Contract Language/Legal Issue; Informatio | 1 | 0.1% |
| Claim Recoding/Bundling; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Insufficient Information; Record Only | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs | Corrective Action Taken | 1 | 0.1% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 1 | 0.1% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Company Pos | 1 | 0.1% |
| Other | Referred To; Company Position Upheld; Information Furnished | 1 | 0.1% |
| Coordination of Benefits; Recoupment Of Claims Payment; Timely Filing Deficiency | Corrective Action Taken; Contract Lan | 1 | 0.1% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company | 1 | 0.1% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Informati | 1 | 0.1% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Additional Monies | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs | Contract Language/Legal Issue; Company Position Upheld; Additional Payment Expected | 1 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Information Furnished | 1 | 0.1% |
| Other | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Misleading sales | 1 | 0.1% |
| Prompt Pay | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.1% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Corrective | 1 | 0.1% |
| Prompt Pay | Complaint Withdrawn | 1 | 0.1% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Language/L | 1 | 0.1% |
| Prior Authorization | Question of Fact; Information Furnished | 1 | 0.1% |
| Prior Authorization | Information Furnished; Question of Fact | 1 | 0.1% |
| Cust Service Claim Handling | Corrective Action Taken; Information Furnished; Additional Monies Received | 1 | 0.1% |
| Authorization Dispute; Recoupment Of Claims Payment | Corrective Action Taken; Claim Settled; Information Furnished | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.1% |
| Authorization Dispute; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company Posit | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Retaliation By Mgd Care Plans | Company Position Upheld; Information Furnished | 1 | 0.1% |
| Cust Service Claim Handling; Recoupment Of Claims Payment | Additional Monies Received; Information Furnished; Correctiv | 1 | 0.1% |
| Timely Filing Deficiency; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Additional Monie | 1 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Claim Settled; Information Furnished; Corrective Action Taken | 1 | 0.1% |
| Other | Information Furnished; Company Position Upheld | 1 | 0.1% |
| Pediatric Care; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Language/Legal Is | 1 | 0.1% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished | 1 | 0.1% |
| Claim Recoding/Bundling; Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Company Posit | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Pediatric Care; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Payment Expected; Information Furnishe | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs | Information Furnished; Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs | Record Only; Referred To; No Jurisdiction | 1 | 0.1% |
| Access to Care; Cust Srvc Policy Holder Srvcs; Identification Card Issue | Information Furnished; Question of Fact | 1 | 0.1% |
| Cust Service Claim Handling; Recoupment Of Claims Payment | Company Position Upheld; Additional Monies Received; Informa | 1 | 0.1% |
| Cust Service Claim Handling; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled | 1 | 0.1% |
| Authorization Dispute; External Review | Company Position Upheld; Information Furnished | 1 | 0.1% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer | Information Furnished; Policy Not In Force; Company Position Uphe | 1 | 0.1% |
| Maternity and Newborn Care; Maximum Out of Pocket; Pediatric Care; Unsatisfactory Settle/Offer | Information Furnished; | 1 | 0.1% |
| Cust Service Claim Handling; Maternity and Newborn Care; Pediatric Care; Unsatisfactory Settle/Offer | Information Furni | 1 | 0.1% |
| Cust Service Claim Handling; Maximum Out of Pocket | Information Furnished; Additional Monies Received; Corrective Actio | 1 | 0.1% |
| Authorization Dispute; Cust Service Claim Handling; Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies | 1 | 0.1% |
| Claim Recoding/Bundling; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Langu | 1 | 0.1% |
| Cust Service Claim Handling; Misrepresentation; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Claim Settled | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Claim Settled | 1 | 0.1% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Contract Lang | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Disclosure Of Benefits | Company Position Upheld; Information Furnished; Contract Languag | 1 | 0.1% |
| Continuation of Benefits | Information Furnished; Policy Issued/Restored; Corrective Action Taken | 1 | 0.1% |
| Coordination of Benefits | No Jurisdiction | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Fraud; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Payment Expected; Corrective Action Taken | 1 | 0.1% |
| Cust Service Claim Handling; Pediatric Care; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Le | 1 | 0.1% |
| Recoupment Of Claims Payment | Information Furnished | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; Corrective Action Taken; Information Furnished | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Payment Expected; Information Furnished | 1 | 0.1% |
| Recoupment Of Claims Payment | Company Position Upheld; Information Furnished | 1 | 0.1% |
| Prompt Pay; Recoupment Of Claims Payment | Information Furnished; Company Position Upheld | 1 | 0.1% |
| Prompt Pay | Company Position Upheld; Information Furnished | 1 | 0.1% |
health Complaints by State
| State | Complaints |
|---|---|
| Texas | 1,239 |
| Connecticut | 21 |
Recent health Complaints Against Health Care Service Corporation, a Mutual Legal Reserve Company
- health Complaint #TX-456327-897b7f71 — Texas (2026-05-11)
- health Complaint #TX-455498-b19ed674 — Texas (2026-05-04)
- health Complaint #TX-454968-712de46c — Texas (2026-04-28)
- health Complaint #TX-454932-d9c4e1b6 — Texas (2026-04-28)
- health Complaint #TX-454831-f0ad5bad — Texas (2026-04-27)
- health Complaint #TX-454732-ec7b69f8 — Texas (2026-04-27)
- health Complaint #TX-454704-ee45ad60 — Texas (2026-04-27)
- health Complaint #TX-454587-e8560ec5 — Texas (2026-04-24)
- health Complaint #CT-7084994-006f3790 — Connecticut (2026-04-24)
- health Complaint #TX-454536-d9c4e1b6 — Texas (2026-04-23)
Frequently Asked Questions
How many health complaints does Health Care Service Corporation, a Mutual Legal Reserve Company have?
Health Care Service Corporation, a Mutual Legal Reserve Company has 1260 health insurance complaints on file, according to NAIC and state DOI data.
What are the most common health complaint issues with Health Care Service Corporation, a Mutual Legal Reserve Company?
The most common health complaint issues for Health Care Service Corporation, a Mutual Legal Reserve Company are: Claim denial (507), Delayed payment (175), Premium or billing dispute (107), Unfair settlement (44), Policy cancellation (29).
Which states have the most health complaints against Health Care Service Corporation, a Mutual Legal Reserve Company?
The states with the most health complaints against Health Care Service Corporation, a Mutual Legal Reserve Company are: Texas (1239), Connecticut (21).
health Complaints by State
Health Care Service Corporation, a Mutual Legal Reserve Company Complaints by State
- Health Care Service Corporation, a Mutual Legal Reserve Company Complaints in California
- Health Care Service Corporation, a Mutual Legal Reserve Company Complaints in Texas
- Health Care Service Corporation, a Mutual Legal Reserve Company Complaints in New York
- Health Care Service Corporation, a Mutual Legal Reserve Company Complaints in Florida
- Health Care Service Corporation, a Mutual Legal Reserve Company Complaints in Illinois
- Health Care Service Corporation, a Mutual Legal Reserve Company Complaints in Pennsylvania
- Health Care Service Corporation, a Mutual Legal Reserve Company Complaints in Ohio
- Health Care Service Corporation, a Mutual Legal Reserve Company Complaints in Georgia
- Health Care Service Corporation, a Mutual Legal Reserve Company Complaints in North Carolina
- Health Care Service Corporation, a Mutual Legal Reserve Company Complaints in New Jersey