InsuranceComplaintCheck

Horizon Blue Cross Blue Shield — Insurance Complaint Report

Horizon Blue Cross Blue Shield: Near-Industry Average Complaints with Recent Uptick

Key Metrics

  • Total Complaints: 481
  • NAIC Complaint Ratio: 0.98
  • Market Share: 0.7%
  • AI Risk Score: 50/100
  • Most Recent Complaint: 2025-02-07

AI Insurer Analysis

Horizon Blue Cross Blue Shield has accumulated 481 insurance complaints on record. Their NAIC complaint ratio of 0.98 is near the industry average, meaning they receive fewer complaints than expected for an insurer of their market size. With approximately 0.7% market share, Horizon Blue Cross Blue Shield is a smaller player in the insurance market. The most common complaint categories are: health (20). Complaints are concentrated in premium increases and claim denials. Horizon Blue Cross Blue Shield has a near-industry average complaint ratio. The insurer has seen a recent uptick in complaints, particularly in health coverage issues. Complaints have increased recently, particularly regarding premium increases and claim denials. Areas of concern include: Recent increase in complaints; High claim denial rate. On the positive side: Near-industry average complaint ratio.

Risk Breakdown

  • regulatoryActions: none
  • complaintRatio: moderate
  • claimDenialRate: moderate
  • responseTime: poor

Red Flags

  • Recent increase in complaints
  • High claim denial rate

Green Flags

  • Near-industry average complaint ratio

Consumer Tips

When dealing with Horizon Blue Cross Blue Shield, keep these practical tips in mind: 1. Check your premium increase notifications and verify the reasons for any hikes. 2. Be proactive in disputing claim denials by reviewing policy details and seeking second opinions. 3. Stay informed about network changes and ensure your healthcare providers are in-network. 4. Review coverage gaps and ensure your policy meets your needs. Before purchasing a policy, compare Horizon Blue Cross Blue Shield's complaint ratio (0.98, near the industry average) with competitors offering similar coverage. Always read the full policy document, paying attention to exclusions and limitations. Document all communications with the insurer in writing. If you experience a dispute, file a complaint with your state Department of Insurance — it is free and often results in faster resolution.

Trend Analysis

Complaints have increased recently, particularly regarding premium increases and claim denials.

Frequently Asked Questions about Horizon Blue Cross Blue Shield

Is Horizon Blue Cross Blue Shield a good insurance company?

Horizon Blue Cross Blue Shield has 481 complaints on record. Their NAIC complaint ratio is 0.98, which is near the industry average. They hold approximately 0.7% market share. A complaint ratio below 1.00 indicates fewer complaints than expected for a company of this size; above 1.00 indicates more.

What are the most common complaints about Horizon Blue Cross Blue Shield?

The most common complaint categories for Horizon Blue Cross Blue Shield are: health (20). The leading specific issues are: Premium increase (5), Coverage gap (4), Claim denial (4).

How does Horizon Blue Cross Blue Shield compare to competitors?

Horizon Blue Cross Blue Shield's NAIC complaint ratio of 0.98 is near the industry average. Companies with ratios below 1.00 receive fewer complaints relative to their size. When comparing insurers, also consider financial strength ratings, coverage options, and premium pricing alongside complaint data.

Should I file a DOI complaint against Horizon Blue Cross Blue Shield?

If you have an unresolved dispute with Horizon Blue Cross Blue Shield, filing a complaint with your state Department of Insurance (DOI) is a free and effective option. Steps: (1) Gather all documentation including your policy, correspondence, and claim records. (2) Contact your state DOI — most Horizon Blue Cross Blue Shield complaints come from Tennessee. (3) File online or by mail. (4) The DOI typically responds within 30-45 days.

Are Horizon Blue Cross Blue Shield complaints getting better or worse?

Horizon Blue Cross Blue Shield has 481 total complaints. In the most recent data, 20 complaints were recorded across 1 coverage categories. Check the NAIC Consumer Information Source for the most current complaint ratio trends.

What insurance companies have the lowest complaint ratios?

Insurance companies with the lowest complaint ratios typically include mutual insurers and member-owned companies. To find alternatives to Horizon Blue Cross Blue Shield, compare NAIC complaint ratios for companies offering the same coverage types (health, etc.). Your state DOI website provides complaint data specific to companies licensed in your state.

Has Horizon Blue Cross Blue Shield been fined or sanctioned by insurance regulators?

Regulatory action information is available through your state Department of Insurance and the NAIC. Horizon Blue Cross Blue Shield has 481 consumer complaints on record with a complaint ratio of 0.98. For specific regulatory actions, check the NAIC Regulatory Actions database and your state DOI enforcement records.

Which states have the most complaints against Horizon Blue Cross Blue Shield?

The states with the most complaints against Horizon Blue Cross Blue Shield are: Tennessee (2), Colorado (2), Iowa (2), Wyoming (1), Texas (1). This distribution may reflect the company's market presence in those states rather than indicating worse service in specific locations.

What patterns emerge from Horizon Blue Cross Blue Shield's complaint data?

Complaints are concentrated in premium increases and claim denials.

How does Horizon Blue Cross Blue Shield handle claims compared to peers?

The insurer has seen a recent uptick in complaints, particularly in health coverage issues.

What is the complaint trend for Horizon Blue Cross Blue Shield?

Complaints have increased recently, particularly regarding premium increases and claim denials.

What should prospective policyholders know about Horizon Blue Cross Blue Shield?

The complaint ratio is near the industry average, indicating a balanced performance.

Are there systemic issues in Horizon Blue Cross Blue Shield's complaint history?

Health coverage issues are the primary source of complaints.

Recent Complaints Against Horizon Blue Cross Blue Shield

Horizon Blue Cross Blue Shield Complaints by State

Horizon Blue Cross Blue Shield Complaints by Coverage Type

Browse Horizon Blue Cross Blue Shield Complaints by State

Browse Horizon Blue Cross Blue Shield Complaints by Category

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This analysis is based on NAIC complaint data and AI interpretation. Not legal, financial, or insurance advice.