HUMANA HEALTH PLAN OF TEXAS, INC. — health Insurance Complaints
Analysis of 3,200 health insurance complaints filed against HUMANA HEALTH PLAN OF TEXAS, INC., based on public NAIC and state DOI data.
Key Statistics
- health Complaints: 3,200
- Total Complaints (All Types): 3,200
- health Share: 100.0%
- NAIC Complaint Ratio: 10.98
- AI Risk Score: 94/100
health Complaint Issues
| Issue Type | Complaints | % of Total |
|---|---|---|
| Claim denial | 851 | 26.6% |
| Delayed payment | 574 | 17.9% |
| Premium or billing dispute | 218 | 6.8% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue | 165 | 5.2% |
| Usual And Customary | Contract Language/Legal Issue | 141 | 4.4% |
| Prompt Pay | Question of Fact; Contract Language/Legal Issue | 79 | 2.5% |
| Prompt Pay | Contract Language/Legal Issue; Question of Fact | 78 | 2.4% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 48 | 1.5% |
| Prompt Pay | Contract Language/Legal Issue; Referred for Disciplinary Actn | 44 | 1.4% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 44 | 1.4% |
| Prompt Pay | Referred for Disciplinary Actn; Contract Language/Legal Issue | 31 | 1.0% |
| Prompt Pay | Contract Language/Legal Issue | 30 | 0.9% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished | 27 | 0.8% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Information Furnished | 21 | 0.7% |
| Prompt Pay; SB418 Rule Violation | Claim Not Clean; Contract Language/Legal Issue | 20 | 0.6% |
| Unsatisfactory Settle/Offer | Information Furnished | 19 | 0.6% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished | 18 | 0.6% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Contract Language/Legal Issue | 17 | 0.5% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue | 16 | 0.5% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 15 | 0.5% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Additional Monies Received | 15 | 0.5% |
| Unsatisfactory Settle/Offer | Company Position Upheld | 14 | 0.4% |
| Provider or network dispute | 13 | 0.4% |
| Unsatisfactory Settle/Offer | No Jurisdiction | 13 | 0.4% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished | 10 | 0.3% |
| Recoupment Of Claims Payment | No Jurisdiction | 10 | 0.3% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 9 | 0.3% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 9 | 0.3% |
| Coverage dispute | 9 | 0.3% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Claim Settled | 9 | 0.3% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Language/Legal Issue | 8 | 0.3% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue; Claim Not Clean | 8 | 0.3% |
| Prompt Pay; SB418 Rule Violation | Question of Fact; Contract Language/Legal Issue | 8 | 0.3% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue; Clean Claims Violation | 8 | 0.3% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 7 | 0.2% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Company Position Upheld | 7 | 0.2% |
| Prompt Pay | Question of Fact; Referred for Disciplinary Actn; Contract Language/Legal Issue | 7 | 0.2% |
| Prompt Pay | Contract Language/Legal Issue; Question of Fact; Referred for Disciplinary Actn | 7 | 0.2% |
| Policy cancellation | 7 | 0.2% |
| Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received | 7 | 0.2% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received | 6 | 0.2% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue | 6 | 0.2% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction | 6 | 0.2% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled | 6 | 0.2% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld | 6 | 0.2% |
| Unsatisfactory Settle/Offer; Usual And Customary | Claim Settled; Contract Language/Legal Issue | 6 | 0.2% |
| Other | Information Furnished | 6 | 0.2% |
| Prompt Pay | Company Position Upheld; Information Furnished | 5 | 0.2% |
| Unsatisfactory Settle/Offer | Additional Monies Received | 5 | 0.2% |
| Coordination of Benefits | Contract Language/Legal Issue | 5 | 0.2% |
| Prompt Pay | Referred for Disciplinary Actn; Contract Language/Legal Issue; Question of Fact | 5 | 0.2% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue | 5 | 0.2% |
| Prompt Pay | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 4 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished; Company Positio | 4 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Company Position Upheld; Contract Language/Leg | 4 | 0.1% |
| Prompt Pay; SB418 Rule Violation | Question of Fact; Referred for Disciplinary Actn; Contract Language/Legal Issue | 4 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction | 4 | 0.1% |
| Prompt Pay; SB418 Rule Violation | Information Furnished; Contract Language/Legal Issue | 4 | 0.1% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue | 4 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received | 4 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Claim Settled | 4 | 0.1% |
| Other | No Jurisdiction | 4 | 0.1% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 3 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Language/Legal Issue; Information F | 3 | 0.1% |
| Access to Care | Information Furnished | 3 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken | 3 | 0.1% |
| Not Within TDI Jurisdiction | No Jurisdiction | 3 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Record Only; Contract Language/Legal Issue | 3 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken; Additional Monies Received | 3 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Company Position Upheld; Information F | 3 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Information Furnished | 3 | 0.1% |
| Prompt Pay; SB418 Rule Violation | Corrective Action Taken; Clean Claims Violation; Stat Pen Pd-46 To 90 Dys Late | 3 | 0.1% |
| Prompt Pay | Claim Not Clean; Contract Language/Legal Issue | 3 | 0.1% |
| Prompt Pay | Question of Fact; Contract Language/Legal Issue; Referred for Disciplinary Actn | 3 | 0.1% |
| Prompt Pay | Contract Language/Legal Issue; Referred for Disciplinary Actn; Question of Fact | 3 | 0.1% |
| Prompt Pay; SB418 Rule Violation | Claim Not Clean | 3 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 3 | 0.1% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 3 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld | 3 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received | 3 | 0.1% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received | 3 | 0.1% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 3 | 0.1% |
| Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received; Corrective Action Taken | 3 | 0.1% |
| Unsatisfactory Settle/Offer | Claim Settled; Corrective Action Taken; Additional Monies Received | 3 | 0.1% |
| Access to Care | No Jurisdiction | 3 | 0.1% |
| Prompt Pay; SB418 Rule Violation | Information Furnished | 3 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 2 | 0.1% |
| Prompt Pay | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 2 | 0.1% |
| Prompt Pay | Corrective Action Taken; Information Furnished; Stat Pen Pd-Over 90 Dys Late | 2 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken; Claim Settled | 2 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Additional Monies Received | 2 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Corrective Action Taken | 2 | 0.1% |
| Prompt Pay | Contract Language/Legal Issue; Additional Monies Received | 2 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Record Only | 2 | 0.1% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Company Position | 2 | 0.1% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 2 | 0.1% |
| Unsatisfactory Settle/Offer | Insufficient Information | 2 | 0.1% |
| Prompt Pay | Corrective Action Taken; Stat Pen Pd-Over 90 Dys Late | 2 | 0.1% |
| Other | Record Only | 2 | 0.1% |
| Prompt Pay; SB418 Rule Violation | Referred for Disciplinary Actn; Contract Language/Legal Issue; Question of Fact | 2 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue | 2 | 0.1% |
| Prompt Pay | Additional Monies Received | 2 | 0.1% |
| Prompt Pay | Referred To; Contract Language/Legal Issue | 2 | 0.1% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue; Question of Fact | 2 | 0.1% |
| Prompt Pay; SB418 Rule Violation | Clean Claims Violation; Contract Language/Legal Issue | 2 | 0.1% |
| Prompt Pay; SB418 Rule Violation | Referred for Disciplinary Actn; Question of Fact; Contract Language/Legal Issue | 2 | 0.1% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Over 90 Dys Late; Corrective Action Taken; Clean Claims Violation | 2 | 0.1% |
| Prompt Pay | Contract Language/Legal Issue; Claim Not Clean | 2 | 0.1% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Claim Not Clean; Contract Language/Legal Issue | 2 | 0.1% |
| Unsatisfactory Settle/Offer | 2 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Contract Language/Legal Issue | 2 | 0.1% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 2 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 2 | 0.1% |
| Prompt Pay; SB418 Rule Violation | Claim Not Clean; Information Furnished | 2 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Additional Monies Received | 2 | 0.1% |
| SB418 Rule Violation; Timely Filing Deficiency | Contract Language/Legal Issue; Information Furnished | 2 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld | 2 | 0.1% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue; Information Furnished | 2 | 0.1% |
| Recoupment Of Claims Payment | Information Furnished; Contract Language/Legal Issue | 2 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; Information Furnished | 2 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Claim Settled | 2 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Claim Settled; Information Furnished | 2 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; No Jurisdiction | 2 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Additional Monies Received | 2 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Information Furnished | 2 | 0.1% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished | 2 | 0.1% |
| Den/N-Pymt MD Nec RX | Contract Language/Legal Issue | 2 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction | 2 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Claim Settled | 2 | 0.1% |
| Coordination of Benefits | Information Furnished | 2 | 0.1% |
| Agent Handling | Information Furnished | 2 | 0.1% |
| Access to Care | Contract Language/Legal Issue; Information Furnished | 2 | 0.1% |
| PPACA-Choice Prim Care/Pediat | No Jurisdiction | 2 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Information Furnished | 2 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction; Additional Monies Received | 2 | 0.1% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received; Information Furnished | 2 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Claim Not Clean; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Maximum Out of Pocket | Corrective Action Taken; Stat Pen Pd-46 To 90 Dys Late; Additional Monies Received | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Company Position Upheld; Claim Not Clean; Information Furnished | 1 | 0.0% |
| Prompt Pay | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Claim Not Clean; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Prompt Pay | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Prompt Pay | Corrective Action Taken; Stat Pen Pd-Over 90 Dys Late; Information Furnished | 1 | 0.0% |
| Prompt Pay | Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Prompt Pay | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Prompt Pay | Stat Pen Pd-Up To 45 Dys Late; Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Prompt Pay | Information Furnished; Stat Pen Pd-46 To 90 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Pediatric Care; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnish | 1 | 0.0% |
| Claim Recoding/Bundling; Pediatric Care | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Stat Pen Pd-Over 90 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Maximum Out of Pocket; Patient Protection Rules; Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment | Corrective Action Taken; Information Furnished; Claim Settle | 1 | 0.0% |
| Prompt Pay | Corrective Action Taken; Stat Pen Pd-46 To 90 Dys Late; Additional Monies Received | 1 | 0.0% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Referred To | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Stat Pen Pd-Up To 45 Dys Late; Information Furnished | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Continuation of Benefits | Referred To; Information Furnished | 1 | 0.0% |
| Essential Health Benefit; Fraud; Unsatisfactory Settle/Offer | Information Furnished; Referred To; Contract Language/Leg | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Referred To; Information Furnished | 1 | 0.0% |
| Not Within TDI Jurisdiction; Other | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished; Additional Moni | 1 | 0.0% |
| Access to Care | Contract Language/Legal Issue | 1 | 0.0% |
| Misrepresentation; Primary Care Providr Selection | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Corrective Action Taken; Additional Monies Received; Contract Language/Legal Issue | 1 | 0.0% |
| Maternity and Newborn Care | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling | Insufficient Information | 1 | 0.0% |
| Timely Filing Deficiency | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Insufficient Information | 1 | 0.0% |
| Den/N-Pymt MD Nec DME/Supplies | Failure to Timely Respond; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| Usual And Customary | Additional Monies Received; Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Additional Monies Received; Information Furn | 1 | 0.0% |
| Usual And Customary | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Corrective Action Taken | 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 | Contract Language/Legal Issue; No Jurisdiction; Corrective Action Tak | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Usual And Customary | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Consumer Withdraw; Information Furnished | 1 | 0.0% |
| Other | Mediation Not Eligible; Additional Payment Expected; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Additional Monies Received; Contract Languag | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Information Furnished; Contract Language/Leg | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Prompt Pay | Contract Language/Legal Issue; Additional Payment Expected; Referred To | 1 | 0.0% |
| Prompt Pay | Question of Fact; Claim Not Clean; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Company Position Upheld | 1 | 0.0% |
| Usual And Customary | Additional Monies Received; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Stat Pen Pd-46 To 90 Dys Late; Clean Claims Violation; Corrective Action Taken | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Claim Not Clean; Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Record Only | 1 | 0.0% |
| Prompt Pay; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Coordination of Benefits | Claim Not Clean; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Stat Pen Pd-Up To 45 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Claim Not Clean | 1 | 0.0% |
| Coordination of Benefits | Clean Claims Violation | 1 | 0.0% |
| Coordination of Benefits; Prompt Pay; SB418 Rule Violation | Claim Not Clean; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Clean Claims Violation; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Claim Not Clean | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Coordination of Benefits; Prompt Pay | Contract Language/Legal Issue; Question of Fact | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Stat Pen Pd-Over 90 Dys L | 1 | 0.0% |
| Coordination of Benefits | Contract Language/Legal Issue; Claim Not Clean | 1 | 0.0% |
| SB418 Rule Violation | Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay | Additional Payment Expected | 1 | 0.0% |
| Prompt Pay | Clean Claims Violation; Corrective Action Taken; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Information Furnished | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Clean Claims Violation; Stat Pen Pd-46 To 90 Dys Late; Additional Payment Expected | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Claim Not Clean; Contract Language/Legal Issue; Question of Fact | 1 | 0.0% |
| Prompt Pay | Contract Language/Legal Issue; Question of Fact; Claim Not Clean | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue; Additional Monies Rece | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Stat Pen Pd-Up To 45 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Referred for Disciplinary Actn; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Corrective Action Taken; Additional Monies Received; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Complaint Withdrawn | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Referred for Disciplinary | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue; Referred for Disciplinary Actn | 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 | Question of Fact; Contract Language/Legal Issue; Claim Not Clean | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Clean Claims Violation | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Overpaid Claim Recouped; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Insufficient Information | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue; Claim Settled; Clean Claims Violation | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Clean Claims Violation | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Clean Claims Violation; Stat Pen Pd-Over 90 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-46 To 90 Dys Late; Claim Settled; Clean Claims Violation | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Stat Pen Pd-46 To 90 Dy | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue; Claim Settled; Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Up To 45 Dys Late; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Over 90 Dys Late; Clean Claims Violation; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-46 To 90 Dys Late; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Over 90 Dys Late; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Corrective Action Taken; Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Prompt Pay | Question of Fact; Contract Language/Legal Issue; Referred To | 1 | 0.0% |
| Continuity of Treatment; Unsatisfactory Settle/Offer | Mediation Not Eligible | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Company Position Upheld; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Additional Monies Received; Claim Not Clean | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Claim Not Clean | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-46 To 90 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue; Claim Not Clean; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Company Position Upheld; Claim Not Clean | 1 | 0.0% |
| Not Within TDI Jurisdiction; Prompt Pay; SB418 Rule Violation | No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Overpaid Claim Recouped; Company Position Upheld | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | No Jurisdiction; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Information Furnished; Contract Language/Legal Issue; Claim Not Clean | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Claim Not Clean; Company Position Upheld | 1 | 0.0% |
| Ambulatory Patient Services; Unsatisfactory Settle/Offer | Claim Settled | 1 | 0.0% |
| Prompt Pay | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Company Position Upheld | 1 | 0.0% |
| SB418 Rule Violation | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Claim Settled; Contract Language/Legal Issue; Additional Mon | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Stat Pen Pd-46 To 90 Dys Late; Addi | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Clean Claims Violation; Stat Pen Pd-Over 90 Dys Late; Co | 1 | 0.0% |
| Prompt Pay | Question of Fact; Information Furnished | 1 | 0.0% |
| Agent Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Contrac | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received; No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Claim Not Clean; Contract Language/Legal Issue; Informat | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Co | 1 | 0.0% |
| Cust Service Claim Handling | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Ambulatory Patient Services; Usual And Customary | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Lan | 1 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld | 1 | 0.0% |
| Hlth Care Svcs Covg/Copay/Lmts; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Overpa | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Information Furnished; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Claim Settled | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Contract Language/Legal Issue; Informatio | 1 | 0.0% |
| Den/N-Pymt MD Nec DME/Supplies | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Information Furnished; Claim Settled | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Overpaid Claim Recouped; Contract Language/Legal Issue; Claim Settled | 1 | 0.0% |
| Coordination of Benefits; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Contract La | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received; Claim Settled | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Claim Settled; Information Furnished; Additional Monies Rece | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Maximum Out of Pocket; Overcharges; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; | 1 | 0.0% |
| Cust Service Claim Handling; PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Information Furnished; Addition | 1 | 0.0% |
| Enrllmt/Canc/Rnwl Of Enrollee | Contract Language/Legal Issue | 1 | 0.0% |
| Agent Handling | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Summary of Benefits; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished | 1 | 0.0% |
| Other | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Policy Not In Force; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Continuity of Treatment; Notice Requirements | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Mediation Billed Amount; Policy Not In Force | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Failure to Timely Respond; Claim Settled; Additional Monies Received | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment | Overpaid Claim Recouped; Contract Language/Legal Issue | 1 | 0.0% |
| Claims Reimb/Bal Bill Problems; PPACA-Out-Of-Ntwk Emerg Care; Pediatric Care; Unsatisfactory Settle/Offer | Mediation Bi | 1 | 0.0% |
| Access to Care; Identification Card Issue | No Jurisdiction | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Info | 1 | 0.0% |
| Material Change To Contract | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Contract Language/Legal Issue; Additional Mo | 1 | 0.0% |
| Material Change To Contract | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Access to Care | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Overpaid Claim Recouped; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Claim Settled | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Claim Not Clean; Contract Language/Legal Issue | 1 | 0.0% |
| Disclosure Of Benefits | Information Furnished | 1 | 0.0% |
| Disclosure Of Benefits; Material Change To Contract; Misrepresentation | Company Position Upheld; Contract Language/Lega | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Laboratory Services; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Company Positio | 1 | 0.0% |
| Continuity of Treatment | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Disclosure Of Benefits; Material Change To Contract; Other; Other | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Company Position Upheld | 1 | 0.0% |
| Claims Reimb/Bal Bill Problems; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Rehabilitative/habilitative ; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Contrac | 1 | 0.0% |
| Coordination of Benefits; Maternity and Newborn Care | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Liability Dispute; Lifetime/Annual Limits; Maximum Out of Pocket; Misrepresentation; Overcharges; Unsatisfactory Settle/ | 1 | 0.0% |
| SB418 Rule Violation; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Claim Not Clean; Information Furnished; Co | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; SB418 Rule Violation; Unsatisfactory Settle/Offer | Claim Not Clean; Additional Monies Rec | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Claim Not Clean | 1 | 0.0% |
| Claims Reimb/Bal Bill Problems; Hlth Care Svcs Covg/Copay/Lmts | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Claims Reimb/Bal Bill Problems | Claim Settled; Additional Monies Received | 1 | 0.0% |
| SB418 Rule Violation; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Information Furnished; Claim Not Clean; Co | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Question of Fact | 1 | 0.0% |
| Disclosure Of Benefits | Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Access to Care; Continuity of Treatment; Den/N-Pymt MD Nec RX | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Claims Reimb/Bal Bill Problems; Hlth Care Svcs Covg/Copay/Lmts; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| Primary Care Providr Selection | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Access to Care; Continuity of Treatment | No Jurisdiction | 1 | 0.0% |
| Primary Care Providr Selection | Information Furnished | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Disclosure Of Benefits; Material Change To Contract | Contract Language/Legal Issue | 1 | 0.0% |
| Hlth Care Svcs Covg/Copay/Lmts | No Jurisdiction | 1 | 0.0% |
| Continuity Of Treatment | No Jurisdiction | 1 | 0.0% |
| Access to Care; Continuity of Treatment; Cust Service Claim Handling | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; Contract Language/Legal Issue | 1 | 0.0% |
| Other | Other; Information Furnished | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| Access to Care; Continuity of Treatment | Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Claim Not Clean; Information Furnished | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; SB418 Rule Violation | Additional Monies Received; Information Furnished | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-46 To 90 Dys Late; Additional Monies Received | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Misrepresentation; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Claims Reimb/Bal Bill Problems | Additional Payment Expected; Information Furnished | 1 | 0.0% |
| Coordination of Benefits; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Agent Handling; Misrepresentation | No Jurisdiction | 1 | 0.0% |
| Other | Policy Not In Force; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Insufficient Information | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg | Additional Monies Received | 1 | 0.0% |
| SB418 Rule Violation | Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issu | 1 | 0.0% |
| Refusal to Insure | Contract Language/Legal Issue; Policy Not In Force | 1 | 0.0% |
| Den/N-Pymt MD Nec DME/Supplies | Claim Settled; Additional Monies Received | 1 | 0.0% |
| Overcharges | Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received; No Jurisdi | 1 | 0.0% |
| Coordination of Benefits; Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Overpaid Claim Recouped; Policy Not In Force | 1 | 0.0% |
| Cust Service Claim Handling; Unfair Discrim-Clms Handling | No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Claim Not Clean | 1 | 0.0% |
| Recoupment Of Claims Payment; SB418 Rule Violation | No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment | Information Furnished; Additional Monies Received | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Additional Monies Received; Informatio | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Additional Monies Received | 1 | 0.0% |
| Coordination of Benefits | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| SB418 Rule Violation | Corrective Action Taken | 1 | 0.0% |
| Not Within TDI Jurisdiction | Clean Claims Violation | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Claim Not Clean | 1 | 0.0% |
| URA Failed To Abide By IRO Dec | Information Furnished | 1 | 0.0% |
| Overcharges | Claim Settled | 1 | 0.0% |
| Prompt Pay | Claim Not Clean; Information Furnished | 1 | 0.0% |
| Other | No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Stat Pen Pd-Up To 45 Dys Late; Additional Monies Received | 1 | 0.0% |
| SB418 Rule Violation | Information Furnished | 1 | 0.0% |
| Misrepresentation | Information Furnished | 1 | 0.0% |
| IRO Compnsblty/Extent Decision | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Not Within TDI Jurisdiction | No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| SB418 Rule Violation | Information Furnished; Claim Not Clean | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Additional Payment Expected | 1 | 0.0% |
| Recoupment Of Claims Payment | Additional Monies Received; Information Furnished; No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer; XX-Recoupment | Contract Language/Legal Issue; Information Fur | 1 | 0.0% |
health Complaints by State
| State | Complaints |
|---|---|
| Texas | 3,200 |
Recent health Complaints Against HUMANA HEALTH PLAN OF TEXAS, INC.
- health Complaint #TX-437292-b2c582a9 — Texas (2025-10-16)
- health Complaint #TX-424905-a84555fb — Texas (2025-05-28)
- health Complaint #TX-424850-b2c582a9 — Texas (2025-05-28)
- health Complaint #TX-422223-b2c582a9 — Texas (2025-04-28)
- health Complaint #TX-422208-afee0233 — Texas (2025-04-28)
- health Complaint #TX-422206-b2c582a9 — Texas (2025-04-28)
- health Complaint #TX-420670-afee0233 — Texas (2025-04-09)
- health Complaint #TX-420662-afee0233 — Texas (2025-04-09)
- health Complaint #TX-419547-21bb8296 — Texas (2025-03-27)
- health Complaint #TX-419315-21bb8296 — Texas (2025-03-25)
Frequently Asked Questions
How many health complaints does HUMANA HEALTH PLAN OF TEXAS, INC. have?
HUMANA HEALTH PLAN OF TEXAS, INC. has 3200 health insurance complaints on file, according to NAIC and state DOI data.
What are the most common health complaint issues with HUMANA HEALTH PLAN OF TEXAS, INC.?
The most common health complaint issues for HUMANA HEALTH PLAN OF TEXAS, INC. are: Claim denial (851), Delayed payment (574), Premium or billing dispute (218), Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue (165), Usual And Customary | Contract Language/Legal Issue (141).
Which states have the most health complaints against HUMANA HEALTH PLAN OF TEXAS, INC.?
The states with the most health complaints against HUMANA HEALTH PLAN OF TEXAS, INC. are: Texas (3200).
health Complaints by State
HUMANA HEALTH PLAN OF TEXAS, INC. Complaints by State
- HUMANA HEALTH PLAN OF TEXAS, INC. Complaints in California
- HUMANA HEALTH PLAN OF TEXAS, INC. Complaints in Texas
- HUMANA HEALTH PLAN OF TEXAS, INC. Complaints in New York
- HUMANA HEALTH PLAN OF TEXAS, INC. Complaints in Florida
- HUMANA HEALTH PLAN OF TEXAS, INC. Complaints in Illinois
- HUMANA HEALTH PLAN OF TEXAS, INC. Complaints in Pennsylvania
- HUMANA HEALTH PLAN OF TEXAS, INC. Complaints in Ohio
- HUMANA HEALTH PLAN OF TEXAS, INC. Complaints in Georgia
- HUMANA HEALTH PLAN OF TEXAS, INC. Complaints in North Carolina
- HUMANA HEALTH PLAN OF TEXAS, INC. Complaints in New Jersey