HUMANA INSURANCE COMPANY — health Insurance Complaints
Analysis of 4,193 health insurance complaints filed against HUMANA INSURANCE COMPANY, based on public NAIC and state DOI data.
Key Statistics
- health Complaints: 4,193
- Total Complaints (All Types): 4,206
- health Share: 99.7%
- NAIC Complaint Ratio: 2.14
- AI Risk Score: 83/100
health Complaint Issues
| Issue Type | Complaints | % of Total |
|---|---|---|
| Claim denial | 1,402 | 33.4% |
| Delayed payment | 875 | 20.9% |
| Premium or billing dispute | 397 | 9.5% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue | 159 | 3.8% |
| Usual And Customary | Contract Language/Legal Issue | 124 | 3.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 88 | 2.1% |
| Unsatisfactory Settle/Offer | No Jurisdiction | 83 | 2.0% |
| Policy cancellation | 64 | 1.5% |
| Coverage dispute | 26 | 0.6% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction | 24 | 0.6% |
| Unsatisfactory Settle/Offer | Additional Monies Received | 20 | 0.5% |
| Prompt Pay | Contract Language/Legal Issue; Question of Fact | 20 | 0.5% |
| Prompt Pay | Question of Fact; Contract Language/Legal Issue | 20 | 0.5% |
| Recoupment Of Claims Payment | No Jurisdiction | 19 | 0.5% |
| Unsatisfactory Settle/Offer | Information Furnished | 18 | 0.4% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Language/Legal Issue | 17 | 0.4% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 16 | 0.4% |
| Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction | 14 | 0.3% |
| Other | Information Furnished | 13 | 0.3% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished | 12 | 0.3% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished | 11 | 0.3% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received | 11 | 0.3% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld | 11 | 0.3% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue | 10 | 0.2% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received | 10 | 0.2% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 9 | 0.2% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Contract Language/Legal Issue | 9 | 0.2% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Company Position Upheld | 9 | 0.2% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction | 9 | 0.2% |
| Not Within TDI Jurisdiction | No Jurisdiction | 9 | 0.2% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 9 | 0.2% |
| Unsatisfactory Settle/Offer | Insufficient Information | 8 | 0.2% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 8 | 0.2% |
| Prompt Pay | Contract Language/Legal Issue; Referred for Disciplinary Actn | 8 | 0.2% |
| Prompt Pay | Contract Language/Legal Issue | 8 | 0.2% |
| Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction | 8 | 0.2% |
| Prompt Pay | Referred for Disciplinary Actn; Contract Language/Legal Issue | 7 | 0.2% |
| Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received | 7 | 0.2% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 7 | 0.2% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld | 6 | 0.1% |
| Misleading sales | 5 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 5 | 0.1% |
| Other | Contract Language/Legal Issue | 5 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished | 5 | 0.1% |
| Unsatisfactory Settle/Offer | Company Position Upheld | 5 | 0.1% |
| Misrepresentation | No Jurisdiction | 5 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken | 4 | 0.1% |
| Cust Service Claim Handling | No Jurisdiction | 4 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Information Furnished; Contract Language/Leg | 4 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Contract Language/Legal Issue | 4 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 4 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled | 4 | 0.1% |
| Other | No Jurisdiction | 4 | 0.1% |
| Claim Procedure | Claim Handling | 3 | 0.1% |
| Prompt Pay | Stat Pen Pd-46 To 90 Dys Late | 3 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished | 3 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 3 | 0.1% |
| Recoupment Of Claims Payment | Information Furnished | 3 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Additional Monies Received | 3 | 0.1% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue | 3 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken | 3 | 0.1% |
| Agent Handling | No Jurisdiction | 3 | 0.1% |
| Other | Record Only | 3 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received | 3 | 0.1% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue | 3 | 0.1% |
| Unsatisfactory Settle/Offer | 3 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; No Jurisdiction | 3 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Claim Settled | 3 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 3 | 0.1% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Information Furnished | 3 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 3 | 0.1% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Additional Payment Expected | 3 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction | 3 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received; Information Furnished | 3 | 0.1% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished | 3 | 0.1% |
| Unsatisfactory Settle/Offer | Other | 3 | 0.1% |
| Other | Insufficient Information | 3 | 0.1% |
| Other | Information Furnished; Contract Language/Legal Issue | 3 | 0.1% |
| Den/N-Pymt MD Nec RX | Contract Language/Legal Issue | 3 | 0.1% |
| Misrepresentation | Contract Language/Legal Issue | 3 | 0.1% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished | 3 | 0.1% |
| Misrepresentation | Information Furnished | 3 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled; Additional Monies Received | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Contract Language/Legal Issue | 2 | 0.0% |
| Prompt Pay | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 2 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Referred To | 2 | 0.0% |
| Other | Corrective Action Taken | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Language/Legal Issue; Information F | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Corrective Action Taken | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Insufficient Information; Record Only | 2 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken; Additional Monies Received | 2 | 0.0% |
| Provider or network dispute | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Company Position Upheld; Contract Language/Leg | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished; Company Positio | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Company Position Upheld; Information F | 2 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Claim Not Clean; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Contract Language/Legal Issue; Corrective | 2 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | No Jurisdiction | 2 | 0.0% |
| Coordination of Benefits; Usual And Customary | Contract Language/Legal Issue | 2 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | No Jurisdiction | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue; Question of Fact | 2 | 0.0% |
| Prompt Pay | Question of Fact; Referred for Disciplinary Actn; Contract Language/Legal Issue | 2 | 0.0% |
| Prompt Pay | Question of Fact; Contract Language/Legal Issue; Referred for Disciplinary Actn | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Question of Fact; Contract Language/Legal Issue; Referred for Disciplinary Actn | 2 | 0.0% |
| Prompt Pay | Referred for Disciplinary Actn; Contract Language/Legal Issue; Question of Fact | 2 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue; Claim Not Clean | 2 | 0.0% |
| Prompt Pay | Claim Not Clean; Contract Language/Legal Issue | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Claim Not Clean; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Claim Settled; Contract Language/Legal Issue | 2 | 0.0% |
| Closed-Lack Of Info Cmplainant; Unsatisfactory Settle/Offer; Usual And Customary | Insufficient Information | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Additional Monies Received | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue | 2 | 0.0% |
| Recoupment Of Claims Payment; SB418 Rule Violation | No Jurisdiction | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Payment Expected; No Jurisdiction | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction | 2 | 0.0% |
| Coordination of Benefits; Recoupment Of Claims Payment | Information Furnished; No Jurisdiction | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received; Information Furnished | 2 | 0.0% |
| Coordination of Benefits; Recoupment Of Claims Payment | No Jurisdiction | 2 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Additional Monies Received | 2 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Not Clean; Contract Language/Legal Issue; Additional Monies Received | 2 | 0.0% |
| Recoupment Of Claims Payment | No Jurisdiction; Additional Monies Received | 2 | 0.0% |
| Agent Handling; Misrepresentation | No Jurisdiction | 2 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Claim Not Clean | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Not Clean | 2 | 0.0% |
| SB418 Rule Violation | Information Furnished; Company Position Upheld | 2 | 0.0% |
| Refusal to Insure | Contract Language/Legal Issue | 2 | 0.0% |
| Refusal to Insure | Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received; Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled | 2 | 0.0% |
| Recoupment Of Claims Payment | Additional Monies Received | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received; No Jurisdiction | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Record Only | 2 | 0.0% |
| Cust Srvc Policy Holder Srvcs | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Misrepresentation | Claim Settled; Additional Monies Received; Information Furnished | 1 | 0.0% |
| Unfair settlement | 1 | 0.0% |
| Cust Service Claim Handling; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Lang | 1 | 0.0% |
| Commissions; Cust Srvc Policy Holder Srvcs | Referred To; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Other | Information Furnished; Referred To; Insufficient Information | 1 | 0.0% |
| Prompt Pay | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Prompt Pay | Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Cust Service Claim Handling; Prompt Pay; Timely Filing Deficiency | Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Referred To | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Information Furnished; Claim Settled | 1 | 0.0% |
| Other | 1 | 0.0% |
| Bad Faith Participation | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Coordination of Benefits; Recoupment Of Claims Payment | Company Position Upheld; Information Furnished; Contract Langua | 1 | 0.0% |
| Prompt Pay | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Assignment of Benefits; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Claim Settled | 1 | 0.0% |
| Assignment of Benefits | Claim Settled; Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Coordination of Benefits; Recoupment Of Claims Payment | Claim Settled; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Corrective | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Stat Pen Pd-Up To 45 Dys | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Referred To; No Jurisdiction | 1 | 0.0% |
| Coordination of Benefits; Prompt Pay; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Claim Settled; No Juri | 1 | 0.0% |
| Access to Care; Continuity of Treatment | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Additional Monies Received; Stat Pen Pd-Up T | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Referred To; No Jurisdiction | 1 | 0.0% |
| Not Within TDI Jurisdiction; Other | Record Only; No Jurisdiction | 1 | 0.0% |
| Other | Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Record Only | 1 | 0.0% |
| Essential Health Benefit | No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Essential Health Benefit; Fraud; Unsatisfactory Settle/Offer | Referred To; Contract Language/Legal Issue | 1 | 0.0% |
| Access to Care | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Access to Care | Contract Language/Legal Issue | 1 | 0.0% |
| Misrepresentation | Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Cust Service Claim Handling | Information Furnished | 1 | 0.0% |
| Access to Care | No Jurisdiction; Referred To; Information Furnished | 1 | 0.0% |
| Access to Care | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Not Within TDI Jurisdiction | Information Furnished; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Commissions | Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Referred To; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Claim Settled; Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment | No Jurisdiction; Information Furnished; Referred To | 1 | 0.0% |
| Recoupment Of Claims Payment | Referred To; No Jurisdiction; Information Furnished | 1 | 0.0% |
| Misrepresentation | Referred To; No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Contract Language/Legal Issue; Additional Moni | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Other | Complaint Withdrawn | 1 | 0.0% |
| Assignment of Benefits; Cust Service Claim Handling | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Timely Filing Deficiency | Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Cust Service Claim Handling | Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Other | Additional Monies Received; Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Record Only | 1 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Other | Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Disclosure Of Benefits; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received | 1 | 0.0% |
| Unfair Discrim-Clms Handling; Usual And Customary | Contract Language/Legal Issue | 1 | 0.0% |
| Language Access; Other | Information Furnished | 1 | 0.0% |
| Access to Care; Mental Health Parity | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; No Jurisdiction; Corrective Action Tak | 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 | Insufficient Information; Record Only | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Contract Language/Legal Issue; Additional Mo | 1 | 0.0% |
| Claimant Fraud; Unsatisfactory Settle/Offer | Mediation Paid Amount; Mediation Billed Amount | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Insufficient Information | 1 | 0.0% |
| Unfair Discrim-Clms Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Agent/Agency Contrct Termin | Contract Language/Legal Issue | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 1 | 0.0% |
| Cust Service Claim Handling | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Prompt Pay | Contract Language/Legal Issue; Referred for Disciplinary Actn; Question of Fact | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Additional Monies Received; Corrective | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Paid Amount; Mediation Billed Amount | 1 | 0.0% |
| Prompt Pay | Contract Language/Legal Issue; Question of Fact; Referred for Disciplinary Actn | 1 | 0.0% |
| Prompt Pay | Corrective Action Taken | 1 | 0.0% |
| Closed-Lack Of Info Cmplainant | Other | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Referred for Disciplinary Actn; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Company Position Upheld | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue; Addi | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-46 To 90 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment | Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Stat Pen Pd-Over 90 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | Referred for Disciplinary Actn; Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Referred for Disciplin | 1 | 0.0% |
| Prompt Pay | Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Clean Claims Violation; Contract Language/Legal Issue | 1 | 0.0% |
| Closed-Lack Of Info Cmplainant; Den/N-Pymt MD Nec RX; Other | Record Only | 1 | 0.0% |
| Prompt Pay | 1 | 0.0% |
| Recoupment Of Claims Payment | Additional Monies Received; No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Overpaid Claim Recouped; Contract Language/Legal Issue; Comp | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue; Claim Settled | 1 | 0.0% |
| Ambulatory Patient Services; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay | No Jurisdiction | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Company Position Upheld | 1 | 0.0% |
| Closed-Lack Of Info Cmplainant; Cust Service Claim Handling | Insufficient Information | 1 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; No Jurisd | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Referred To | 1 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction | 1 | 0.0% |
| Continuity of Treatment; Cust Service Claim Handling | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Question of Fact | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Insufficient Information | 1 | 0.0% |
| Assignment of Benefits; Cust Service Claim Handling | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Closed-Lack Of Info Cmplainant | Insufficient Information | 1 | 0.0% |
| Prompt Pay | Additional Monies Received; Stat Pen Pd-Up To 45 Dys Late; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Den/N-Pymt MD Nec DME/Supplies | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment | Additional Monies Received; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Referred for Disciplinary Actn; Information Furnished | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; I | 1 | 0.0% |
| Overcharges; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld; Policy Not In Force; Information Fu | 1 | 0.0% |
| Cust Service Claim Handling; Overcharges; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Ambulatory Patient Services; Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Langua | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Cust Service Claim Handling; Disclosure Of Benefits; Unsatisfactory Settle/Offer | Additional Monies Received; Claim Set | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Referred To; Contract Language/Legal Issue | 1 | 0.0% |
| Fraud; Unfair Discrim-Clms Handling | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Company Position Upheld | 1 | 0.0% |
| Agent Handling; Misrepresentation | Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Additional Payment Expected | 1 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Additional Monies Received; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Cust Service Claim Handling; Overcharges | Additional Monies Received; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Insufficient Information; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Overpaid Claim Recouped | 1 | 0.0% |
| Cust Service Claim Handling | Corrective Action Taken; No Jurisdiction | 1 | 0.0% |
| Access to Care; Continuity of Treatment; Den/N-Pymt MD Nec RX | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Closed-Lack Of Info Cmplainant; Continuity Of Treatment | Insufficient Information | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled; Additional Payment Expected | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Additional Payment Expected | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Overpaid Claim Recouped; No Jurisdictio | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Payment Expected | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Overpaid Claim Recouped | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Disclosure Of Benefits; Material Change To Contract | Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction; Information Furnished | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished; Claim Not Clean | 1 | 0.0% |
| Material Change To Contract; Unsatisfactory Settle/Offer | Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction; Additional Monies Re | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Mediation Paid Amount; Mediation Billed Amount | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Record Only; Information Furnished | 1 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer | Company Position Upheld; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; Corrective Action Taken | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Pediatric Care; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furn | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Referred To | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| PPACA-Preventive Health Svcs; Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled; Corrective Action | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Compan | 1 | 0.0% |
| Cust Service Claim Handling; Laboratory Services; Other; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; In | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | No Jurisdiction; Insufficient Information | 1 | 0.0% |
| Closed-Lack Of Info Cmplainant; Other | Insufficient Information | 1 | 0.0% |
| Other; Unsatisfactory Settle/Offer | Complainant Retained Attorney; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Claim Settled | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Claim Settled | 1 | 0.0% |
| Fraud; Other | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; No Jurisdiction | 1 | 0.0% |
| Den/N-Pymt MD Nec DME/Supplies | No Jurisdiction; Additional Monies Received; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Overpaid Claim Recouped; Company Position U | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Claim Settle | 1 | 0.0% |
| Liability Dispute; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Contract Language/Le | 1 | 0.0% |
| Prompt Pay | Information Furnished; Claim Not Clean | 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 | Information Furnished; Additional Monies Received; Contract | 1 | 0.0% |
| Disclosure Of Benefits; Material Change To Contract | Information Furnished | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Cust Service Claim Handling; Disclosure Of Benefits; Material Change To Contract; Unsatisfactory Settle/Offer | No Juris | 1 | 0.0% |
| Disclosure Of Benefits; Material Change To Contract | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; No Jurisdiction | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received; Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment | Information Furnished | 1 | 0.0% |
| Hospitalization; PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Re | 1 | 0.0% |
| Primary Care Providr Selection | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Insufficient Information; Additional Monies Received | 1 | 0.0% |
| Agent Handling; Disclosure Of Benefits | Contract Language/Legal Issue; Policy Issued/Restored | 1 | 0.0% |
| Continuity Of Treatment; Den/N-Pymt MD Nec RX | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Additional Monies Received | 1 | 0.0% |
| Coordination of Benefits; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received; Claim Settled | 1 | 0.0% |
| Refusal to Insure | No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Overcharges; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Claim Settled | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled; Contract Language | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Contract Languag | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; No Jurisdiction | 1 | 0.0% |
| Overcharges | Other | 1 | 0.0% |
| Recoupment Of Claims Payment | Question of Fact; Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished; Additional Moni | 1 | 0.0% |
| Material Change To Contract; Other | Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment | No Jurisdiction | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Claim Not Clean | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Clean Claims Violation; Stat Pen Pd-Up To 45 Dys Late | 1 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Overpaid Claim Recouped | 1 | 0.0% |
| Pre-Existing Condition; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Identification Card Issue | Question of Fact | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Claim Not Clean | 1 | 0.0% |
| Den/N-Pymt MD Nec RX; Mdcare Pt D RX Drg "DNut Hole"; Not Within TDI Jurisdiction | No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Additional Monies Received | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Information Furnished; Claim Not Clean | 1 | 0.0% |
| Cust Service Claim Handling | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Clean Claims Violation; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received; Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Den/N-Pymt MD Nec RX | No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Refusal to Insure | Company Position Upheld; Information Furnished | 1 | 0.0% |
| SB418 Rule Violation | Claim Not Clean; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment | Clean Claims Violation; Stat Pen Pd-Over 90 Dys Late; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Contract Language/Legal Issue; Additional Monies Received | 1 | 0.0% |
| Other | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Disclosure Of Benefits | Contract Language/Legal Issue | 1 | 0.0% |
| Overcharges | No Jurisdiction | 1 | 0.0% |
| Overcharges | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Den/N-Pymt MD Nec RX; Misrepresentation | Contract Language/Legal Issue | 1 | 0.0% |
| Coordination of Benefits; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Agent Handling; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Insufficient Information; Claim Not Clean | 1 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Claim Settled | 1 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Claim Settled | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Claim Settled | 1 | 0.0% |
| Disclosure Of Benefits; Material Change To Contract; Misrepresentation | No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Claim Not Clean; Information Furnished | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| Refusal to Insure | Policy Not In Force; Contract Language/Legal Issue | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg; SB418 Rule Violation; Unsatisfactory Settle/Offer; Usual And Customary | Contract Languag | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Claim Not Clean; Additional Monies Received | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Monies Received; No Juri | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received; Claim Set | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Clean Claims Violation; Additional Monies Received; Stat | 1 | 0.0% |
| Refusal to Insure | Contract Language/Legal Issue; Policy Not In Force | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Claim Not Clean | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Claim Not Clean | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment; SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken | 1 | 0.0% |
| Pre-Existing Condition | Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment | Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Access to Care; Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction; Additional Payment Expected | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Claim Settled | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Claim Settled | 1 | 0.0% |
| Recoupment Of Claims Payment | Corrective Action Taken | 1 | 0.0% |
| Coordination of Benefits; Deficient Claim Notice; SB418 Rule Violation | No Jurisdiction; Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment; SB418 Rule Violation | Claim Settled; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Additional Payment Expected | 1 | 0.0% |
| Refusal to Insure | Policy Not In Force; Company Position Upheld; Information Furnished | 1 | 0.0% |
| Agent/Agency Contrct Termin | Contract Language/Legal Issue; Information Furnished; No Jurisdiction | 1 | 0.0% |
| Identification Card Issue | Information Furnished | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | No Jurisdiction | 1 | 0.0% |
| Prohibited PHI Disclosure | Contract Language/Legal Issue; Other | 1 | 0.0% |
| Refusal to Insure | Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Clean Claims Violation; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Claim Settled | 1 | 0.0% |
| Agent Handling; Misrepresentation | Information Furnished; Other | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling | Insufficient Information | 1 | 0.0% |
| Post-Claim Underwriting; Refusal to Insure | Contract Language/Legal Issue | 1 | 0.0% |
| SB418 Rule Violation; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-Ov | 1 | 0.0% |
| Agent Handling | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Information Furnished | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished; Additional Monies Rec | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Additional Monies | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished; Claim Not Clean; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Failure to Timely Respond; Additional Monies Received | 1 | 0.0% |
| Access to Care | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Continuity Of Treatment | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Access to Care | Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Additional Monies Received; Failure to Timely Respond; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; Information Furnished; No Jurisdiction | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment | Claim Settled; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Clean Claims Violation | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Claim Settled | 1 | 0.0% |
| Other | Company Position Upheld; Policy Not In Force | 1 | 0.0% |
| Recoupment Of Claims Payment | Overpaid Claim Recouped; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Clean Claims Violation; Additional Monies Received; Claim Not Clean | 1 | 0.0% |
| SB418 Rule Violation; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Claim Not Clean | 1 | 0.0% |
| Endorsement / Rider | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; No Jurisdiction | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Not Clean; Information Furnished; Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment | Additional Payment Expected | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Information Furnished | 1 | 0.0% |
| SB418 Rule Violation; Timely Filing Deficiency | Clean Claims Violation; Information Furnished | 1 | 0.0% |
| SB418 Rule Violation | Claim Not Clean; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Clean Claims Violation | 1 | 0.0% |
| Not Within TDI Jurisdiction | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Clean Claims Violation; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Not Clean; Information Furnished | 1 | 0.0% |
| Endorsement / Rider | Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Claim Not Clean | 1 | 0.0% |
| Coordination of Benefits; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Advertising Withdrawn/Amended | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment | Additional Monies Received; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Insufficient Information; Contract Language/Legal Issue; Info | 1 | 0.0% |
| Cust Service Claim Handling | Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Post-Claim Underwriting | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Insufficient Information; Additional Monies Received; Contract Language/Legal Issue | 1 | 0.0% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
health Complaints by State
| State | Complaints |
|---|---|
| Texas | 4,181 |
| Connecticut | 12 |
Recent health Complaints Against HUMANA INSURANCE COMPANY
- health Complaint #TX-455092-c9130fcd — Texas (2026-04-29)
- health Complaint #TX-453603-0d0007e9 — Texas (2026-04-15)
- health Complaint #TX-453507-c9130fcd — Texas (2026-04-14)
- health Complaint #TX-452692-1f33d68e — Texas (2026-04-06)
- health Complaint #CT-7084270-5f560b69 — Connecticut (2026-03-31)
- health Complaint #TX-450336-56fdda95 — Texas (2026-03-16)
- health Complaint #TX-449244-ca1a02c3 — Texas (2026-03-04)
- health Complaint #TX-448648-1f33d68e — Texas (2026-02-25)
- health Complaint #TX-448211-05d3e237 — Texas (2026-02-20)
- health Complaint #TX-448082-ca1a02c3 — Texas (2026-02-19)
Frequently Asked Questions
How many health complaints does HUMANA INSURANCE COMPANY have?
HUMANA INSURANCE COMPANY has 4193 health insurance complaints on file, according to NAIC and state DOI data.
What are the most common health complaint issues with HUMANA INSURANCE COMPANY?
The most common health complaint issues for HUMANA INSURANCE COMPANY are: Claim denial (1402), Delayed payment (875), Premium or billing dispute (397), Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue (159), Usual And Customary | Contract Language/Legal Issue (124).
Which states have the most health complaints against HUMANA INSURANCE COMPANY?
The states with the most health complaints against HUMANA INSURANCE COMPANY are: Texas (4181), Connecticut (12).
health Complaints by State
HUMANA INSURANCE COMPANY Complaints by State
- HUMANA INSURANCE COMPANY Complaints in California
- HUMANA INSURANCE COMPANY Complaints in Texas
- HUMANA INSURANCE COMPANY Complaints in New York
- HUMANA INSURANCE COMPANY Complaints in Florida
- HUMANA INSURANCE COMPANY Complaints in Illinois
- HUMANA INSURANCE COMPANY Complaints in Pennsylvania
- HUMANA INSURANCE COMPANY Complaints in Ohio
- HUMANA INSURANCE COMPANY Complaints in Georgia
- HUMANA INSURANCE COMPANY Complaints in North Carolina
- HUMANA INSURANCE COMPANY Complaints in New Jersey