InsuranceComplaintCheck

METROPOLITAN LIFE INSURANCE COMPANY — health Insurance Complaints

Analysis of 1,722 health insurance complaints filed against METROPOLITAN LIFE INSURANCE COMPANY, based on public NAIC and state DOI data.

Key Statistics

  • health Complaints: 1,722
  • Total Complaints (All Types): 1,858
  • health Share: 92.7%
  • NAIC Complaint Ratio: 0.5
  • AI Risk Score: 53/100

health Complaint Issues

Issue TypeComplaints% of Total
Delayed payment70240.8%
Claim denial54731.8%
Premium or billing dispute1046.0%
Unsatisfactory Settle/Offer | No Jurisdiction291.7%
Policy cancellation181.0%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue120.7%
Cash Value | Information Furnished80.5%
Unfair settlement70.4%
Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction70.4%
Recoupment Of Claims Payment | No Jurisdiction70.4%
Cash Value | Contract Language/Legal Issue70.4%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished60.3%
Provider or network dispute40.2%
Coverage dispute40.2%
Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue40.2%
Not Within TDI Jurisdiction | No Jurisdiction40.2%
Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received40.2%
Cash Value | Information Furnished; Contract Language/Legal Issue30.2%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue30.2%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue30.2%
Coordination of Benefits | No Jurisdiction30.2%
Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue30.2%
Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction30.2%
Other | Contract Language/Legal Issue30.2%
Unsatisfactory Settle/Offer | Additional Monies Received30.2%
Coordination of Benefits; Unsatisfactory Settle/Offer | Contract Language/Legal Issue30.2%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Lang20.1%
Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Language/Legal Issue20.1%
Claim Handling Other | Claim Handling | Company Position Substantiated20.1%
Recoupment Of Claims Payment | Company Position Upheld; Information Furnished20.1%
Unsatisfactory Settle/Offer | Referred To; No Jurisdiction20.1%
Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Referred To; Information Furnished20.1%
Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer | No Jurisdiction20.1%
Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue20.1%
Unsatisfactory Settle/Offer | Insufficient Information20.1%
Cust Service Claim Handling | Contract Language/Legal Issue20.1%
Recoupment Of Claims Payment | Contract Language/Legal Issue20.1%
Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; No Jurisdiction20.1%
Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled20.1%
Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction; Information Furnished20.1%
Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction20.1%
Den/N-Pymt MD Nec Trmt N-Emrg | No Jurisdiction20.1%
Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction20.1%
Cash Value | Contract Language/Legal Issue; Information Furnished20.1%
Cust Service Claim Handling | Company Position Upheld; Contract Language/Legal Issue; Information Furnished10.1%
Cust Service Claim Handling | Contract Language/Legal Issue; Information Furnished; Company Position Upheld10.1%
Cash Value; Cust Srvc Policy Holder Srvcs | Company Position Upheld; Policy Not In Force; Contract Language/Legal Issue10.1%
Cust Srvc Policy Holder Srvcs; Material Change To Contract | Referred To; Company Position Upheld; Contract Language/Leg10.1%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken; Information Furnished10.1%
Recoupment Of Claims Payment | Company Position Upheld; Policy Not In Force; Information Furnished10.1%
Recoupment Of Claims Payment | Information Furnished; Contract Language/Legal Issue; Company Position Upheld10.1%
Misrepresentation | Company Position Upheld; Information Furnished10.1%
Maternity and Newborn Care; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Informati10.1%
Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Information Furnished10.1%
Claim Handling Other | Claim Handling10.1%
Cash Value | Contract Language/Legal Issue; Company Position Upheld; Information Furnished10.1%
Cust Srvc Policy Holder Srvcs | Claim Settled; Information Furnished; Failure to Timely Respond10.1%
Coordination of Benefits; Maximum Out of Pocket | Contract Language/Legal Issue; Corrective Action Taken; Company Positi10.1%
Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received; Corrective Action Taken10.1%
Cust Srvc Policy Holder Srvcs | Information Furnished; Company Position Upheld; Contract Language/Legal Issue10.1%
Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Information Furnished10.1%
Other; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Corrective Action Taken10.1%
Claim Procedure | Claim Handling10.1%
Cust Srvc Policy Holder Srvcs; Misrepresentation | Company Position Upheld; Information Furnished; Contract Language/Leg10.1%
Cash Value; Cust Srvc Policy Holder Srvcs | Contract Language/Legal Issue; Information Furnished; Company Position Uphel10.1%
Cust Srvc Policy Holder Srvcs | Contract Language/Legal Issue; Information Furnished10.1%
Unprofessional Conduct | PolicyHolder Service10.1%
Cust Srvc Policy Holder Srvcs | Corrective Action Taken; Information Furnished10.1%
Fraud | Information Furnished; Referred To10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Additional Mo10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished10.1%
Policy Service Other | PolicyHolder Service | Company Position Substantiated10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Company10.1%
Recoupment Of Claims Payment | Corrective Action Taken; Claim Settled; Stat Pen Pd-Up To 45 Dys Late10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Claim Settled10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Additional Payment Expected; Correctiv10.1%
Endorsement / Rider; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue10.1%
Usual, Customary, Reasonable (UCR) Charges | Claim Handling | Claim Settled10.1%
Assignment of Benefits; Cust Service Claim Handling | Information Furnished; Contract Language/Legal Issue10.1%
Claim Handling Other | Claim Handling | Claim Settled10.1%
Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled; Additional Monies Received10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Contract Lang10.1%
Unsatisfactory Settle/Offer | Additional Payment Expected; Corrective Action Taken; Information Furnished10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished10.1%
Co-pay, Deductible, and Co-Insurance Issues | Claim Handling | Company Position Substantiated10.1%
Unsatisfactory Settle/Offer | Information Furnished; Claim Settled; Corrective Action Taken10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company10.1%
Claim Procedure | Claim Handling | Claim Settled10.1%
Cust Service Claim Handling | Corrective Action Taken; Claim Settled10.1%
Conversion | Contract Language/Legal Issue10.1%
Cash Value; Misrepresentation | Contract Language/Legal Issue; Information Furnished10.1%
Cash Value | Cash Surrender Paid10.1%
Material Change To Contract; Unauthorized Acts | Corrective Action Taken10.1%
Assignment of Benefits; Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Inform10.1%
Cust Service Claim Handling | Referred To; No Jurisdiction; Information Furnished10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Referred To; No Jurisdiction10.1%
Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Referred To; No Jurisdiction10.1%
Recoupment Of Claims Payment | No Jurisdiction; Referred To10.1%
Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Contract Language/Legal Issue10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken; Addit10.1%
Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Language/Legal Issue10.1%
Other | Contract Language/Legal Issue; Information Furnished10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | No Jurisdiction10.1%
Cust Service Claim Handling | No Jurisdiction; Referred To10.1%
Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue10.1%
Cust Service Claim Handling; Not Within TDI Jurisdiction | No Jurisdiction10.1%
Cash Value; Unsatisfactory Settle/Offer | Information Furnished10.1%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Referred To10.1%
Pre-Existing Condition; Unsatisfactory Settle/Offer | Complaint Withdrawn10.1%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company Position Upheld10.1%
Recoupment Of Claims Payment | Contract Language/Legal Issue; Corrective Action Taken; Additional Monies Received10.1%
Cash Value | Insufficient Information; Policy Not In Force10.1%
Cash Value; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction10.1%
Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Record Only10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received10.1%
Cash Value | Consumer Withdraw10.1%
Agent Handling | Contract Language/Legal Issue; Information Furnished10.1%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction10.1%
Continuation of Benefits | Contract Language/Legal Issue10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction10.1%
Assignment of Benefits | No Jurisdiction10.1%
Coordination of Benefits; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Policy Not In Force; Information 10.1%
Not Within TDI Jurisdiction; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction10.1%
Cash Value | Insufficient Information10.1%
Unfair Discrim-Clms Handling | Insufficient Information10.1%
Insurer Fraud | Insufficient Information10.1%
Cash Value; Cust Service Claim Handling; Notice Requirements | Referred To; Contract Language/Legal Issue10.1%
Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction10.1%
Coordination of Benefits; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction10.1%
Cash Value | No Jurisdiction10.1%
Prompt Pay | Stat Pen Pd-Over 90 Dys Late; Contract Language/Legal Issue10.1%
Other | Information Furnished10.1%
Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished10.1%
Misrepresentation; Unsatisfactory Settle/Offer | No Jurisdiction10.1%
Recoupment Of Claims Payment | Corrective Action Taken10.1%
Recoupment Of Claims Payment | Information Furnished; Policy Not In Force10.1%
Unsatisfactory Settle/Offer; Usual And Customary | Claim Settled; No Jurisdiction; Additional Monies Received10.1%
Cash Value; Unsatisfactory Settle/Offer | Question of Fact; Contract Language/Legal Issue10.1%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Claim Settled; Additional Monies Received10.1%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Stat Pen Pd-Up To 45 Dys Late; No Jurisdiction10.1%
Coordination of Benefits; Cust Service Claim Handling; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received; Contract Languag10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Consumer Withdraw10.1%
Grp Conversion/Continuation; Other | Information Furnished; Contract Language/Legal Issue10.1%
Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction10.1%
Prompt Pay; Unsatisfactory Settle/Offer | No Jurisdiction; Insufficient Information; Contract Language/Legal Issue10.1%
Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; No Jurisdiction10.1%
Disclosure Of Benefits; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue10.1%
Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished10.1%
Other | No Jurisdiction; Contract Language/Legal Issue10.1%
Agent Handling | Contract Language/Legal Issue10.1%
Overcharges; Recoupment Of Claims Payment | Contract Language/Legal Issue; Information Furnished10.1%
Overcharges | No Jurisdiction10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished10.1%
Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction; Question of Fact10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Referred To10.1%
Agent Handling | Information Furnished; Question of Fact10.1%
Fraud | Information Furnished; No Jurisdiction10.1%
Cash Value; Notice Requirements | Contract Language/Legal Issue10.1%
Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Claim Settled10.1%
Unsatisfactory Settle/Offer | No Jurisdiction; Corrective Action Taken; Additional Monies Received10.1%
Liability Dispute; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction10.1%
Other; Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue10.1%
Cust Service Claim Handling; Overcharges | Information Furnished; Company Position Upheld; Contract Language/Legal Issue10.1%
Unsatisfactory Settle/Offer | Referred To10.1%
Coordination of Benefits; Unsatisfactory Settle/Offer | Information Furnished; Complainant Retained Attorney; Claim Sett10.1%
Other | Other; Additional Monies Received10.1%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Claim Settled10.1%
Coordination of Benefits; Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue10.1%
Unsatisfactory Settle/Offer | No Enforcement Case Opened10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Claim Settled; Contract Language/Legal Issue10.1%
Recoupment Of Claims Payment | Contract Language/Legal Issue; No Jurisdiction10.1%
Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received10.1%
Disclosure Of Benefits; Material Change To Contract; Unsatisfactory Settle/Offer | No Jurisdiction; Company Position Uph10.1%
Other; Unsatisfactory Settle/Offer | No Jurisdiction10.1%
Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished; Complainant Retained Attorney10.1%
Disclosure Of Benefits; Material Change To Contract; Unsatisfactory Settle/Offer | Information Furnished; Additional Pay10.1%
Assignment of Benefits; Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction10.1%
Coordination of Benefits; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Overpaid Claim Recouped; Correctiv10.1%
Unsatisfactory Settle/Offer | Information Furnished; Claim Settled; Additional Monies Received10.1%
Unsatisfactory Settle/Offer | No Jurisdiction; Claim Settled10.1%
Unsatisfactory Settle/Offer | Additional Payment Expected; Corrective Action Taken; Additional Monies Received10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; No Jurisdict10.1%
Unsatisfactory Settle/Offer | No Jurisdiction; Claim Settled; Additional Monies Received10.1%
Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue10.1%
Notice Requirements; Other | Contract Language/Legal Issue10.1%
Misrepresentation | No Jurisdiction; Contract Language/Legal Issue10.1%
Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; No Jurisdiction10.1%
Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Contract Language/Legal Issue10.1%
Misrepresentation | Information Furnished; Contract Language/Legal Issue10.1%
Cash Value | No Jurisdiction; Information Furnished10.1%
Cust Service Claim Handling | Referred To; No Jurisdiction10.1%
Cash Value; Misrepresentation | Contract Language/Legal Issue10.1%
Cust Service Claim Handling | No Jurisdiction; Information Furnished10.1%
Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction; Referred To10.1%
Unsatisfactory Settle/Offer | Referred To; No Jurisdiction; Additional Monies Received10.1%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received10.1%
Lifetime/Annual Limits; Unsatisfactory Settle/Offer | Contract Language/Legal Issue10.1%
Recoupment Of Claims Payment | Referred To; Contract Language/Legal Issue; No Jurisdiction10.1%
Cust Service Claim Handling; Fraud; Overcharges | No Jurisdiction10.1%
Other | No Jurisdiction10.1%
Unsatisfactory Settle/Offer | Referred To; Contract Language/Legal Issue10.1%
SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction10.1%
Unsatisfactory Settle/Offer | Claim Settled; No Jurisdiction; Additional Monies Received10.1%
Coordination of Benefits; SB418 Rule Violation; Timely Filing Deficiency | No Jurisdiction10.1%
Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Referred To10.1%
Other | Corrective Action Taken10.1%
Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received10.1%
Unsatisfactory Settle/Offer | Claim Settled; No Jurisdiction10.1%
Unsatisfactory Settle/Offer | Additional Payment Expected10.1%
Unsatisfactory Settle/Offer | Information Furnished; Claim Settled10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished10.1%
Cash Value; Other | Information Furnished; Contract Language/Legal Issue10.1%
Other | Insufficient Information; Failure to Timely Respond10.1%
Other | Insufficient Information10.1%
Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished10.1%
Capitation Issue | Information Furnished; Additional Monies Received10.1%
Assignment of Benefits; Coordination of Benefits; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Informati10.1%
Misrepresentation | Information Furnished; Question of Fact10.1%
Cash Value; Unsatisfactory Settle/Offer | Contract Language/Legal Issue10.1%
Cust Service Claim Handling | Information Furnished10.1%
Cash Value | Record Only10.1%
Misrepresentation | Information Furnished10.1%
Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue10.1%
Unsatisfactory Settle/Offer | Information Furnished10.1%
Unsatisfactory Settle/Offer | Record Only10.1%
Other | Information Furnished; Contract Language/Legal Issue10.1%
Unsatisfactory Settle/Offer | Claim Settled10.1%
Cust Service Claim Handling | Other10.1%

health Complaints by State

StateComplaints
Texas1,682
Connecticut40

Recent health Complaints Against METROPOLITAN LIFE INSURANCE COMPANY

Frequently Asked Questions

How many health complaints does METROPOLITAN LIFE INSURANCE COMPANY have?

METROPOLITAN LIFE INSURANCE COMPANY has 1722 health insurance complaints on file, according to NAIC and state DOI data.

What are the most common health complaint issues with METROPOLITAN LIFE INSURANCE COMPANY?

The most common health complaint issues for METROPOLITAN LIFE INSURANCE COMPANY are: Delayed payment (702), Claim denial (547), Premium or billing dispute (104), Unsatisfactory Settle/Offer | No Jurisdiction (29), Policy cancellation (18).

Which states have the most health complaints against METROPOLITAN LIFE INSURANCE COMPANY?

The states with the most health complaints against METROPOLITAN LIFE INSURANCE COMPANY are: Texas (1682), Connecticut (40).

health Complaints by State

METROPOLITAN LIFE INSURANCE COMPANY Complaints by State

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