Oscar Insurance Company — health Insurance Complaints
Analysis of 942 health insurance complaints filed against Oscar Insurance Company, based on public NAIC and state DOI data.
Key Statistics
- health Complaints: 942
- Total Complaints (All Types): 942
- health Share: 100.0%
- NAIC Complaint Ratio: 24.41
- AI Risk Score: 99/100
health Complaint Issues
| Issue Type | Complaints | % of Total |
|---|---|---|
| Claim denial | 368 | 39.1% |
| Delayed payment | 160 | 17.0% |
| Premium or billing dispute | 126 | 13.4% |
| Usual And Customary | Contract Language/Legal Issue | 24 | 2.5% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue | 17 | 1.8% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Contract Language/Legal Issue | 14 | 1.5% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished | 12 | 1.3% |
| Unsatisfactory Settle/Offer; Usual And Customary | Insufficient Information | 11 | 1.2% |
| Provider or network dispute | 10 | 1.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 6 | 0.6% |
| Claim Recoding/Bundling; Cust Service Claim Handling; Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Receiv | 5 | 0.5% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 5 | 0.5% |
| Cust Srvc Policy Holder Srvcs | Information Furnished | 4 | 0.4% |
| Policy cancellation | 4 | 0.4% |
| Unfair settlement | 3 | 0.3% |
| Other | Information Furnished | 3 | 0.3% |
| Other | Information Furnished; Contract Language/Legal Issue | 3 | 0.3% |
| Claim Recoding/Bundling; Cust Service Claim Handling; Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; A | 3 | 0.3% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received | 3 | 0.3% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Contract Language/Legal Issue | 3 | 0.3% |
| Prior Authorization | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Additional Payment Expected | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 2 | 0.2% |
| Prior Authorization | Contract Language/Legal Issue; Information Furnished | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 2 | 0.2% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 2 | 0.2% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Lang | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 2 | 0.2% |
| Prompt Pay; Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Additional Monies Received; Corrective Action Ta | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Corrective Action Taken | 2 | 0.2% |
| Claim Recoding/Bundling; Cust Service Claim Handling; Prompt Pay; Unsatisfactory Settle/Offer | Corrective Action Taken; | 2 | 0.2% |
| Claim Recoding/Bundling; Cust Service Claim Handling; Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; C | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Additional Monies Received | 2 | 0.2% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Corrective Action Taken | 2 | 0.2% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken | 2 | 0.2% |
| Cust Srvc Policy Holder Srvcs | Information Furnished; Contract Language/Legal Issue; Referred To | 1 | 0.1% |
| Cust Service Claim Handling | Referred To; Policy Not In Force; Contract Language/Legal Issue | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Misrepresentation | Contract Language/Legal Issue; Information Furnished; Referred To | 1 | 0.1% |
| Misrepresentation; Unauthorized Acts | Corrective Action Taken; Information Furnished | 1 | 0.1% |
| Maximum Out of Pocket | Additional Monies Received; Information Furnished; Corrective Action Taken | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs | Information Furnished; Policy Not In Force; Contract Language/Legal Issue | 1 | 0.1% |
| Other | Information Furnished; Question of Fact | 1 | 0.1% |
| Maximum Out of Pocket | Corrective Action Taken; Information Furnished; Claim Settled | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs | Referred To; Information Furnished | 1 | 0.1% |
| Unauthorized Acts | Information Furnished; Company Position Upheld | 1 | 0.1% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 1 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Payment Expected; Corrective Action Taken | 1 | 0.1% |
| Prior Authorization | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Coordination of Benefits; Timely Filing Deficiency | Corrective Action Taken; Information Furnished; Company Position Up | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs | Information Furnished; Question of Fact | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-46 To 90 Dys Late; Corrective Action Taken | 1 | 0.1% |
| Cust Srvc Policy Holder Srvcs; Prior Authorization | Contract Language/Legal Issue; Company Position Upheld; Information | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Claim Settled | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 1 | 0.1% |
| Access to Care; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken | 1 | 0.1% |
| Commissions | Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Prior Authorization | Information Furnished; Corrective Action Taken | 1 | 0.1% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Corrective Action Taken; Stat Pen Pd-Over 90 Dys Late; Claim | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled; Additional Monies Received | 1 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled; Stat Pen Pd-Over 90 | 1 | 0.1% |
| Access to Care; Policy Exclusion | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 1 | 0.1% |
| Maximum Out of Pocket | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Prompt Pay; Recoupment Of Claims Payment | Additional Payment Expected; Information Furnished | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Claim Settled | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Corrective Action Taken | 1 | 0.1% |
| Other | Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.1% |
| Access to Care | Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Stat Pen Pd-Over 90 Dys Late | 1 | 0.1% |
| Prompt Pay; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Ta | 1 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Stat Pen Pd-Over 90 Dys Late | 1 | 0.1% |
| Recoupment Of Claims Payment | Information Furnished; Corrective Action Taken | 1 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished | 1 | 0.1% |
| Recoupment Of Claims Payment | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Claim Settled; Corrective Action Taken; Information Furnished | 1 | 0.1% |
| Maximum Out of Pocket | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.1% |
| Recoupment Of Claims Payment | Information Furnished | 1 | 0.1% |
| Other | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Claim Settled; Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Other | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Claim Settled; Corrective Action Taken; Information Furnished | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Claim Settled; Information Furnished; Additional Monies Received | 1 | 0.1% |
| Other; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Recoupment Of Claims Payment | Referred To; Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.1% |
| Other | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.1% |
| Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld; Inform | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished | 1 | 0.1% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Company Posit | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Insufficient Information | 1 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Additional Monies Received | 1 | 0.1% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Payment Expected; Corrective Action Taken; Informa | 1 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Stat Pen Pd-46 To 90 Dys | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late; Information Furnished | 1 | 0.1% |
| Maximum Out of Pocket; Pediatric Care; Prompt Pay | Corrective Action Taken; Claim Settled; Information Furnished | 1 | 0.1% |
| Pediatric Care; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company Position Uph | 1 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late; Corrective Action Ta | 1 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Additional Monies Receiv | 1 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Additional Monies Received; Claim Settled | 1 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer | Claim Settled; Stat Pen Pd-Over 90 Dys Late; Additional Monies Received | 1 | 0.1% |
| Maternity and Newborn Care; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Inform | 1 | 0.1% |
| Cust Service Claim Handling; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Information Furnished; Contract Langua | 1 | 0.1% |
| Cust Service Claim Handling; Prompt Pay; Unsatisfactory Settle/Offer | Corrective Action Taken; Stat Pen Pd-Over 90 Dys | 1 | 0.1% |
| Cust Service Claim Handling; Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Tak | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Payment Expected | 1 | 0.1% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Contract Langu | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Payment Expected; Claim Settled | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Claim Settled; Additional Payment Expected; Corrective Action Taken | 1 | 0.1% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Claim Recoding/Bundling; Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.1% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Claim Settled; Corrective Action Taken | 1 | 0.1% |
| Claim Recoding/Bundling; Pediatric Care; Unsatisfactory Settle/Offer | Claim Settled; Corrective Action Taken; Additiona | 1 | 0.1% |
| Essential Health Benefit | Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Maternity and Newborn Care; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Essential Health Benefit; Other | Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Access to Care | Information Furnished | 1 | 0.1% |
| Material Change To Contract | Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Languag | 1 | 0.1% |
| Access to Care; Cust Service Claim Handling | Claim Settled; Corrective Action Taken; Information Furnished | 1 | 0.1% |
| Access to Care; Continuity of Treatment | Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Additional Monies Received | 1 | 0.1% |
| Cust Service Claim Handling; Essential Health Benefit; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Claim Settle | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Payment Expected | 1 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Disclosure Of Benefits | Contract Language/Legal Issue | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Claim Not Clean | 1 | 0.1% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Informat | 1 | 0.1% |
| Access to Care | Information Furnished; Contract Language/Legal Issue | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.1% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received; Information Furnish | 1 | 0.1% |
| Recoupment Of Claims Payment | Insufficient Information | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received; Claim Settled | 1 | 0.1% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Claim Settled | 1 | 0.1% |
| Usual And Customary | Insufficient Information | 1 | 0.1% |
| Access to Care; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.1% |
| Timely Filing Deficiency | Claim Settled | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Insufficient Information | 1 | 0.1% |
| Unfair Discrim-Clms Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Corrective Action Taken | 1 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Corrective Action Taken; Additional Mo | 1 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Contract Language/Legal Issue; Additional Mo | 1 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Language/Legal Issue; Information F | 1 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Information Furnished; Contract Language/Leg | 1 | 0.1% |
| Other | Contract Language/Legal Issue | 1 | 0.1% |
| Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Referred for Disciplinary Actn; Contract Language/Legal Issue | 1 | 0.1% |
| Misleading sales | 1 | 0.1% |
| Unsatisfactory Settle/Offer | Mediation Billed Amount; Mediation Paid Amount | 1 | 0.1% |
| Den/N-Pymt MD Nec RX; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.1% |
| Coverage dispute | 1 | 0.1% |
| Unfair Discrim-Clms Handling; Usual And Customary | Contract Language/Legal Issue | 1 | 0.1% |
| Cust Service Claim Handling | Contract Language/Legal Issue | 1 | 0.1% |
| Overcharges | Contract Language/Legal Issue | 1 | 0.1% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue | 1 | 0.1% |
health Complaints by State
| State | Complaints |
|---|---|
| Texas | 942 |
Recent health Complaints Against Oscar Insurance Company
- health Complaint #TX-454714-3a81340d — Texas (2026-04-27)
- health Complaint #TX-454269-3a81340d — Texas (2026-04-21)
- health Complaint #TX-454268-3a81340d — Texas (2026-04-21)
- health Complaint #TX-454266-3a81340d — Texas (2026-04-21)
- health Complaint #TX-454145-7cfbaab6 — Texas (2026-04-21)
- health Complaint #TX-453152-cf960575 — Texas (2026-04-10)
- health Complaint #TX-453102-3a81340d — Texas (2026-04-09)
- health Complaint #TX-452720-6f68343b — Texas (2026-04-07)
- health Complaint #TX-452612-03f3dcda — Texas (2026-04-06)
- health Complaint #TX-452408-cf960575 — Texas (2026-04-02)
Frequently Asked Questions
How many health complaints does Oscar Insurance Company have?
Oscar Insurance Company has 942 health insurance complaints on file, according to NAIC and state DOI data.
What are the most common health complaint issues with Oscar Insurance Company?
The most common health complaint issues for Oscar Insurance Company are: Claim denial (368), Delayed payment (160), Premium or billing dispute (126), Usual And Customary | Contract Language/Legal Issue (24), Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue (17).
Which states have the most health complaints against Oscar Insurance Company?
The states with the most health complaints against Oscar Insurance Company are: Texas (942).
health Complaints by State
Oscar Insurance Company Complaints by State
- Oscar Insurance Company Complaints in California
- Oscar Insurance Company Complaints in Texas
- Oscar Insurance Company Complaints in New York
- Oscar Insurance Company Complaints in Florida
- Oscar Insurance Company Complaints in Illinois
- Oscar Insurance Company Complaints in Pennsylvania
- Oscar Insurance Company Complaints in Ohio
- Oscar Insurance Company Complaints in Georgia
- Oscar Insurance Company Complaints in North Carolina
- Oscar Insurance Company Complaints in New Jersey