InsuranceComplaintCheck

SUPERIOR HEALTHPLAN, INC. — health Insurance Complaints

Analysis of 1,182 health insurance complaints filed against SUPERIOR HEALTHPLAN, INC., based on public NAIC and state DOI data.

Key Statistics

  • health Complaints: 1,182
  • Total Complaints (All Types): 1,182
  • health Share: 100.0%
  • NAIC Complaint Ratio: 2.2
  • AI Risk Score: 85/100

health Complaint Issues

Issue TypeComplaints% of Total
Claim denial44938.0%
Delayed payment44938.0%
Premium or billing dispute746.3%
Provider or network dispute463.9%
Unsatisfactory Settle/Offer | No Jurisdiction90.8%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue60.5%
Policy cancellation50.4%
Other | Information Furnished40.3%
Misleading sales40.3%
Access to Care | Information Furnished40.3%
Not Within TDI Jurisdiction | No Jurisdiction40.3%
Other | No Jurisdiction40.3%
Prior Authorization | Company Position Upheld; Information Furnished; Contract Language/Legal Issue30.3%
Cust Srvc Policy Holder Srvcs | Information Furnished30.3%
Prior Authorization | Contract Language/Legal Issue; Information Furnished30.3%
Cust Service Claim Handling | Information Furnished30.3%
Coverage dispute30.3%
Recoupment Of Claims Payment | Information Furnished20.2%
Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Language/Legal Issue20.2%
Access to Care | Information Furnished; Corrective Action Taken20.2%
Other | Corrective Action Taken; Information Furnished20.2%
Other | Contract Language/Legal Issue; Information Furnished20.2%
Access to Care | Contract Language/Legal Issue; Information Furnished20.2%
Unsatisfactory Settle/Offer | Information Furnished20.2%
Recoupment Of Claims Payment | No Jurisdiction20.2%
Cust Service Claim Handling; Maximum Out of Pocket | Information Furnished; Contract Language/Legal Issue10.1%
Unauthorized Acts | Corrective Action Taken; Contract Language/Legal Issue; Information Furnished10.1%
Cust Srvc Policy Holder Srvcs; Other | Corrective Action Taken; Information Furnished10.1%
Cust Service Claim Handling; Prior Authorization | Contract Language/Legal Issue; Information Furnished10.1%
Prior Authorization | Contract Language/Legal Issue; Company Position Upheld; Information Furnished10.1%
Cust Srvc Policy Holder Srvcs | Information Furnished; Company Position Upheld; Contract Language/Legal Issue10.1%
Access to Care; Prior Authorization | Information Furnished; Contract Language/Legal Issue10.1%
Cust Service Claim Handling | Question of Fact; Information Furnished10.1%
Cust Srvc Policy Holder Srvcs | Company Position Upheld; Information Furnished10.1%
Access to Care; Prior Authorization | Information Furnished; Company Position Upheld; Contract Language/Legal Issue10.1%
Other | Information Furnished; Company Position Upheld; Contract Language/Legal Issue10.1%
Recoupment Of Claims Payment; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Information Furnished; Company Pos10.1%
Maximum Out of Pocket | Question of Fact; Claim Settled; Information Furnished10.1%
Recoupment Of Claims Payment | Company Position Upheld; Information Furnished; Contract Language/Legal Issue10.1%
Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Company Position Upheld10.1%
Authorization Dispute | Corrective Action Taken; Additional Payment Expected; Information Furnished10.1%
Recoupment Of Claims Payment | Corrective Action Taken; Additional Payment Expected10.1%
Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Information Furnished10.1%
Access to Care | Information Furnished; Company Position Upheld10.1%
Authorization Dispute; Cust Service Claim Handling | Contract Language/Legal Issue; Information Furnished10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Claim Settled; Stat Pen Pd-46 To 90 Dys Late10.1%
Cust Srvc Policy Holder Srvcs | Information Furnished; Contract Language/Legal Issue10.1%
Recoupment Of Claims Payment | Additional Payment Expected; Information Furnished; Corrective Action Taken10.1%
Unauthorized Acts | Information Furnished; Referred To; Contract Language/Legal Issue10.1%
Cust Service Claim Handling | Contract Language/Legal Issue; Information Furnished10.1%
Cust Service Claim Handling; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Company Position Upheld; Information F10.1%
Access to Care; Cust Srvc Policy Holder Srvcs | Question of Fact; Information Furnished10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished10.1%
Prompt Pay | Additional Payment Expected; Information Furnished; Corrective Action Taken10.1%
Unauthorized Acts | Referred To; Information Furnished10.1%
Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished10.1%
Misrepresentation; Other | Information Furnished; Contract Language/Legal Issue10.1%
Unauthorized Acts | Information Furnished; Contract Language/Legal Issue10.1%
Maximum Out of Pocket; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue10.1%
Maternity and Newborn Care; Unsatisfactory Settle/Offer | Contract Language/Legal Issue10.1%
Recoupment Of Claims Payment | Corrective Action Taken; Information Furnished; Additional Payment Expected10.1%
Cust Service Claim Handling; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Information Furnished; Corrective Acti10.1%
Access to Care; Unauthorized Acts | Information Furnished; Question of Fact; Contract Language/Legal Issue10.1%
Unauthorized Acts | Policy Not In Force; Information Furnished10.1%
Maximum Out of Pocket | Company Position Upheld; Contract Language/Legal Issue; Information Furnished10.1%
Unsatisfactory Settle/Offer | Claim Settled; Information Furnished; Corrective Action Taken10.1%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished10.1%
Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Payment Expected; Information Furnished10.1%
Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Information Furnished10.1%
Timely Filing Deficiency; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information 10.1%
Maximum Out of Pocket | Information Furnished; Company Position Upheld10.1%
Essential Health Benefit; Unsatisfactory Settle/Offer | Information Furnished; Additional Payment Expected10.1%
Access to Care | Additional Monies Received; Information Furnished10.1%
Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Claim Settled10.1%
Access to Care | Corrective Action Taken; Information Furnished10.1%
Enrllmt/Canc/Rnwl Of Enrollee | Policy Issued/Restored; Information Furnished10.1%
Other | Contract Language/Legal Issue10.1%
Recoupment Of Claims Payment | Additional Monies Received; Corrective Action Taken10.1%
Other | Company Position Upheld10.1%
Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken10.1%
Fraud; Not Within TDI Jurisdiction | No Jurisdiction; Corrective Action Taken; Referred To10.1%
Not Within TDI Jurisdiction; Other | Record Only; Referred To10.1%
Closed-Lack Of Info Cmplainant | Record Only; Insufficient Information10.1%
Other | No Jurisdiction; Record Only10.1%
Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue10.1%
Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld10.1%
Unsatisfactory Settle/Offer | Claim Settled10.1%
Cust Service Claim Handling | Insufficient Information10.1%
Den/N-Pymt MD Nec RX | Information Furnished; No Jurisdiction10.1%
Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue10.1%
Commissions | Contract Language/Legal Issue; Information Furnished10.1%
Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished10.1%
Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished10.1%
Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished10.1%
Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled; Information Furnished10.1%
Disclosure Of Benefits; Enrllmt/Canc/Rnwl Of Enrollee; Hlth Care Svcs Covg/Copay/Lmts; Material Change To Contract; Misr10.1%
Access to Care; Disclosure Of Benefits; Hlth Care Svcs Covg/Copay/Lmts | Corrective Action Taken; Information Furnished10.1%
Recoupment Of Claims Payment | Company Position Upheld; No Jurisdiction; Information Furnished10.1%
Claims Reimb/Bal Bill Problems; Hlth Care Svcs Covg/Copay/Lmts; Recoupment Of Claims Payment; Unsatisfactory Settle/Offe10.1%
Continuity Of Treatment; Primary Care Providr Selection | Information Furnished10.1%
Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Policy Not In Force10.1%
Access to Care; Continuity Of Treatment | No Jurisdiction10.1%
Access to Care | No Jurisdiction10.1%
Other | Information Furnished; No Jurisdiction10.1%
Access to Care; Continuity of Treatment | No Jurisdiction10.1%
Den/N-Pymt MD Nec DME/Supplies | No Jurisdiction10.1%
Access to Care; Den/N-Pymt MD Nec Trmt N-Emrg; Other | Information Furnished; Contract Language/Legal Issue10.1%
PPACA-Choice Prim Care/Pediat | No Jurisdiction10.1%
Other | Information Furnished; Record Only; No Jurisdiction10.1%
Continuity Of Treatment; Out Of Ntwk Referral | No Jurisdiction10.1%
Cust Service Claim Handling | No Jurisdiction10.1%
Recoupment Of Claims Payment | Corrective Action Taken; No Jurisdiction10.1%
Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction10.1%
Continuity Of Treatment | Information Furnished; No Jurisdiction10.1%
Material Change To Contract | Information Furnished; No Jurisdiction10.1%
Not Within TDI Jurisdiction | Information Furnished; No Jurisdiction; Contract Language/Legal Issue10.1%
Refusal to Insure | No Jurisdiction; Information Furnished10.1%
Usual And Customary | No Jurisdiction10.1%

health Complaints by State

StateComplaints
Texas1,182

Recent health Complaints Against SUPERIOR HEALTHPLAN, INC.

Frequently Asked Questions

How many health complaints does SUPERIOR HEALTHPLAN, INC. have?

SUPERIOR HEALTHPLAN, INC. has 1182 health insurance complaints on file, according to NAIC and state DOI data.

What are the most common health complaint issues with SUPERIOR HEALTHPLAN, INC.?

The most common health complaint issues for SUPERIOR HEALTHPLAN, INC. are: Claim denial (449), Delayed payment (449), Premium or billing dispute (74), Provider or network dispute (46), Unsatisfactory Settle/Offer | No Jurisdiction (9).

Which states have the most health complaints against SUPERIOR HEALTHPLAN, INC.?

The states with the most health complaints against SUPERIOR HEALTHPLAN, INC. are: Texas (1182).

health Complaints by State

SUPERIOR HEALTHPLAN, INC. Complaints by State

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