UNITEDHEALTHCARE INSURANCE COMPANY — health Insurance Complaints
Analysis of 19,369 health insurance complaints filed against UNITEDHEALTHCARE INSURANCE COMPANY, based on public NAIC and state DOI data.
Key Statistics
- health Complaints: 19,369
- Total Complaints (All Types): 19,664
- health Share: 98.5%
- NAIC Complaint Ratio: 6.63
- AI Risk Score: 88/100
health Complaint Issues
| Issue Type | Complaints | % of Total |
|---|---|---|
| Claim denial | 6,007 | 31.0% |
| Premium or billing dispute | 5,729 | 29.6% |
| Delayed payment | 2,189 | 11.3% |
| Usual And Customary | Contract Language/Legal Issue | 547 | 2.8% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue | 541 | 2.8% |
| Unsatisfactory Settle/Offer | No Jurisdiction | 369 | 1.9% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 330 | 1.7% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction | 90 | 0.5% |
| Usual And Customary | No Jurisdiction | 81 | 0.4% |
| Provider or network dispute | 68 | 0.4% |
| Policy cancellation | 68 | 0.4% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 65 | 0.3% |
| Coverage dispute | 63 | 0.3% |
| Unfair settlement | 60 | 0.3% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Contract Language/Legal Issue | 60 | 0.3% |
| Unsatisfactory Settle/Offer | Additional Monies Received | 52 | 0.3% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 50 | 0.3% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Additional Monies Received | 48 | 0.2% |
| Not Within TDI Jurisdiction | No Jurisdiction | 48 | 0.2% |
| Unsatisfactory Settle/Offer | Information Furnished | 47 | 0.2% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Overpaid Claim Recouped; Contract Langu | 47 | 0.2% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 45 | 0.2% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue | 42 | 0.2% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Overpaid | 40 | 0.2% |
| Claim Procedure | Claim Handling | 37 | 0.2% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue | 33 | 0.2% |
| Recoupment Of Claims Payment | No Jurisdiction | 30 | 0.2% |
| Usual And Customary | Additional Monies Received; Contract Language/Legal Issue | 23 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction | 22 | 0.1% |
| Other | Information Furnished | 21 | 0.1% |
| Unsatisfactory Settle/Offer | Claim Settled | 21 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue | 21 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Language/Legal Issue | 21 | 0.1% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer | No Jurisdiction | 20 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received | 20 | 0.1% |
| Other | No Jurisdiction | 20 | 0.1% |
| Misleading sales | 19 | 0.1% |
| Usual And Customary | Contract Language/Legal Issue; Additional Monies Received | 19 | 0.1% |
| Unsatisfactory Settle/Offer | Company Position Upheld | 19 | 0.1% |
| External Review | Claim Handling | 18 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 18 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished | 18 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Contract Language/Legal Issue | 18 | 0.1% |
| Unsatisfactory Settle/Offer | Insufficient Information | 18 | 0.1% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 18 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished | 17 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Company Position Upheld | 17 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction | 17 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 16 | 0.1% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue | 15 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Contract Language/Legal Issue | 15 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld | 15 | 0.1% |
| Timely Filing Deficiency; Unsatisfactory Settle/Offer | No Jurisdiction | 15 | 0.1% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 14 | 0.1% |
| Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received | 14 | 0.1% |
| CPT Code Issue | Claim Handling | 13 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 13 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Question of Fact; Contract Language/Legal Issue | 13 | 0.1% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 12 | 0.1% |
| Recoupment Of Claims Payment | Information Furnished; Contract Language/Legal Issue | 12 | 0.1% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken | 12 | 0.1% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue | 12 | 0.1% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished | 12 | 0.1% |
| Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 11 | 0.1% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Information Furnished | 11 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Additional Monies Received | 11 | 0.1% |
| Recoupment Of Claims Payment; Usual And Customary | Contract Language/Legal Issue | 11 | 0.1% |
| Other | 10 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 10 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld | 10 | 0.1% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction | 10 | 0.1% |
| Other | Contract Language/Legal Issue | 10 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; No Jurisdiction | 10 | 0.1% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Corrective Action Taken; Additional Mo | 9 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Corrective Action Taken | 9 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished | 9 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | No Jurisdiction | 9 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Overpaid Claim Recouped | 9 | 0.0% |
| Other | Contract Language/Legal Issue; Information Furnished | 8 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received | 8 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 8 | 0.0% |
| Usual And Customary | Record Only | 8 | 0.0% |
| Usual And Customary | Contract Language/Legal Issue; No Jurisdiction | 8 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Insufficient Information | 8 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Corrective Action Taken | 8 | 0.0% |
| Other | Insufficient Information | 8 | 0.0% |
| Cust Service Claim Handling | No Jurisdiction | 8 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; No Juris | 8 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Claim Settled; Contract Language/Legal Issue | 8 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 8 | 0.0% |
| Co-pay, Deductible, and Co-Insurance Issues | Claim Handling | Company Position Substantiated | 7 | 0.0% |
| Other | Information Furnished; Contract Language/Legal Issue | 7 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished | 7 | 0.0% |
| Usual And Customary | No Jurisdiction; Record Only | 7 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Contract Language/Legal Issue; Corrective | 7 | 0.0% |
| Usual And Customary | Corrective Action Taken; Contract Language/Legal Issue; Additional Monies Received | 7 | 0.0% |
| Usual And Customary | Record Only; No Jurisdiction | 7 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue | 7 | 0.0% |
| Other | Record Only | 7 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received | 7 | 0.0% |
| Recoupment Of Claims Payment | Overpaid Claim Recouped | 7 | 0.0% |
| Recoupment | Claim Handling | 6 | 0.0% |
| Prior Authorization | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 6 | 0.0% |
| Claim Handling Other | Claim Handling | Claim Settled | 6 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 6 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken | 6 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Contract Language/Legal Issue; Company Positio | 6 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 6 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Corrective Action Taken | 6 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue | 6 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Contract Language/Legal Issue | 6 | 0.0% |
| Unsatisfactory Settle/Offer | Record Only | 6 | 0.0% |
| Not Within TDI Jurisdiction; Recoupment Of Claims Payment | No Jurisdiction | 6 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 6 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Question of Fact | 6 | 0.0% |
| Closed-Lack Of Info Cmplainant | Insufficient Information | 6 | 0.0% |
| Prior Authorization | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 5 | 0.0% |
| Prior Authorization | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 5 | 0.0% |
| Other | Corrective Action Taken; Information Furnished | 5 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished | 5 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken; Additional Monies Received | 5 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 5 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld | 5 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Company Posi | 5 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | No Jurisdiction; Referred To; Information Furnished | 5 | 0.0% |
| Claim Recoding/Bundling; Prompt Pay; Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contrac | 5 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken | 5 | 0.0% |
| Cust Service Claim Handling | Contract Language/Legal Issue | 5 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; No Jurisdiction | 5 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Record Only | 5 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction | 5 | 0.0% |
| Usual And Customary | Corrective Action Taken; Contract Language/Legal Issue | 5 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Contract Language/Legal Issue; Additional Mo | 5 | 0.0% |
| Usual And Customary | Contract Language/Legal Issue; Corrective Action Taken; Additional Monies Received | 5 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction | 5 | 0.0% |
| Usual And Customary | Contract Language/Legal Issue; Corrective Action Taken | 5 | 0.0% |
| Access to Care | No Jurisdiction | 5 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken | 5 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue | 5 | 0.0% |
| Assignment of Benefits; Unsatisfactory Settle/Offer | No Jurisdiction | 5 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | No Jurisdiction | 5 | 0.0% |
| Den/N-Pymt MD Nec RX | Contract Language/Legal Issue | 5 | 0.0% |
| Misrepresentation | No Jurisdiction | 5 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received; Corrective Action Taken | 4 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Claim Settled | 4 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Company Position Upheld | 4 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Claim Settled | 4 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Languag | 4 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Referred To; No Jurisdiction; Record Only | 4 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Company Po | 4 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Informat | 4 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 4 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Information Furnished; Contract Language/Leg | 4 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Language/ | 4 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 4 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Contract Language/Le | 4 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Info | 4 | 0.0% |
| Cust Service Claim Handling | Information Furnished | 4 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Contract Langu | 4 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken | 4 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 4 | 0.0% |
| Recoupment Of Claims Payment | No Jurisdiction; Contract Language/Legal Issue | 4 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Additional Monies Received; Contract Languag | 4 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken | 4 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received | 4 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Additional Monies Received; Corrective | 4 | 0.0% |
| Usual And Customary | No Jurisdiction; Contract Language/Legal Issue | 4 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Corrective Action Taken; Contract Languag | 4 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished; Company Positio | 4 | 0.0% |
| Usual And Customary | Contract Language/Legal Issue; Additional Monies Received; Corrective Action Taken | 4 | 0.0% |
| Usual And Customary | Additional Monies Received; Corrective Action Taken; Contract Language/Legal Issue | 4 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction | 4 | 0.0% |
| Usual And Customary | Additional Monies Received; Contract Language/Legal Issue; Corrective Action Taken | 4 | 0.0% |
| Assignment of Benefits; Cust Service Claim Handling | No Jurisdiction | 4 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Monies Received | 4 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Contract Language/Legal Issue | 4 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Contract Language/Lega | 4 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Contract Language/Legal Issue; Information Furnished | 4 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Clean Claims Violation | 4 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Correcti | 4 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished | 4 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Overpaid Claim Recouped | 4 | 0.0% |
| Den/N-Pymt MD Nec RX | Information Furnished | 4 | 0.0% |
| Prior Authorization | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 3 | 0.0% |
| Prior Authorization | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue; Information Furnished | 3 | 0.0% |
| Cust Service Claim Handling | Additional Monies Received; Corrective Action Taken | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Stat Pen Pd-Over 90 Dys Late; Corrective Action Taken | 3 | 0.0% |
| Notice Requirements | PolicyHolder Service | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Additional Monies Received | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Information Furnished | 3 | 0.0% |
| Other | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 3 | 0.0% |
| Co-pay, Deductible, and Co-Insurance Issues | Claim Handling | Question of Fact/Contract/Provision/Legal Issue | 3 | 0.0% |
| Access to Care | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Payment Expected | 3 | 0.0% |
| Co-pay, Deductible, and Co-Insurance Issues | Claim Handling | Company Position Overturned | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue; Additional Monies Received | 3 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received; Information Furnished | 3 | 0.0% |
| Access to Care | Contract Language/Legal Issue; Information Furnished | 3 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld | 3 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Language/Legal Issue; Information F | 3 | 0.0% |
| Misrepresentation | Information Furnished | 3 | 0.0% |
| Not Within TDI Jurisdiction | Information Furnished | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Claim Settled; Additional Monies Received | 3 | 0.0% |
| Other | Corrective Action Taken | 3 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received | 3 | 0.0% |
| Prompt Pay | No Jurisdiction | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Corrective Action Taken | 3 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue | 3 | 0.0% |
| Usual And Customary | Record Only; Contract Language/Legal Issue | 3 | 0.0% |
| Usual And Customary | Contract Language/Legal Issue; Information Furnished | 3 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction | 3 | 0.0% |
| COBRA | No Jurisdiction | 3 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Insufficient Information | 3 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished; Corrective Acti | 3 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Information Furnished; Corrective Action | 3 | 0.0% |
| Usual And Customary | Corrective Action Taken; Additional Monies Received; Contract Language/Legal Issue | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Claim Settled | 3 | 0.0% |
| Prompt Pay | Contract Language/Legal Issue | 3 | 0.0% |
| Coordination of Benefits | No Jurisdiction | 3 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Information Furnished | 3 | 0.0% |
| Coordination of Benefits; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 3 | 0.0% |
| Access to Care | Information Furnished | 3 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 3 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg | No Jurisdiction | 3 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Claim Settled | 3 | 0.0% |
| Recoupment Of Claims Payment | Additional Monies Received; Claim Settled | 3 | 0.0% |
| Recoupment Of Claims Payment | Additional Monies Received | 3 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received | 3 | 0.0% |
| Unsatisfactory Settle/Offer | 3 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Overpaid Claim Recouped; Contract Language/Legal Issue | 3 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Referred To; No Jurisdiction | 3 | 0.0% |
| Cust Service Claim Handling | Insufficient Information | 3 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received | 3 | 0.0% |
| Access to Care; Continuity of Treatment | No Jurisdiction | 3 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Additional Monies Received | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Claim Settled | 3 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled | 3 | 0.0% |
| Den/N-Pymt MD Nec RX; IRO Notice Of Review | Referred To; Information Furnished | 3 | 0.0% |
| Den/N-Pymt MD Nec RX | No Jurisdiction | 3 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Insufficient Information | 3 | 0.0% |
| Overcharges | Contract Language/Legal Issue | 3 | 0.0% |
| Commissions | No Jurisdiction | 3 | 0.0% |
| Recoupment Of Claims Payment | Claim Settled | 3 | 0.0% |
| Policy Service | PolicyHolder Service | 2 | 0.0% |
| Co-pay, Deductible, and Co-Insurance Issues | Claim Handling | 2 | 0.0% |
| Bad Faith Participation | Information Furnished | 2 | 0.0% |
| Prior Authorization | Information Furnished; Corrective Action Taken | 2 | 0.0% |
| Cust Service Claim Handling | Company Position Upheld | 2 | 0.0% |
| Cust Srvc Policy Holder Srvcs; Prior Authorization | Contract Language/Legal Issue; Company Position Upheld; Information | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Record Only; Insufficient Information | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Corrective Action Taken; Additional Monies Received | 2 | 0.0% |
| Prior Authorization | Information Furnished; Contract Language/Legal Issue | 2 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Infor | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled; Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late; Corrective Action Taken | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Stat Pen Pd-Over 90 Dys Late | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Stat Pen Pd-Over 90 Dys Late | 2 | 0.0% |
| Recoupment | Claim Handling | Claim Settled | 2 | 0.0% |
| Authorization Dispute | Claim Handling | 2 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Company Position Upheld; Corrective Action Taken; Contract La | 2 | 0.0% |
| Claim Handling Other | Claim Handling | Company Position Substantiated | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Claim Settled | 2 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Lang | 2 | 0.0% |
| Usual & Customary Fees | Claim Handling | 2 | 0.0% |
| Bad Faith Participation | Corrective Action Taken; Information Furnished | 2 | 0.0% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Information | 2 | 0.0% |
| Other | Information Furnished; Contract Language/Legal Issue; Company Position Upheld | 2 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 2 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Contract Language/Legal Issue; Corrective Action Taken | 2 | 0.0% |
| Recoupment Of Claims Payment | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 2 | 0.0% |
| Policy Service | PolicyHolder Service | No Jurisdiction | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Failure to Timely Respond | 2 | 0.0% |
| Coordination of Benefits; Recoupment Of Claims Payment | Contract Language/Legal Issue; Claim Settled; Corrective Action | 2 | 0.0% |
| Recoupment Of Claims Payment | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Payment Expected | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken; Information Furnished | 2 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Stat Pen Pd-Over 90 Dys L | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Corrective Action Taken; Additional Monies Received | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received; Contract Language/Legal Issue | 2 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Information Furnished; Corrective Action Taken | 2 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Corrective Action Taken | 2 | 0.0% |
| Coordination of Benefits | Contract Language/Legal Issue; Information Furnished; Claim Settled | 2 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Informat | 2 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received; Corrective Action Taken | 2 | 0.0% |
| Recoupment Of Claims Payment | Company Position Upheld; Information Furnished | 2 | 0.0% |
| Not Within TDI Jurisdiction; Other | Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; No Jurisdiction | 2 | 0.0% |
| Prompt Pay | Information Furnished; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Referred To | 2 | 0.0% |
| Bad Faith Participation | Record Only | 2 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 2 | 0.0% |
| Claim Recoding/Bundling; Essential Health Benefit; Prompt Pay; Unsatisfactory Settle/Offer; Usual And Customary | Inform | 2 | 0.0% |
| Claim Recoding/Bundling; Prompt Pay; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; C | 2 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; Referred To; No Jurisdiction | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Referred To; No Jurisdiction; Information Furnished | 2 | 0.0% |
| Recoupment Of Claims Payment | Additional Monies Received; Corrective Action Taken; Contract Language/Legal Issue | 2 | 0.0% |
| Recoupment Of Claims Payment | Corrective Action Taken; Contract Language/Legal Issue | 2 | 0.0% |
| Refusal to Insure | Contract Language/Legal Issue | 2 | 0.0% |
| Recoupment Of Claims Payment | Record Only | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Contract Language/Legal Issue; Additional Monies Rec | 2 | 0.0% |
| Unfair Discrim-Clms Handling | Information Furnished; No Jurisdiction | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Contract Language/Legal Issue; Additional Moni | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Information Furnished | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received; Contract Langua | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Contract Language/Legal Issue; Information F | 2 | 0.0% |
| Recoupment Of Claims Payment; Usual And Customary | No Jurisdiction | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken | 2 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; C | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Additional Monies Received | 2 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Record Only | 2 | 0.0% |
| Overcharges; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Additional Monies Received | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Billed Amount; SOAH Referral | 2 | 0.0% |
| Unsatisfactory Settle/Offer | SOAH Referral; Mediation Billed Amount | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Billed Amount; Mediation Not Eligible | 2 | 0.0% |
| Coordination of Benefits | Contract Language/Legal Issue | 2 | 0.0% |
| Coordination of Benefits; Unsatisfactory Settle/Offer | Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Overpaid Claim Recouped; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Claim Settled | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Company Position Upheld | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Referred To; No Jurisdiction | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Claim Settled | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received; Corrective Action Taken | 2 | 0.0% |
| Den/N-Pymt MD Nec RX | Contract Language/Legal Issue; Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue; Information Furnished | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction; Company Position Upheld | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; No Jurisdiction; Referred To | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Insufficient Information | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Company | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Overpaid Claim Recouped; Contract Language/Legal Issue; Comp | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Overpaid Claim Recouped; Information Fu | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Info | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Overpaid Claim Recouped | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; No Jurisdiction | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Information Fu | 2 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Contract Language/Legal Issue; Referred T | 2 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Overpaid Claim Recouped | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Lan | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld; No Jurisdiction | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 2 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished | 2 | 0.0% |
| Den/N-Pymt MD Nec RX | Claim Settled | 2 | 0.0% |
| Recoupment Of Claims Payment | Insufficient Information | 2 | 0.0% |
| Den/N-Pymt MD Nec RX | Information Furnished; Referred To | 2 | 0.0% |
| Recoupment Of Claims Payment | Additional Monies Received; Information Furnished | 2 | 0.0% |
| Overcharges | Information Furnished; Contract Language/Legal Issue | 2 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Claim Settled | 2 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue; Additional Monies Received | 2 | 0.0% |
| Den/N-Pymt MD Nec RX; IRO Notice Of Review | Information Furnished; Referred To | 2 | 0.0% |
| Den/N-Pymt MD Nec RX | Information Furnished; Contract Language/Legal Issue | 2 | 0.0% |
| IRO Request Not Filed Timely | Failure to Timely Respond; Contract Language/Legal Issue | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Referred To | 2 | 0.0% |
| Den/N-Pymt MD Nec DME/Supplies | No Jurisdiction | 2 | 0.0% |
| Continuity Of Treatment | No Jurisdiction | 2 | 0.0% |
| Recoupment Of Claims Payment | Overpaid Claim Recouped; Contract Language/Legal Issue | 2 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction | 2 | 0.0% |
| Overcharges; Unsatisfactory Settle/Offer | No Jurisdiction | 2 | 0.0% |
| Deficient Claim Notice; SB418 Rule Violation; Timely Filing Deficiency | No Jurisdiction | 2 | 0.0% |
| Unsatisfactory Settle/Offer | Clean Claims Violation; Information Furnished | 2 | 0.0% |
| Cust Service Claim Handling; Other | No Jurisdiction | 2 | 0.0% |
| Timely Filing Deficiency; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken | 2 | 0.0% |
| Recoupment Of Claims Payment; SB418 Rule Violation | No Jurisdiction | 2 | 0.0% |
| Claim Handling Other | Claim Handling | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment | Information Furnished; Claim Settled; Claim Not Clean | 1 | 0.0% |
| Cust Service Claim Handling | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Authorization Dispute | Contract Language/Legal Issue; Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Maximum Out of Pocket | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Refusal to Insure | Underwriting | Company Position Substantiated | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs | Information Furnished; Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Policy Service | PolicyHolder Service | Question of Fact/Contract/Provision/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Timely Filing Deficiency | Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Other | Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Other; Unauthorized Acts | Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Preventive Care | Claim Handling | Question of Fact/Contract/Provision/Legal Issue | 1 | 0.0% |
| Other | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Coordination of Benefits | Claim Handling | 1 | 0.0% |
| Coordination of Benefits | Claim Settled; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Coordination of Benefits; Pediatric Care | Corrective Action Taken; Claim Settled; Information Furnished | 1 | 0.0% |
| Authorization Dispute | Claim Handling | Company Position Substantiated | 1 | 0.0% |
| Cust Service Claim Handling; Maximum Out of Pocket | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Payment Expected; Inform | 1 | 0.0% |
| Authorization Dispute; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company Posit | 1 | 0.0% |
| Continuity of Treatment; Cust Srvc Policy Holder Srvcs | Information Furnished | 1 | 0.0% |
| Inadequate Reimbursement/Rates | PolicyHolder Service | Company Position Substantiated | 1 | 0.0% |
| Continuity of Treatment; Out Of Ntwk Referral | Company Position Upheld; Contract Language/Legal Issue; Information Furn | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs | Referred To; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Prior Authorization | Question of Fact; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Corrective Action Taken | 1 | 0.0% |
| Authorization Dispute; Recoupment Of Claims Payment | Claim Settled; Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment | Contract Language/Legal Issue; Company Position Upheld; Info | 1 | 0.0% |
| Refusal to Insure | Information Furnished; Policy Issued/Restored | 1 | 0.0% |
| Cust Service Claim Handling; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Referred To; Contract Language/Legal I | 1 | 0.0% |
| Cust Service Claim Handling; Fraud | Claim Not Clean; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Preexisting Condition | Claim Handling | 1 | 0.0% |
| Cust Service Claim Handling | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Record Only; Referred To; No Jurisdiction | 1 | 0.0% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Information | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Policy Issued/Restored; Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Insufficient Information | 1 | 0.0% |
| Authorization Dispute; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Corrective Actio | 1 | 0.0% |
| Cust Service Claim Handling; Maternity and Newborn Care; Unsatisfactory Settle/Offer | Claim Settled; Contract Language/ | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs; Prior Authorization | Question of Fact; Company Position Upheld; Contract Language/Legal | 1 | 0.0% |
| Prior Authorization | Corrective Action Taken; Information Furnished; Claim Settled | 1 | 0.0% |
| Cust Service Claim Handling | Question of Fact; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Question of Fact; Information Furnished | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling; Recoupment Of Claims Payment | Information Furnished; Contract La | 1 | 0.0% |
| Cust Service Claim Handling; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Additional Monies Received; Correct | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Not Clean; Additional Monies Received | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Claim Settled; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Claim Settled; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Stat Pen Pd-Up To 45 Dys Late; Information Furnished | 1 | 0.0% |
| Other | Question of Fact; Information Furnished | 1 | 0.0% |
| Prior Authorization; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Corrective Action | 1 | 0.0% |
| Other | Information Furnished; Question of Fact | 1 | 0.0% |
| Prior Authorization | Corrective Action Taken; Claim Settled; Additional Payment Expected | 1 | 0.0% |
| Cust Service Claim Handling | Company Position Upheld; Additional Payment Expected; Corrective Action Taken | 1 | 0.0% |
| Cust Service Claim Handling | Corrective Action Taken; Additional Payment Expected; Company Position Upheld | 1 | 0.0% |
| Cust Service Claim Handling | Corrective Action Taken; Company Position Upheld; Additional Payment Expected | 1 | 0.0% |
| Cust Service Claim Handling | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Prior Authorization | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Claim Settled; Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Cust Service Claim Handling; Pediatric Care; Recoupment Of Claims Payment | Claim Settled; Information Furnished; Correc | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs; Prior Authorization | Company Position Upheld; Information Furnished; Contract Language/L | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs; Other | Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment; Timely Filing Deficiency | Corrective Action Taken; Claim Settled; Contract Language/Legal | 1 | 0.0% |
| Fraud | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Authorization Dispute; Cust Service Claim Handling; Unsatisfactory Settle/Offer | Company Position Upheld; Information F | 1 | 0.0% |
| Cust Service Claim Handling; Maximum Out of Pocket | Contract Language/Legal Issue; Company Position Upheld; Additional | 1 | 0.0% |
| Payment Not Credited | PolicyHolder Service | Company Position Substantiated | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling; Recoupment Of Claims Payment | Contract Language/Legal Issue; Com | 1 | 0.0% |
| Bad Faith Participation; Cust Service Claim Handling | Additional Monies Received; Corrective Action Taken; Information | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment; Timely Filing Deficiency | Company Position Upheld; Contract | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Claim Settled; Stat Pen Pd-Over 90 Dys Late; Corrective Actio | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs; Prior Authorization | Information Furnished; Company Position Upheld | 1 | 0.0% |
| Coordination of Benefits | Claim Handling | No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received; Corrective | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs; Misrepresentation | Contract Language/Legal Issue; Question of Fact; Company Position Uph | 1 | 0.0% |
| Cust Service Claim Handling; Cust Srvc Policy Holder Srvcs; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Informa | 1 | 0.0% |
| Usual, Customary, Reasonable (UCR) Charges | Claim Handling | 1 | 0.0% |
| Bad Faith Participation | Information Furnished; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Prior Authorization | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Coordination of Benefits | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Unauthorized Acts | Record Only; Referred To | 1 | 0.0% |
| Recoupment Of Claims Payment | Corrective Action Taken; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Other | Referred To; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Referred To; Corrective Action | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected; Contract Language/Legal Issue; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Additional Monies Received | 1 | 0.0% |
| Authorization Dispute; Cust Service Claim Handling | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Language/L | 1 | 0.0% |
| Coordination of Benefits; Post-Claim Underwriting; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Informati | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs | Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Claim Settled; Information Furnished; Contract Language/Legal | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs; Patient Protection Rules | Question of Fact; Information Furnished; Contract Language/Leg | 1 | 0.0% |
| Continuity of Care | PolicyHolder Service | Question of Fact/Contract/Provision/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment | Additional Monies Received; Corrective Action Taken; Informa | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Authorization Dispute | Claim Handling | Claim Settled | 1 | 0.0% |
| Coordination of Benefits; Recoupment Of Claims Payment | Information Furnished; Contract Language/Legal Issue; Company P | 1 | 0.0% |
| Recoupment | Claim Handling | Company Position Substantiated | 1 | 0.0% |
| Claim Recoding/Bundling; Fraud; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; In | 1 | 0.0% |
| Coordination of Benefit | Claim Handling | Claim Settled | 1 | 0.0% |
| Policy Service | PolicyHolder Service | Company Position Overturned | 1 | 0.0% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Cust Srvc Policy Holder Srvcs | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Other | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 1 | 0.0% |
| Authorization Dispute; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| CPT Code Issue | Claim Handling | Claim Settled | 1 | 0.0% |
| Authorization Dispute | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Coordination of Benefits; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Company Po | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled; Stat Pen Pd-Over 90 | 1 | 0.0% |
| Other | Failure to Timely Respond; Information Furnished | 1 | 0.0% |
| Other | Information Furnished; Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Language/L | 1 | 0.0% |
| Mandated Benefit | Claim Handling | 1 | 0.0% |
| Other; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Information Furnished | 1 | 0.0% |
| Maternity and Newborn Care; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Contract Langu | 1 | 0.0% |
| Maximum Out of Pocket | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Claim Settled; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay | Claim Handling | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Claim Settled; Information Furnished; Corrective Action Take | 1 | 0.0% |
| Maximum Out of Pocket | Contract Language/Legal Issue; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Other | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Preventive Care | Claim Handling | Company Position Substantiated | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Claim Settled | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue; Clai | 1 | 0.0% |
| Cust Service Claim Handling; Patient Protection Rules | Company Position Upheld; Contract Language/Legal Issue; Informat | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Coordination of Benefits; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Claim Settled; Information Furnis | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; | 1 | 0.0% |
| Other | Information Furnished; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Question of Fact; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld; Referred To | 1 | 0.0% |
| Health Privacy | Information Furnished; Referred To | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Claim Settled | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Claim Recoding/Bundling | Claim Handling | No Jurisdiction | 1 | 0.0% |
| Access to Care | Information Furnished; Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Coordination of Benefits | Information Furnished | 1 | 0.0% |
| Access to Care | Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Stat Pen Pd-Up To 45 Dys Late; Claim Settled | 1 | 0.0% |
| Maximum Out of Pocket | Information Furnished; Corrective Action Taken; Company Position Upheld | 1 | 0.0% |
| Recoupment Of Claims Payment | Claim Settled; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Co-pay, Deductible, and Co-Insurance Issues | Claim Handling | Claim Settled | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Prompt Pay | Company Position Upheld; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Corrective Ac | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled; Informat | 1 | 0.0% |
| Unsatisfactory Offer | Claim Handling | Claim Settled | 1 | 0.0% |
| Prompt Pay | Information Furnished | 1 | 0.0% |
| Coordination of Benefits; Unsatisfactory Settle/Offer | Information Furnished; Claim Settled; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Contract Language/L | 1 | 0.0% |
| Cust Service Claim Handling; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Informa | 1 | 0.0% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Payment Expected; Corrective Action Taken | 1 | 0.0% |
| Misrepresentation | Information Furnished; Policy Issued/Restored; Corrective Action Taken | 1 | 0.0% |
| Claim Recoding/Bundling | Claim Handling | 1 | 0.0% |
| Claim Recoding/Bundling; Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Maternity and Newborn Care; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Contract | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled; Information Furnished | 1 | 0.0% |
| Pediatric Care; Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Company | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Information Furnished; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Claim Settled | 1 | 0.0% |
| Other | Information Furnished; Mediation Billed Amount; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received; Information Furnished | 1 | 0.0% |
| Cash Value; Unsatisfactory Settle/Offer | Question of Fact; Claim Settled; Additional Monies Received | 1 | 0.0% |
| UR Procedure | Claim Handling | Company Position Overturned | 1 | 0.0% |
| Recoupment Of Claims Payment | Corrective Action Taken; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment | Claim Settled; Corrective Action Taken | 1 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 1 | 0.0% |
| Essential Health Benefit | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 1 | 0.0% |
| Essential Health Benefit; Recoupment Of Claims Payment | Corrective Action Taken; Contract Language/Legal Issue; Informa | 1 | 0.0% |
| Essential Health Benefit; Recoupment Of Claims Payment | Contract Language/Legal Issue; Corrective Action Taken; Informa | 1 | 0.0% |
| Essential Health Benefit; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Contract | 1 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Corrective Actio | 1 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Information Furnished; Claim Settled; Additional Monies Received | 1 | 0.0% |
| Essential Health Benefit; Prompt Pay; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Iss | 1 | 0.0% |
| Maternity and Newborn Care | Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Contract Lang | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken; Infor | 1 | 0.0% |
| Pediatric Care; Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; Claim Settled; Corrective Action Taken | 1 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Essential Health Benefit | Referred To; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Payment Expected; Claim Settled | 1 | 0.0% |
| No Jurisdiction | 1 | 0.0% |
| Pharmacy Benefits | Claim Handling | Company Position Substantiated | 1 | 0.0% |
| Other | Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Access to Care | No Jurisdiction; Information Furnished; Referred To | 1 | 0.0% |
| Recoupment Of Claims Payment | Insufficient Information; Information Furnished | 1 | 0.0% |
| Claim Handling Other | Claim Handling | Company Position Overturned | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Informat | 1 | 0.0% |
| Essential Health Benefit | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Claim Procedure | Claim Handling | Company Position Substantiated | 1 | 0.0% |
| Continuation of Benefits | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Medically Necessary | Claim Handling | Company Position Overturned | 1 | 0.0% |
| Claim Recoding/Bundling; Recoupment Of Claims Payment | Information Furnished; Corrective Action Taken; Contract Languag | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Company Position Upheld; Referred To; Contract Language/Legal | 1 | 0.0% |
| Emergency Services | Claim Handling | 1 | 0.0% |
| Essential Health Benefit; Pediatric Care; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal I | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information F | 1 | 0.0% |
| Access to Care | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Essential Health Benefit; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Com | 1 | 0.0% |
| Delivery of Policy | PolicyHolder Service | 1 | 0.0% |
| Recoupment Of Claims Payment | Claim Settled; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Company Position Upheld; I | 1 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Referred To; No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer | Claim Not Clean; Information Furnished | 1 | 0.0% |
| Claim Procedure | Claim Handling | Question of Fact/Contract/Provision/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Policy Not In Force; Company | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Additional M | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction; Referred To | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Correctiv | 1 | 0.0% |
| Essential Health Benefit | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction; Referred To | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | No Jurisdiction; Company Position Upheld; Referred To | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction; Referred To | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | No Jurisdiction; Referred To | 1 | 0.0% |
| Prompt Pay | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Prompt Pay | No Jurisdiction; Referred To; Contract Language/Legal Issue | 1 | 0.0% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Referred To | 1 | 0.0% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Additional Monies | 1 | 0.0% |
| Recoupment Of Claims Payment | No Jurisdiction; Referred To | 1 | 0.0% |
| Maximum Out of Pocket | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Insurer Fraud | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Corrective Acti | 1 | 0.0% |
| Health Privacy; Prohibited PHI Disclosure | Referred To; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Referred To; No Jurisdiction | 1 | 0.0% |
| Misrepresentation | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling | Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Referred To; No Jurisdiction; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Claim Settled; Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Infor | 1 | 0.0% |
| Not Within TDI Jurisdiction | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Prompt Pay | Corrective Action Taken; Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Referred To; Information Furnished | 1 | 0.0% |
| Access to Care; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Claim Recoding/Bundling; Essential Health Benefit; Prompt Pay; Unsatisfactory Settle/Offer; Usual And Customary | Contra | 1 | 0.0% |
| Fraud; Misrepresentation; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment | Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Claim Recoding/Bundling; Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Company Position Uphe | 1 | 0.0% |
| Cust Service Claim Handling; Essential Health Benefit; Maternity and Newborn Care; Unsatisfactory Settle/Offer | Claim S | 1 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Referred To; Information Furnis | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished; Referred To | 1 | 0.0% |
| Access to Care | Information Furnished; Referred To; No Jurisdiction | 1 | 0.0% |
| Access to Care; Cust Service Claim Handling; Essential Health Benefit | Claim Settled; Information Furnished; No Jurisdi | 1 | 0.0% |
| Essential Health Benefit; Maternity and Newborn Care; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Infor | 1 | 0.0% |
| Essential Health Benefit; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken | 1 | 0.0% |
| Access to Care | Contract Language/Legal Issue | 1 | 0.0% |
| Health Privacy; Lack of Required PHI Training; Prohibited PHI Disclosure | Corrective Action Taken; Information Furnishe | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Insufficient Information; Contract Language/Legal Issue; Company Position Uphe | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Ta | 1 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Cash Value; Cust Service Claim Handling | Claim Settled; Additional Payment Expected | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late; No Jurisdiction | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Contract Language/Legal Issue; Additional Monies | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Referred To; Contract Language/Legal Issue | 1 | 0.0% |
| Fraud | No Jurisdiction; Referred To | 1 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Referred To; Information Furnished; No Jurisdiction | 1 | 0.0% |
| Other | No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment | No Jurisdiction; Information Furnished; Referred To | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Referred To; No Jurisdiction | 1 | 0.0% |
| Access to Care; Cust Service Claim Handling | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Claim Not Clean; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Additional Monies Received | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Record Only; Information Furnished | 1 | 0.0% |
| Misrepresentation | Policy Issued/Restored; Corrective Action Taken | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling; Misrepresentation; Unsatisfactory Settle/Offer | Information Furn | 1 | 0.0% |
| Not Within TDI Jurisdiction | No Jurisdiction; Referred To | 1 | 0.0% |
| Not Within TDI Jurisdiction | Referred To; No Jurisdiction | 1 | 0.0% |
| Essential Health Benefit; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Referred To; Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling; Maternity and Newborn Care; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Co | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; Timely Filing Deficiency | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Stat Pen Pd-46 To 90 Dys Late; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Access to Care | Record Only | 1 | 0.0% |
| Recoupment Of Claims Payment; Usual And Customary | Record Only | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment | Additional Monies Received; Corrective Action Taken; Contrac | 1 | 0.0% |
| Recoupment Of Claims Payment | Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer | Referred To; No Jurisdiction | 1 | 0.0% |
| Prompt Pay; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Access to Care; Continuity of Treatment | Information Furnished; Policy Not In Force; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment | Additional Monies Received; Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Insufficient Information | 1 | 0.0% |
| Cust Service Claim Handling | No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment | Corrective Action Taken; Contract Language/Legal Issue; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Claim Settled; Information Furnished | 1 | 0.0% |
| Access to Care; Continuity of Treatment; Summary of Benefits | Company Position Upheld; No Jurisdiction; Contract Langua | 1 | 0.0% |
| Usual And Customary | Contract Language/Legal Issue; Record Only | 1 | 0.0% |
| Usual And Customary | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Physician Ranking Programs | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Complaint Withdrawn; Stat Pen Pd-Up To 45 Dys Late | 1 | 0.0% |
| Other; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Coordination of Benefits; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Failure to Timely Respond; Contract Langu | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Additional Monies Received; No Jurisdi | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Contract Language/Legal Issue; No Jurisdi | 1 | 0.0% |
| Usual And Customary | Insufficient Information | 1 | 0.0% |
| Continuation of Benefits | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Additional Monies Received; Informatio | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Timely Filing Deficiency | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished; Additional Moni | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Stat Pen Pd-Up To 45 Dys Late | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Record Only | 1 | 0.0% |
| Unfair Discrim-Clms Handling; Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Stat Pen Pd-Over 90 Dys Late; Additional Monies Received; Contract La | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received; C | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Additional Monies Received; Information Furn | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Information Furnished; Additional Monies Rec | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Corrective Action Taken; Additional Monies Rec | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Additional Monies Received; Corrective Action | 1 | 0.0% |
| Usual And Customary | Additional Monies Received; Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Misrepresentation | Information Furnished; Corrective Action Taken; Policy Not In Force | 1 | 0.0% |
| Usual And Customary | Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Corrective Action Taken; Information F | 1 | 0.0% |
| Other | Claim Settled | 1 | 0.0% |
| Cust Service Claim Handling | Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Usual And Customary | Record Only; No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Usual And Customary | Complaint Withdrawn | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Corrective Action Taken; Information Furn | 1 | 0.0% |
| Usual And Customary | Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Other | Consumer Withdraw | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Overpaid Claim Recouped | 1 | 0.0% |
| Usual And Customary | Corrective Action Taken; No Jurisdiction | 1 | 0.0% |
| Usual And Customary | Additional Payment Expected; Corrective Action Taken | 1 | 0.0% |
| Usual And Customary | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Consumer Withdraw | 1 | 0.0% |
| Usual And Customary | Contract Language/Legal Issue; Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Information Furnished; Additional Payment Ex | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Insufficient Information; Record Only | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Payment Expected; Information Furnished | 1 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received; Contract Languag | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action Taken; Additional Payment Expected | 1 | 0.0% |
| Closed-Lack Of Info Cmplainant | Insufficient Information; Record Only | 1 | 0.0% |
| Claimant Fraud | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Other | Mediation Not Eligible | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction; Information Furnished | 1 | 0.0% |
| Closed-Lack Of Info Cmplainant; Unsatisfactory Settle/Offer | Record Only | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late; Corrective Action Ta | 1 | 0.0% |
| Claimant Fraud; Unsatisfactory Settle/Offer | Mediation Billed Amount; Out-of-Net/Mediation/Settl_Exp | 1 | 0.0% |
| Attorney Fraud; Unsatisfactory Settle/Offer | Mediation Not Eligible; Mediation Billed Amount | 1 | 0.0% |
| Claimant Fraud; Unsatisfactory Settle/Offer | Additional Payment Expected; Mediation Billed Amount | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Stat Pen Pd-Over 90 Dys Late; Additional Monies Received | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Stat Pe | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Additional Monies Received | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Cust Service Claim Handling; Not Within TDI Jurisdiction; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Question of Fact | 1 | 0.0% |
| Inaccurate Info In IRO Decsn | Corrective Action Taken; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Additional Monies Received | 1 | 0.0% |
| Prompt Pay | No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Claimant Fraud; Unsatisfactory Settle/Offer | Mediation Billed Amount; Mediation Paid Amount; Claim Settled | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Not Eligible | 1 | 0.0% |
| Claimant Fraud; Unsatisfactory Settle/Offer | Mediation Billed Amount; Mediation Paid Amount | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer; Usual And Customary | Referred for Disciplinary Actn; Informa | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Informat | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Stat Pen Pd-Over 90 Dys Late; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Unfair Discrim-Clms Handling; Unsatisfactory Settle/Offer | Company Position Upheld | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Other | 1 | 0.0% |
| Cust Service Claim Handling; Prompt Pay; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Misrepresentation | Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment | Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment; Usual And Customary | Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment | Corrective Action Taken; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Paid Amount; No Jurisdiction; Mediation Billed Amount | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Paid Amount; Mediation Billed Amount; No Jurisdiction | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg | Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Other | Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Not Eligible; Additional Monies Received; Mediation Billed Amount | 1 | 0.0% |
| Improper Inducements | Information Furnished | 1 | 0.0% |
| Cust Service Claim Handling | No Jurisdiction; Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Not Within TDI Jurisdiction; Other | Referred To; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Billed Amount; Additional Monies Received; Mediation Not Eligible | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Billed Amount; Mediation Paid Amount | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Stat Pen Pd-46 To 90 Dys Late; Additional Monies Received | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Contract L | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Billed Amount; No Jurisdiction; Mediation Not Eligible | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Not Eligible; No Jurisdiction; Mediation Billed Amount | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Paid Amount; Mediation Billed Amount | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg | Company Position Upheld; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Other | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Deficient Claim Notice; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Material Change To Contract; Misrepresentation; Unauthorized Acts; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| Laboratory Services | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Consumer Withdraw; Claim Settled | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment | Question of Fact; Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment; Unfair Discrim-Clms Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment; Unfair Discrim-Clms Handling; Usual And Customary | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Ambulatory Patient Services; Hospitalization | Additional Monies Received | 1 | 0.0% |
| Maternity and Newborn Care; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Referred To; No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Timely Filing Deficiency; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Corrective Action Taken; Stat Pen Pd-Up To 45 Dys Late; Clean Claims Violation | 1 | 0.0% |
| PPACA-Access To OB/GYN; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Stat Pen Pd-46 To 90 Dys Late; Contract Language/Legal Issue | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling; Unsatisfactory Settle/Offer | Additional Monies Received; Correct | 1 | 0.0% |
| Cust Service Claim Handling; IRO Failed To Obtn Med Rcrds; Unsatisfactory Settle/Offer | Corrective Action Taken | 1 | 0.0% |
| Prompt Pay | Corrective Action Taken; Clean Claims Violation; Stat Pen Pd-Up To 45 Dys Late | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Corrective Action Taken; No Jurisdicti | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Contract Language/Legal Issue; No Jurisdicti | 1 | 0.0% |
| Commissions | Other | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Company Position Upheld; Contract Language/Leg | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Additional Monies Received | 1 | 0.0% |
| Cust Service Claim Handling; Laboratory Services; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg | Referred for Disciplinary Actn | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; SB418 Rule Violation | No Jurisdiction | 1 | 0.0% |
| Access to Care; Continuity of Treatment; Den/N-Pymt MD Nec Trmt N-Emrg | Company Position Upheld; Contract Language/Lega | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Policy | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished; Contract | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction; Referred To | 1 | 0.0% |
| Access to Care; Continuity of Treatment; Den/N-Pymt MD Nec RX | Company Position Upheld; Information Furnished; Contract | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Additional Monies Received; Stat Pen Pd-Up To 45 Dys Late; Claim Settled | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction; Corrective Action Taken; Contract Language/ | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Overcharges; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Record Only | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Corrective Action Taken; Clean Claims Violation; Stat Pen Pd-Up To 45 Dys Late | 1 | 0.0% |
| Access to Care | Company Position Upheld | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment | Information Furnished; Company Position Upheld; Overpaid Cla | 1 | 0.0% |
| Material Change To Contract; Other; Unsatisfactory Settle/Offer | Additional Payment Expected | 1 | 0.0% |
| COBRA; Continuation of Benefits | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Stat Pen Pd-Up To 45 Dys Late | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Claim Not Clean | 1 | 0.0% |
| Recoupment Of Claims Payment | No Jurisdiction; Corrective Action Taken | 1 | 0.0% |
| Not Within TDI Jurisdiction; SB418 Rule Violation | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Billed Amount | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Mediation Billed Amount; Mediation Paid Amount | 1 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Contract Language/Legal | 1 | 0.0% |
| Agency Balance; Commissions; Unauthorized Acts | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Mediation Not Eligible; Mediation Billed Amount | 1 | 0.0% |
| Continuity of Treatment | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Other | Company Position Upheld | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Payment Expected; Mediation Billed Amount; Mediation Not E | 1 | 0.0% |
| Recoupment Of Claims Payment; Usual And Customary | No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Not Within TDI Jurisdiction; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; No Jurisd | 1 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; No Jurisdiction; Additional Monies | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Contract Language/Legal Issue; Additional Monies Received | 1 | 0.0% |
| SB418 Rule Violation; Timely Filing Deficiency | Additional Monies Received; Stat Pen Pd-Up To 45 Dys Late; Corrective A | 1 | 0.0% |
| Not Within TDI Jurisdiction; SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Consumer Withdraw; Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Contract Language/Legal Issue; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished; No Jurisdiction | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Additional Mon | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Overpaid Claim Recouped; Info | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Not Eligible; Contract Language/Legal Issue | 1 | 0.0% |
| Unfair Discrimination | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Not Eligible; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Overpaid Claim Recouped; Company Positi | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Overpaid Claim Recouped; Company Position Upheld; Contract L | 1 | 0.0% |
| Cust Service Claim Handling; Overcharges; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Corrective Action | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Compan | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Mental Health Parity; Unsatisfactory Settle/Offer | Referred for Disciplinary Actn; Contract Language/Legal Issue | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Rehabilitative/habilitative ; Unsatisfactory Settle/Offer; Usual And Customary | Corrective | 1 | 0.0% |
| Commissions | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Stat Pen Pd-46 To 90 Dys Late; Clean Claims Violation; Addit | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Information Furnished; Company Position Upheld | 1 | 0.0% |
| Misrepresentation; Unsatisfactory Settle/Offer | Company Position Upheld | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Insuff | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Policy Not In Force | 1 | 0.0% |
| Recoupment Of Claims Payment; Usual And Customary | Contract Language/Legal Issue; Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Contract | 1 | 0.0% |
| Recoupment Of Claims Payment | Overpaid Claim Recouped; No Jurisdiction | 1 | 0.0% |
| Ambulatory Patient Services; Coordination of Benefits; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Addit | 1 | 0.0% |
| Overcharges; Unsatisfactory Settle/Offer | Company Position Upheld; Corrective Action Taken | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; SB418 Rule Violation | Claim Not Clean; Corrective Action Taken; Claim Settled | 1 | 0.0% |
| Access to Care; Den/N-Pymt MD Nec Trmt N-Emrg | Company Position Upheld; Failure to Timely Respond; Information Furnishe | 1 | 0.0% |
| Overcharges; PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Lega | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Overpaid Claim Recouped | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Insufficient Information | 1 | 0.0% |
| Access to Care | Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Referred To; Company Position Upheld; No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Insufficient Information; Other | 1 | 0.0% |
| Prohibited PHI Disclosure | Corrective Action Taken | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Consumer Withdraw | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Payment Expected; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Complainant Retained Attorney | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Addition | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Consumer Withdraw; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Additional Monies Rece | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Referred To; No Jurisdiction | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment | No Jurisdiction; Company Position Upheld | 1 | 0.0% |
| Recoupment Of Claims Payment | Overpaid Claim Recouped; Company Position Upheld; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Information Furnished; Insufficient Information | 1 | 0.0% |
| Recoupment Of Claims Payment | Stat Pen Pd-Over 90 Dys Late; Clean Claims Violation; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Contrac | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg | Information Furnished; Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Access to Care; Continuity of Treatment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnis | 1 | 0.0% |
| Misrepresentation | Information Furnished; Record Only | 1 | 0.0% |
| Den/N-Pymt MD Nec RX; Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction; Claim Settled | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnis | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken | 1 | 0.0% |
| Unfair Discrim-Clms Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Claim Not Clean; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Overpaid Claim Recouped | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue; Compan | 1 | 0.0% |
| Other | Additional Payment Expected; Corrective Action Taken | 1 | 0.0% |
| Overcharges; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Con | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Company Position Upheld; No Jurisdicti | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; Over | 1 | 0.0% |
| Overcharges; Recoupment Of Claims Payment; SB418 Rule Violation | Overpaid Claim Recouped; Corrective Action Taken; Cont | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Record Only | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Contract Language/Legal Issue; Company Position Uphe | 1 | 0.0% |
| Agent Handling | Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Overpaid Claim Recouped; Record Only | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Overpaid Claim Recouped; Contract Language/Legal Issue; Info | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; No Jurisdiction; Additional Monies Rec | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | No Jurisdiction; Additional Monies Received | 1 | 0.0% |
| Coordination of Benefits; Cust Service Claim Handling; Unsatisfactory Settle/Offer | 1 | 0.0% |
| SB418 Rule Violation | Stat Pen Pd-Over 90 Dys Late; Additional Monies Received; Clean Claims Violation | 1 | 0.0% |
| Recoupment Of Claims Payment; Unfair Discrim-Clms Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Insufficient Information; No Jurisdiction | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation; Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment; Usual And Customary | Overpaid Claim Recouped | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Additional Monies Received; Referred T | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Contract La | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Overpaid Claim | 1 | 0.0% |
| Access to Care; Den/N-Pymt MD Nec Trmt N-Emrg | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Overpaid Claim Recouped; No Jurisdictio | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Referred To; Overpaid Claim Recouped | 1 | 0.0% |
| Overcharges; Recoupment Of Claims Payment | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Overpaid Claim Recouped; Failure to Tim | 1 | 0.0% |
| Overcharges; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction; | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; No Juris | 1 | 0.0% |
| Not Within TDI Jurisdiction; Recoupment Of Claims Payment | Overpaid Claim Recouped; No Jurisdiction | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Billed Amount; Mediation Not Eligible; Claim Settled | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Overpaid Claim Recouped; Corrective Act | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; No Jurisdiction | 1 | 0.0% |
| Liability Dispute; Unsatisfactory Settle/Offer | Information Furnished; Claim Settled; Additional Monies Received | 1 | 0.0% |
| Cust Service Claim Handling | Information Furnished; Additional Payment Expected | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Stat Pen Pd-46 To 90 Dys Late; Additional Monies Received; Company Position Upheld | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | No Jurisdiction; Company Position Upheld; Information Furnished | 1 | 0.0% |
| Overcharges | Claim Settled | 1 | 0.0% |
| Coordination of Benefits; Liability Dispute; Unsatisfactory Settle/Offer | No Jurisdiction; Claim Settled | 1 | 0.0% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Additional Mo | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Overpaid Claim Recouped | 1 | 0.0% |
| Fraud; Overcharges; Recoupment Of Claims Payment | Overpaid Claim Recouped; Contract Language/Legal Issue; Corrective Ac | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Failure to Timely Respond; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | No Jurisdiction; Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer; Usual And Customary | Referred To; No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Paid Amount; Referred To; Mediation Billed Amount | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Failure to Timely Respond; Information Furnished | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Information Furnished; Corrective Action Taken | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Billed Amount; Mediation Paid Amount; Mediation Not Eligible | 1 | 0.0% |
| Recoupment Of Claims Payment; SB418 Rule Violation; Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Leg | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Information Furnished; Claim Settled | 1 | 0.0% |
| Cust Service Claim Handling | No Jurisdiction; Contract Language/Legal Issue; Mediation Billed Amount | 1 | 0.0% |
| Refusal to Insure | Policy Issued/Restored | 1 | 0.0% |
| Overcharges; Recoupment Of Claims Payment | Contract Language/Legal Issue; Overpaid Claim Recouped | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Additional Payment Expected; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Mediation Billed Amount; Mediation Paid Amount; Claim Settled | 1 | 0.0% |
| Hospitalization; Laboratory Services; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Overpaid Claim Recouped; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Failure to Timely Respond; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Additional Monies Received; Claim Settled | 1 | 0.0% |
| Coordination of Benefits | Additional Monies Received; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Corrective Action Taken; Additional Monies Received; Information Furnished | 1 | 0.0% |
| Lifetime/Annual Limits | Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Lan | 1 | 0.0% |
| Ambulatory Patient Services; Maternity and Newborn Care; Unsatisfactory Settle/Offer | Company Position Upheld; Contract | 1 | 0.0% |
| Cust Service Claim Handling; Overcharges; Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished; | 1 | 0.0% |
| Cust Service Claim Handling; Laboratory Services; Unsatisfactory Settle/Offer | Company Position Upheld; Information Fur | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld; Contract Langu | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Complainant Retained Attorney; Contra | 1 | 0.0% |
| Coordination of Benefits; Recoupment Of Claims Payment | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Maximum Out of Pocket; Overcharges; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received; Informa | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Claim Settled; Contract Language/Lega | 1 | 0.0% |
| Continuity Of Treatment; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; C | 1 | 0.0% |
| Ambulatory Patient Services; Unsatisfactory Settle/Offer | Company Position Upheld; Claim Settled | 1 | 0.0% |
| COBRA; Continuation of Benefits; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Corrective Actio | 1 | 0.0% |
| Access to Care; Continuity of Treatment | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Liability Dispute; Rehabilitative/habilitative ; Unsatisfactory Settle/Offer | Additional Monies Received; Contract Lang | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Company Position Upheld | 1 | 0.0% |
| Coordination of Benefits; Unsatisfactory Settle/Offer | Stat Pen Pd-Up To 45 Dys Late; Clean Claims Violation; Additiona | 1 | 0.0% |
| Access to Care; Continuity of Treatment; Den/N-Pymt MD Nec RX | Company Position Upheld; Information Furnished | 1 | 0.0% |
| Laboratory Services; Maximum Out of Pocket; Unsatisfactory Settle/Offer; Usual And Customary | Information Furnished; Co | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Insufficient Information; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Misrepresentation | Company Position Upheld | 1 | 0.0% |
| Not Within TDI Jurisdiction | No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Access to Care; Continuity of Treatment; Den/N-Pymt MD Nec DME/Supplies | Contract Language/Legal Issue; Company Positio | 1 | 0.0% |
| Closed-Lack Of Info Cmplainant; Other | Claim Settled | 1 | 0.0% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Informat | 1 | 0.0% |
| Overcharges; Unsatisfactory Settle/Offer | Corrective Action Taken; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Company Position Upheld; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Claim Settled; Contract Language/Legal Issue | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Discl-Fee Schd/Clms Proc Gdlns; Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Compan | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Overpaid Claim Recouped; Additional Payment Expected | 1 | 0.0% |
| Prompt Pay | Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished; Additional Monies Received | 1 | 0.0% |
| IRO Notice Of Review | Information Furnished | 1 | 0.0% |
| Lifetime/Annual Limits; Maximum Out of Pocket; Overcharges; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Failure to Timely Respond | 1 | 0.0% |
| IRO Notice Of Review; Unsatisfactory Settle/Offer | Information Furnished; Referred To | 1 | 0.0% |
| Continuity of Treatment; Enrllmt/Canc/Rnwl Of Enrollee | Information Furnished | 1 | 0.0% |
| Disclosure Of Benefits | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Misrepresentation | Contract Language/Legal Issue; Referred for Disciplinary Actn | 1 | 0.0% |
| Assignment of Benefits; Unsatisfactory Settle/Offer | Claim Settled; Additional Monies Received; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Settled; Failure to Timely Respond | 1 | 0.0% |
| Recoupment Of Claims Payment | Additional Payment Expected | 1 | 0.0% |
| Other | Contract Language/Legal Issue; Referred for Disciplinary Actn | 1 | 0.0% |
| COBRA; Disclosure Of Benefits; Material Change To Contract; Unsatisfactory Settle/Offer | Corrective Action Taken; Claim | 1 | 0.0% |
| Access to Care; Continuity of Treatment | Additional Monies Received | 1 | 0.0% |
| Cust Service Claim Handling; Mental Health Parity; Unsatisfactory Settle/Offer | Information Furnished; Additional Monie | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Other | Referred for Disciplinary Actn | 1 | 0.0% |
| IRO Notice Of Review | Referred To | 1 | 0.0% |
| IRO Notice Of Review | Referred To; Information Furnished | 1 | 0.0% |
| Access to Care; Continuity of Treatment | Insufficient Information | 1 | 0.0% |
| IRO Notice Of Review; Unsatisfactory Settle/Offer | Referred To; Information Furnished | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled | 1 | 0.0% |
| Liability Dispute; Unsatisfactory Settle/Offer | Company Position Upheld; Information Furnished; Contract Language/Legal | 1 | 0.0% |
| Access to Care; Continuity of Treatment; Out Of Ntwk Referral | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Recoupment Of Claims Payment | Claim Settled; Information Furnished; Corrective Action Taken | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Company Position Upheld; Informati | 1 | 0.0% |
| Coordination of Benefits; Recoupment Of Claims Payment | Stat Pen Pd-Up To 45 Dys Late; Additional Monies Received; Stat | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Claim Settled | 1 | 0.0% |
| Access to Care | Information Furnished; Additional Monies Received | 1 | 0.0% |
| COBRA; Continuation of Benefits; Grp Conversion/Continuation | No Jurisdiction; Contract Language/Legal Issue; Informati | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Claim Settled; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Additional Monies Received; Contract Language/Legal Issue | 1 | 0.0% |
| Den/N-Pymt MD Nec RX; IRO Notice Of Review | Information Furnished | 1 | 0.0% |
| Den/N-Pymt MD Nec DME/Supplies | Insufficient Information | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction; Additional Monies Received | 1 | 0.0% |
| Misrepresentation; Refusal to Insure | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Access to Care; Continuity of Treatment; Hlth Care Svcs Covg/Copay/Lmts | Information Furnished | 1 | 0.0% |
| Continuity Of Treatment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Assignment of Benefits | Contract Language/Legal Issue | 1 | 0.0% |
| Access to Care; Continuity of Treatment; Den/N-Pymt MD Nec RX | Contract Language/Legal Issue | 1 | 0.0% |
| IRO Report Incomplete | Referred To; Insufficient Information | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Failure to Timely Respond; Ad | 1 | 0.0% |
| Access to Care | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Ambulatory Patient Services; Other; PPACA-Preventive Health Svcs; Unsatisfactory Settle/Offer; Usual And Customary | Con | 1 | 0.0% |
| Coordination of Benefits; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Payment Expected | 1 | 0.0% |
| Coordination of Benefits | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Other | Additional Monies Received; Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Question of Fact; Contract Language/Legal Issue; Additional Monies Received | 1 | 0.0% |
| Agent Handling; Misrepresentation; Unauthorized Acts | Insufficient Information | 1 | 0.0% |
| Recoupment Of Claims Payment | Contract Language/Legal Issue; Information Furnished; Policy Not In Force | 1 | 0.0% |
| Access to Care; Continuity Of Treatment | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Other | Other; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Question of Fact | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Referred To | 1 | 0.0% |
| Agent Handling | No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Referred To; Additional Monies Received; No Jurisdiction | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Failure to Timely Respond; Additional Monies Received | 1 | 0.0% |
| Pre-Existing Condition | Claim Settled; Information Furnished; Additional Monies Received | 1 | 0.0% |
| Den/N-Pymt MD Nec DME/Supplies | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Policy Not In Force; Insufficient Information | 1 | 0.0% |
| Prompt Pay; SB418 Rule Violation | Information Furnished; Claim Not Clean | 1 | 0.0% |
| Cust Service Claim Handling; Other; Overcharges | No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Usual And Customary | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Not Clean; Additional Monies Received; No Jurisdiction | 1 | 0.0% |
| Deficient Claim Notice; Recoupment Of Claims Payment | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Other | No Jurisdiction; Information Furnished | 1 | 0.0% |
| PPACA-Out-Of-Ntwk Emerg Care; SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished; Additional Moni | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.0% |
| Other; PPACA-Out-Of-Ntwk Emerg Care; Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 1 | 0.0% |
| Access to Care; Continuity Of Treatment | Insufficient Information | 1 | 0.0% |
| Recoupment Of Claims Payment | Referred To; No Jurisdiction; Additional Monies Received | 1 | 0.0% |
| Recoupment Of Claims Payment | Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| Physician Ranking Programs | Contract Language/Legal Issue | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg; Unsatisfactory Settle/Offer; Usual And Customary | Additional Monies Received; Informatio | 1 | 0.0% |
| Den/N-Pymt MD Nec DME/Supplies; Den/N-Pymt MD Nec RX; Misrepresentation | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Referred To; No Jurisdiction; Additional Monies Received | 1 | 0.0% |
| Commissions | Information Furnished; Company Position Upheld | 1 | 0.0% |
| Prompt Pay | Claim Not Clean; Claim Settled | 1 | 0.0% |
| Continuity Of Treatment; Other | No Jurisdiction | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Clean Claims Violation; Additional Monies Received; Stat Pen Pd-Up T | 1 | 0.0% |
| Recoupment Of Claims Payment; SB418 Rule Violation | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Claim Settled | 1 | 0.0% |
| Den/N-Pymt MD Nec RX; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Claim Not Clean; Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Corrective Action Taken; Contract Language/Legal Issue; Claim Settled | 1 | 0.0% |
| Other | Policy Not In Force | 1 | 0.0% |
| Refusal to Insure | Information Furnished | 1 | 0.0% |
| Continuity Of Treatment | Contract Language/Legal Issue | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Question of Fact; Contract Language/Legal Issue | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Insufficient Information | 1 | 0.0% |
| Overcharges; PPACA-Preventive Health Svcs | No Jurisdiction | 1 | 0.0% |
| Fraud; Overcharges; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; SB418 Rule Violation; Unsatisfactory Settle/Offer | Clean Claims Violation; Additional Mon | 1 | 0.0% |
| Continuity Of Treatment; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| COBRA; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Deficient Claim Notice; SB418 Rule Violation | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Claim Settled; Contract Language/Legal Issue | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg | Claim Settled | 1 | 0.0% |
| Fraud; Overcharges | Other; Information Furnished | 1 | 0.0% |
| Material Change To Contract; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 1 | 0.0% |
| Other | Information Furnished; Other | 1 | 0.0% |
| SB418 Rule Violation; Timely Filing Deficiency; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information | 1 | 0.0% |
| Cust Service Claim Handling; SB418 Rule Violation; Unsatisfactory Settle/Offer | Claim Not Clean; Additional Monies Rece | 1 | 0.0% |
| Prompt Pay; Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furni | 1 | 0.0% |
| Access to Care; Other; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Access to Care; Continuity Of Treatment | No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Information Furnished; Claim Settled | 1 | 0.0% |
| COBRA | No Jurisdiction; Contract Language/Legal Issue | 1 | 0.0% |
| Cust Service Claim Handling | Question of Fact | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Insufficient Information; Failure to Timely Respond | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg | Failure to Timely Respond | 1 | 0.0% |
| Recoupment Of Claims Payment | Failure to Timely Respond; Claim Settled; Additional Monies Received | 1 | 0.0% |
| Cust Service Claim Handling; Overcharges | Claim Settled | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late | 1 | 0.0% |
| Pre-Existing Condition | Contract Language/Legal Issue | 1 | 0.0% |
| Overcharges | Insufficient Information | 1 | 0.0% |
| Refusal to Insure | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Overpaid Claim Recouped | 1 | 0.0% |
| PPACA-Appeals And Grievances | Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Stat Pen Pd-Over 90 Dys Late; Clean Claims Violation; Stat Pen Pd-Up To 45 Dys Late | 1 | 0.0% |
| URA Failed To Prov Pr-To-Pr Rv | Claim Settled | 1 | 0.0% |
| Recoupment Of Claims Payment | Additional Monies Received; Clean Claims Violation; Stat Pen Pd-Up To 45 Dys Late | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Clean Claims Violation | 1 | 0.0% |
| Recoupment Of Claims Payment | Claim Settled; Additional Monies Received | 1 | 0.0% |
| Access to Care; Other | No Jurisdiction | 1 | 0.0% |
| Unfair Discrimination | No Jurisdiction | 1 | 0.0% |
| Cust Service Claim Handling; Recoupment Of Claims Payment | Policy Not In Force; Contract Language/Legal Issue; Company | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Opened/Linked to Case File | 1 | 0.0% |
| Access to Care; Material Change To Contract; Other | No Jurisdiction | 1 | 0.0% |
| Discl-Fee Schd/Clms Proc Gdlns | No Jurisdiction | 1 | 0.0% |
| Recoupment Of Claims Payment | Additional Monies Received; Claim Not Clean | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Corrective Action Taken; Insufficient Information | 1 | 0.0% |
| Recoupment Of Claims Payment; SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished | 1 | 0.0% |
| Incomplete URA Notification | Record Only; Information Furnished | 1 | 0.0% |
| Timeliness Of URA Notification; Unsatisfactory Settle/Offer | Additional Payment Expected; Information Furnished | 1 | 0.0% |
| Disclosure Of Benefits; Other | Information Furnished | 1 | 0.0% |
| Coordination of Benefits | Referred To; Other | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Clean Claims Violation | 1 | 0.0% |
| Not Within TDI Jurisdiction | 1 | 0.0% |
| Coordination of Benefits; SB418 Rule Violation | Additional Monies Received; Clean Claims Violation; Information Furnish | 1 | 0.0% |
| Overcharges | Claim Settled; Contract Language/Legal Issue | 1 | 0.0% |
| Overcharges | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Clean Claims Violation | 1 | 0.0% |
| Access to Care; Den/N-Pymt MD Nec Trmt N-Emrg | No Jurisdiction | 1 | 0.0% |
| Den/N-Pymt MD Nec Trmt N-Emrg; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 0.0% |
| Unsatisfactory Settle/Offer | No Jurisdiction; Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Timely Filing Deficiency; Unsatisfactory Settle/Offer | Corrective Action Taken; Information Furnished | 1 | 0.0% |
| Timely Filing Deficiency; Unsatisfactory Settle/Offer | Additional Monies Received; No Jurisdiction | 1 | 0.0% |
| Timely Filing Deficiency; Unsatisfactory Settle/Offer | No Jurisdiction; Information Furnished | 1 | 0.0% |
| Timely Filing Deficiency; Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction | 1 | 0.0% |
| Prompt Pay; Unsatisfactory Settle/Offer | Additional Monies Received; Claim Not Clean | 1 | 0.0% |
| Misrepresentation | Policy Issued/Restored; Contract Language/Legal Issue | 1 | 0.0% |
| SB418 Rule Violation; Unsatisfactory Settle/Offer | Information Furnished; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; Other | 1 | 0.0% |
| IRO Request Not Filed Timely | Information Furnished; Other | 1 | 0.0% |
| Den/N-Pymt MD Nec RX | Claim Settled; Information Furnished | 1 | 0.0% |
| Other | Other | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Stat Pen Pd-46 To 90 Dys Late | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Information Furnished; No Jurisdiction; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Stat Pen Pd-Over 90 Dys Late; Clean Claims Violation | 1 | 0.0% |
| Recoupment Of Claims Payment; SB418 Rule Violation | Claim Settled; Additional Monies Received | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Stat Pen Pd-46 To 90 Dys Late; No Jurisdiction; Information Furnished | 1 | 0.0% |
| XX-Usual, Cstmry, Rsnable Chgs | Contract Language/Legal Issue; Information Furnished | 1 | 0.0% |
| Unsatisfactory Settle/Offer | Clean Claims Violation; Stat Pen Pd-Over 90 Dys Late; Additional Monies Received | 1 | 0.0% |
health Complaints by State
| State | Complaints |
|---|---|
| Texas | 18,829 |
| Connecticut | 540 |
Recent health Complaints Against UNITEDHEALTHCARE INSURANCE COMPANY
- health Complaint #CT-7085574-0b62caa7 — Connecticut (2026-05-12)
- health Complaint #CT-7085506-0b62caa7 — Connecticut (2026-05-12)
- health Complaint #CT-7085154-c5389e34 — Connecticut (2026-04-29)
- health Complaint #TX-454891-04f704ee — Texas (2026-04-28)
- health Complaint #TX-454717-1ea5331e — Texas (2026-04-27)
- health Complaint #CT-7085053-a7c46eb9 — Connecticut (2026-04-27)
- health Complaint #CT-7085010-8eadc90e — Connecticut (2026-04-25)
- health Complaint #TX-454616-181dbe81 — Texas (2026-04-24)
- health Complaint #TX-454609-77e36b31 — Texas (2026-04-24)
- health Complaint #TX-454476-8c9a0926 — Texas (2026-04-23)
Frequently Asked Questions
How many health complaints does UNITEDHEALTHCARE INSURANCE COMPANY have?
UNITEDHEALTHCARE INSURANCE COMPANY has 19369 health insurance complaints on file, according to NAIC and state DOI data.
What are the most common health complaint issues with UNITEDHEALTHCARE INSURANCE COMPANY?
The most common health complaint issues for UNITEDHEALTHCARE INSURANCE COMPANY are: Claim denial (6007), Premium or billing dispute (5729), Delayed payment (2189), Usual And Customary | Contract Language/Legal Issue (547), Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue (541).
Which states have the most health complaints against UNITEDHEALTHCARE INSURANCE COMPANY?
The states with the most health complaints against UNITEDHEALTHCARE INSURANCE COMPANY are: Texas (18829), Connecticut (540).
health Complaints by State
UNITEDHEALTHCARE INSURANCE COMPANY Complaints by State
- UNITEDHEALTHCARE INSURANCE COMPANY Complaints in California
- UNITEDHEALTHCARE INSURANCE COMPANY Complaints in Texas
- UNITEDHEALTHCARE INSURANCE COMPANY Complaints in New York
- UNITEDHEALTHCARE INSURANCE COMPANY Complaints in Florida
- UNITEDHEALTHCARE INSURANCE COMPANY Complaints in Illinois
- UNITEDHEALTHCARE INSURANCE COMPANY Complaints in Pennsylvania
- UNITEDHEALTHCARE INSURANCE COMPANY Complaints in Ohio
- UNITEDHEALTHCARE INSURANCE COMPANY Complaints in Georgia
- UNITEDHEALTHCARE INSURANCE COMPANY Complaints in North Carolina
- UNITEDHEALTHCARE INSURANCE COMPANY Complaints in New Jersey