Which insurance companies deny the most claims? All 152, ranked
By number, Blue Cross Blue Shield of Texas denied the most claims in the plan-year 2027 CMS Transparency in Coverage file, 13,945,257 in-network claims in Texas (21.1%); by share, among records with at least 200,000 claims received, Capital Health Plan in Florida denied the most, 96.2%.
What insurance company denies the most claims, record by record: 152 insurer-state records, 123 companies across 29 states, ranked by the share of in-network claims they denied. These are insurance denial rates as the companies themselves reported them, not a list somebody assembled. National average: 15.7%. The last column is the one that should be bigger.
Looking for a shorter list? Health insurance denial rates by company ranks the national brands rather than the 152 insurer-state records, and what are the worst health insurance companies answers the superlative four different honest ways. The same CMS file, per brand: Blue Cross Blue Shield denial rate, United Healthcare denial rate.
| Insurer | State | Denial rate | Claims denied | External reviews |
|---|---|---|---|---|
| Capital Health Plan | Florida | 96.2% | 448,953 | 0 |
| Imperial Insurance Companies, Inc. | Arizona | 50.1% | 4,472 | 0 |
| Imperial Insurance Companies, Inc. | Texas | 36.8% | 9,707 | 0 |
| Blue Care Network of Michigan | Michigan | 30.9% | 1,248,675 | 68 |
| Harvard Pilgrim Health Care of NE | New Hampshire | 30% | 31,257 | 0 |
| Select Health of South Carolina | South Carolina | 29.9% | 72,807 | 0 |
| AmeriHealth Caritas VIP Next, Inc. | Delaware | 29.3% | 63,845 | not reported |
| Imperial Health Plan of the Southwest, Inc. | Utah | 28.8% | 242 | 0 |
| Premera Blue Cross Blue Shield of Alaska | Alaska | 26.3% | 225,470 | not reported |
| Hawaii Medical Service Association | Hawaii | 26.3% | 203,127 | 0 |
Source: CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain.
97 insurer-state records that appeared in earlier releases are not in the plan-year 2027 file, because those insurers moved off the federal Exchange platform. Their old URLs redirect to the state page for the market they were in, which carries current figures; none of them is counted in the 152 above.
Not in this list: Cigna. The plan-year 2027 file carries no Cigna reporting entity, so there is no current Cigna rate. Its page quotes Cigna's published appeal process instead.
Not in this list: Aetna. The plan-year 2027 file carries no Aetna reporting entity, so there is no current Aetna rate. Its page quotes Aetna's published appeal process instead.
The federal timeframes: 180 days from the date on the denial notice to file the internal appeal, then 4 months from the final internal denial to request independent external review. Put your date in and get the actual calendar dates, with the days remaining.
Runs entirely in your browser, the date you type is never sent to us and never stored. Open the full calculator →
Or let the $29 Appeal Kit date each step and write the claim-file and external-review requests.
What this ranking means for your own denial, and by when. Across the 152 insurer-state records ranked above, 83,907,852 in-network claims were denied and 4,918 independent external reviews were filed, one for every 17,061 denials, and 22.2% (1,092 of 4,918; interval 22.2-23.8% for counts CMS withheld; 32.6% without SelectHealth) of the reviews that were filed were overturned, the national rows in the plan-year 2027 release of the CMS Transparency in Coverage file, read November 4, 2026 (data.healthcare.gov). Whichever way that lands, nobody files the appeal for you, and the filing runs on a clock set by which plan you hold: an employer or Marketplace plan gives you at least 180 days from the denial notice to file the internal appeal (29 CFR 2560.503-1(h)(3)(i), carried onto individual-market coverage by 45 CFR 147.136(b)(3)(i)), while Medicare Advantage gives you 65 calendar days from the date of its notice (CMS, 42 CFR 422.582(b)) and Medicaid managed care 60 calendar days from the date on the notice (42 CFR 438.402(c)(2)(ii)), both stages free, and the free calculator above turns the date on your letter into both of those windows, and the full free walkthrough is on how to appeal. The free steps are above; the $29 kit is the same clock with the letters pre-filled for whichever of these insurers denied you. One payment. No subscription. No cut of your claim.
This page is a list, and a list is a cold thing to land on when you are holding a letter. So: find your insurer, open its page, and read the last column before you read the first one, how many of its denials ever reached the independent stage. That is the number that tells you whether the people around you were using the rights you have. If your insurer is not here, the federal file simply does not report it, and your appeal rights are exactly the same. Write to us if you cannot find yourself in this table and we will point you at the right page.
Axion Labs · hello@getaxionlabs.comGet my Appeal Kit, $29
One payment. No subscription. No cut of your claim. Opens on screen the moment you pay. 14-day refund, no questions, one email to hello@getaxionlabs.com.
Counts: CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain. Rights and timeframes: 29 CFR 2560.503-1 (180 days, and your free right to the claim file) and 45 CFR 147.136 (4 months, and what qualifies), explained at HealthCare.gov. Expedited review is decided in about 72 hours under both sections.
Reading either regulation from a script rather than a browser: eCFR answers automated fetches with a challenge page, so the same two sections are mirrored as government PDFs at govinfo.gov (29 CFR 2560.503-1) and govinfo.gov (45 CFR 147.136).
Questions people ask
These are the questions Google shows people asking alongside this page, in the words they are asked in. Each one gets one sentence, from the same sources as the rest of the page.
What insurance company has the highest denial rate?
The top row of this table holds it, and the claim volume printed beside it is there so a high rate on a small book is not read as the same finding as a high rate on a large one.
What are the top 5 worst insurance companies?
The first five rows of the ranked table on this site answer that on one measure only, the share of in-network claims denied, which is the measure CMS collects and not a judgement of the company.
Which insurance companies approve the most claims?
Approval is the other side of the same column: sort this table the other way and the lowest denial rates are the highest approval rates, against a national 15.7%.
Which insurance company has the most customer complaints?
Complaint counts are held by state insurance departments rather than by the CMS file this table is built from, so we do not rank them; each state page here prints that department's own consumer route.
Which insurance company has the highest denial rate?
The same first row, and it is an insurer-state record rather than a national brand, because that is the level at which the file reports.
What percent of insurance claims are denied?
15.7% of in-network claims in the plan-year 2027 CMS Transparency in Coverage release, 83,907,852 of the claims insurers reported receiving.
What is a good claim denial rate?
There is no published standard to call good, so the only honest comparison is against the national 15.7% and against the other records in this table.
Which health insurance has the lowest denial rate?
The bottom of this ranked table holds it, and it is the same list read upwards rather than a separate ranking.