NU Online News Service, Feb. 11, 11:10 a.m. – The Maryland Insurance Administration in Baltimore has released a consumer complaint ratio index of health insurers and HMOs operating in the state.
The index covers complaints against health plans lodged with the MIA in 2001.
Of those complaints involving medical necessity issues, where the company disagreed with a physician and determined that a service was not “medically necessary,” Metropolitan Life Insurance Company had the lowest index out of 29 companies, with a justified complaint ratio of 0, the MIA reports.
A complaint ratio of one or less means a company had fewer than the expected number of complaints given its size of the market. A ratio larger than one means the company had more complaints than expected for its size, the MIA says.
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The administration defines a justified complaint as one where the company changed its initial decision following an MIA investigation.