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The Hidden Cost of ERISA Denials and a Lack of Appeals

J. Price McNamara

Dec. 23, 2025

"Among states in 2023, the highest average in-network denial rate was 34% (Alabama), with the lowest in South Dakota (6%), perfectly illustrating the wide national variance in claim denials. Whereas, in Florida, the average in-network denial rate was 16%, with individual insurers varying between 8% to 54%, emphasizing the potentially enormous non-network differential."

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