SACRAMENTO, Calif. — California has fined Anthem Blue Cross $5 million for stonewalling customer complaints.

The Department of Managed Health Care announced the fine Wednesday against the nation’s second-largest health insurer. The department has fined Anthem nearly $12 million for such violations since 2002.

Regulators say in the latest investigation, they found 245 violations of the grievance system from 2013 through 2016.

The department says in one case, Anthem pre-authorized surgery but denied the claim when it was submitted.

The patient and others made 22 calls to the insurer but it took six months and a complaint to state regulators before the claim was resolved.

Anthem Blue Cross says it takes responsibility for past errors but has made changes to its grievance process and “strongly disagrees” with findings that issues are ongoing.