Colorado § 10-3-1115 Improper denial of claims - prohibited - definitions - severability

Colorado Statutes

§ 10-3-1115 — Improper denial of claims - prohibited - definitions - severability

Colorado·Title 10 Insurance·Art. Regulation of Insurance Companies

(1)(a) A person engaged in the business of insurance shall not unreasonably delay or deny payment of a claim for benefits owed to or on behalf of any first-party claimant.

(b)For the purposes of this section and section 10-3-1116:

(I)First-party claimant means an individual, corporation, association, partnership, or other legal entity asserting an entitlement to benefits owed directly to or on behalf of an insured under an insurance policy. First-party claimant includes a public entity that has paid a claim for benefits due to an insurer's unreasonable delay or denial of the claim.

(II)First-party claimant does not include:

(A)A nonparticipating provider performing services; or

(B)A person asserting a claim against an insured under a liability policy.

(2)Notwithstanding

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(1) (a) A person engaged in the business of insurance shall not unreasonably delay
or deny payment of a claim for benefits owed to or on behalf of any first-party
claimant.

(b) For the purposes of this section and section 10-3-1116:

(I) First-party claimant means an individual, corporation, association,
partnership, or other legal entity asserting an entitlement to benefits owed directly
to or on behalf of an insured under an insurance policy. First-party claimant
includes a public entity that has paid a claim for benefits due to an insurer's
unreasonable delay or denial of the claim.

(II) First-party claimant does not include:

(A) A nonparticipating provider performing services; or

(B) A person asserting a claim against an insured under a liability policy.

(2) Notwithstanding section 10-3-1113 (3), for the purposes of an action
brought pursuant to this section and section 10-3-1116, an insurer's delay or denial
was unreasonable if the insurer delayed or denied authorizing payment of a covered
benefit without a reasonable basis for that action.

(3) If any provision of this section or its application to any person or
circumstance is held illegal, invalid, or unenforceable, no other provisions or
applications of this section shall be affected that can be given effect without the
illegal, invalid, or unenforceable provision or application, and to this end the
provisions of this section are severable.

(4) The general assembly declares that this section is a law regulating
insurance.

(5) This section and section 10-3-1116 shall not apply to insurance issued in
compliance with the Workers' Compensation Act of Colorado, articles 40 to 47 of
title 8, C.R.S.

(6) This section and section 10-3-1116 shall not apply to title insurance issued
pursuant to article 11 of this title or to life insurance issued pursuant to article 7 of
this title.

(7) The provisions of this section and section 10-3-1116 do not apply to any
claim payment that is delayed or denied because of the insurer's participation in the
child support enforcement mechanism established in section 26-13-122.7, C.R.S.

Colorado § 10-3-1115 (Improper denial of claims - prohibited - definitions - severability) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Legislative History

Source: L. 2008: Entire section added, p. 2172, � 5, effective August 5. L. 2016: (7) added, (HB 16-1165), ch. 157, p. 490, � 1, effective January 1, 2017.