C.R.S. Section 10-3-1115
Improper denial of claims

  • prohibited
  • definitions
  • severability

(1)

Intentionally left blank —Ed.

(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.

Source: Section 10-3-1115 — Improper denial of claims - prohibited - definitions - severability, https://leg.­colorado.­gov/sites/default/files/images/olls/crs2023-title-10.­pdf (accessed Oct. 20, 2023).

10‑3‑101
Formation of insurance companies
10‑3‑102
Purpose of organization or admittance
10‑3‑103
Names of companies
10‑3‑104
Unauthorized companies - penalties
10‑3‑105
Certificate of authority to do business - companies prohibited - definitions
10‑3‑106
Deemed incorporated under corporation law
10‑3‑107
Appointment of registered agent to receive service of process - commissioner required to maintain list - when service of process may be made on commissioner
10‑3‑108
File duly certified copy of charter
10‑3‑109
Reports, statements, assessments, and maintenance of records - publication - penalties for late filing, late payment, or failure to maintain
10‑3‑111
Violations - penalty
10‑3‑112
Directors - terms - election - conflicts of interest - recovery of profits
10‑3‑113
Increase of capital
10‑3‑114
Violations - penalty
10‑3‑117
License automatically extended - when
10‑3‑120
Investments of officers, directors, and principal stockholders
10‑3‑121
Regulation of proxies, consents, or authorizations
10‑3‑122
Duties of foreign companies
10‑3‑123
Assessment accident associations
10‑3‑125
Redomestication of foreign insurers
10‑3‑126
Alien insurers
10‑3‑127
Domicile of nonprofit hospital, medical-surgical, and health services corporations
10‑3‑128
Domestic insurer - requirement to maintain offices in this state
10‑3‑129
Prohibition - display of social security number - insurance companies
10‑3‑130
Certificate of authority application process - tracking compliance with uniform process
10‑3‑131
Acts of producers - responsibility of insurer - definitions
10‑3‑201
Cash capital - guaranty fund - deposit
10‑3‑202
Surplus ascertained - disposition of
10‑3‑203
Additional deposits - withdrawals
10‑3‑204
Payment of dividends
10‑3‑205
Manner of paying surplus
10‑3‑206
Security deposits - certificates
10‑3‑207
Fees paid by insurance companies
10‑3‑208
Financial statements
10‑3‑209
Tax on premiums collected - exemptions - penalties
10‑3‑210
Deposit and safekeeping of securities
10‑3‑211
Deposit only admitted assets
10‑3‑212
Insolvency or impairment of stock insurance company
10‑3‑213
Investments eligible as admitted assets
10‑3‑214
Quantitative investment limitations - manner of applying
10‑3‑215
Evidences of indebtedness
10‑3‑215.5
Investments in medium- and lower-grade obligations
10‑3‑216
Mortgage loans
10‑3‑217
Federally guaranteed or insured real estate loans
10‑3‑218
Real estate for use in company’s business
10‑3‑219
Real estate acquired in satisfaction of indebtedness
10‑3‑220
Real estate for production of income - definition
10‑3‑225
Transportation equipment interests
10‑3‑226
Equity interests - definition
10‑3‑227
Stock for purpose of reinsurance, consolidation, or merger
10‑3‑228
Collateral loans
10‑3‑228.5
Securities lending - repurchase - reverse repurchase - dollar roll transactions
10‑3‑229
Investments for purposes of compliance in other jurisdictions
10‑3‑230
Additional investments
10‑3‑231
Valuation of investments
10‑3‑232
Liens for certain purposes permitted
10‑3‑233
Disposition of certain real estate
10‑3‑234
Approval and record of investments
10‑3‑235
Certain admitted assets deemed securities for deposit purposes
10‑3‑236
Assets acquired through merger, consolidation, or reinsurance
10‑3‑237
Assets acquired under prior law
10‑3‑238
Refunds
10‑3‑239
Subordinated indebtedness
10‑3‑240
Approval of investments
10‑3‑242
Qualified money market funds - definition
10‑3‑243
Derivative transactions - definitions - restrictions - rules
10‑3‑244
Climate risk disclosure - insurer participation - rules - reporting - definition
10‑3‑301
Definitions
10‑3‑302
Deposits required - when
10‑3‑303
Deposits with commissioner
10‑3‑304
Depositaries - responsibility
10‑3‑305
Rights of depositors
10‑3‑306
Release of deposits
10‑3‑307
Commissioner order release
10‑3‑401
Legislative declaration
10‑3‑402
Definitions
10‑3‑403
Scope of part 4
10‑3‑404
Determination of delinquency - procedure
10‑3‑405
Direct supervision
10‑3‑406
Protest of finding of delinquency
10‑3‑407
Costs of direct supervision
10‑3‑411
Penalties for noncompliance
10‑3‑412
Review of action while under direct supervision
10‑3‑413
Appeal from final determination or order of commissioner
10‑3‑414
Nondisclosure of reports and evidence during period of direct supervision or conservatorship
10‑3‑501
Legislative declaration - intents and purposes
10‑3‑502
Definitions
10‑3‑503
Persons covered
10‑3‑504
Jurisdiction - venue
10‑3‑504.5
Application for receivership - penalty
10‑3‑505
Injunctions - orders
10‑3‑506
Cooperation of officers, owners, and employees
10‑3‑507
Continuation of delinquency proceedings
10‑3‑508
Condition on release from delinquency proceedings
10‑3‑509
Court’s seizure order
10‑3‑510
Confidentiality of hearings
10‑3‑511
Grounds for rehabilitation
10‑3‑512
Rehabilitation orders
10‑3‑513
Powers and duties of rehabilitator
10‑3‑514
Actions by and against rehabilitator
10‑3‑514.5
Immunity and indemnification of receiver and employees - applicability
10‑3‑515
Termination of rehabilitation
10‑3‑516
Grounds for liquidation
10‑3‑517
Liquidation orders
10‑3‑518
Continuation of coverage
10‑3‑519
Dissolution of insurer
10‑3‑520
Powers of liquidator
10‑3‑521
Notice to creditors and others
10‑3‑522
Duties of agents
10‑3‑523
Actions by and against liquidator
10‑3‑524
Collection and listing of assets
10‑3‑525
Fraudulent transfers prior to petition
10‑3‑526
Fraudulent transfer after petition
10‑3‑527
Voidable preferences and liens
10‑3‑528
Claims of holders of void or voidable rights
10‑3‑529
Setoffs - effective date - applicability
10‑3‑530
Assessments
10‑3‑531
Reinsurers’ liability
10‑3‑532
Recovery of premiums owed
10‑3‑533
Domiciliary liquidator’s proposal to distribute assets
10‑3‑533.5
Sale of insolvent insurer as a going concern
10‑3‑534
Filing of claims
10‑3‑535
Proof of claim
10‑3‑536
Special claims
10‑3‑537
Special provisions for third-party claims
10‑3‑538
Disputed claims
10‑3‑539
Claims of surety
10‑3‑540
Secured creditors’ claims
10‑3‑540.5
Qualified financial contracts - definitions
10‑3‑541
Priority of distribution - definitions - repeal
10‑3‑542
Liquidator’s recommendations to the court
10‑3‑543
Distribution of assets
10‑3‑544
Unclaimed and withheld funds
10‑3‑545
Termination of proceedings
10‑3‑546
Reopening liquidation
10‑3‑547
Disposition of records during and after termination of liquidation
10‑3‑548
External audit of receiver’s books
10‑3‑549
Conservation of property of foreign or alien insurers found in this state
10‑3‑550
Liquidation of property of foreign or alien insurers found in this state
10‑3‑551
Domiciliary liquidators in other states
10‑3‑552
Ancillary formal proceedings
10‑3‑553
Ancillary summary proceedings
10‑3‑554
Claims of nonresidents against insurers domiciled in this state
10‑3‑555
Claims of residents against insurers domiciled in reciprocal states
10‑3‑556
Attachment, garnishment, and levy of execution
10‑3‑557
Interstate priorities
10‑3‑558
Subordination of claims for noncooperation
10‑3‑559
Severability
10‑3‑601
Short title
10‑3‑602
Exchange of securities
10‑3‑603
Acquiring corporation - definition
10‑3‑604
Procedure for exchange
10‑3‑605
Filing plan of exchange
10‑3‑606
Effect of exchange
10‑3‑607
Authorized insurance business and regulatory authority
10‑3‑608
Domestic company and acquiring corporation separate and distinct entities
10‑3‑609
Examination
10‑3‑610
Application of this part 6
10‑3‑701
Purpose
10‑3‑702
Credit allowed to a domestic ceding insurer - rules - definitions
10‑3‑703
Asset or reduction from liability for reinsurance ceded by a domestic insurer to an assuming insurer not meeting the requirements of section 10-3-702
10‑3‑704
Qualified United States financial institutions
10‑3‑705
Rules
10‑3‑706
Reinsurance agreements affected
10‑3‑801
Definitions
10‑3‑802
Subsidiaries of insurers
10‑3‑803
Acquisition of control of or merger with domestic insurer - definitions
10‑3‑803.5
Acquisitions involving insurers not otherwise covered - definitions
10‑3‑804
Registration of insurers
10‑3‑805
Standards and management of an insurer within an insurance holding company system
10‑3‑806
Examination
10‑3‑807
Supervisory colleges
10‑3‑807.5
Group-wide supervision of internationally active insurance groups - information collection - cooperation - rules
10‑3‑808
Confidential treatment
10‑3‑809
Rules
10‑3‑810
Injunctions - prohibitions against voting securities - sequestration of voting securities
10‑3‑811
Criminal proceedings - civil penalties - definition
10‑3‑812
Receivership
10‑3‑813
Revocation, suspension, or nonrenewal of insurer’s license
10‑3‑814
Judicial review - mandamus
10‑3‑815
Recovery of distributions or payments
10‑3‑816
Conflict with other laws
10‑3‑901
Short title
10‑3‑902
Legislative declaration
10‑3‑903
Definition of transacting insurance business
10‑3‑903.5
Jurisdiction over providers of health-care benefits - rules
10‑3‑904
Commissioner may enjoin unauthorized company
10‑3‑904.5
Emergency cease-and-desist orders - issuance - rules - definition
10‑3‑904.6
Emergency cease-and-desist orders - hearings - judicial review - violations
10‑3‑904.7
Failure to pay penalties or restitution
10‑3‑905
Service of process upon unauthorized company
10‑3‑906
Validity of insurance contracts - liability under insurance contract
10‑3‑907
Investigation and disclosure of insurance contracts
10‑3‑908
Reporting of unauthorized insurance
10‑3‑909
Unauthorized insurance premium tax
10‑3‑910
Application of this part 9
10‑3‑1001
Short title
10‑3‑1002
Legislative declaration
10‑3‑1003
Service of process upon unauthorized insurer
10‑3‑1004
Defense of action by unauthorized insurer
10‑3‑1005
Attorney fees
10‑3‑1101
Legislative declaration
10‑3‑1102
Definitions
10‑3‑1103
Unfair methods of competition - unfair or deceptive acts or practices - prohibited
10‑3‑1104
Unfair methods of competition - unfair or deceptive practices
10‑3‑1104.5
HIV testing - legislative declaration - definitions - requirements for testing - limitations on disclosure of test results - penalty
10‑3‑1104.6
Genetic information - limitations on disclosure of information - liability - definitions - legislative declaration
10‑3‑1104.7
Genetic testing - legislative declaration - definitions - limitations on disclosure of information - liability
10‑3‑1104.8
Domestic abuse discrimination - prohibited
10‑3‑1104.9
Insurers’ use of external consumer data and information sources, algorithms, and predictive models - unfair discrimination prohibited - rules - stakeholder process required - investigations - definitions - repeal
10‑3‑1105
Favored agent or insurer - coercion of debtors
10‑3‑1106
Power of commissioner
10‑3‑1107
Hearings
10‑3‑1108
Orders
10‑3‑1109
Penalty for violation of cease-and-desist orders
10‑3‑1110
Rules
10‑3‑1111
Provisions of part 11 additional to existing law
10‑3‑1112
Immunity from prosecution
10‑3‑1113
Information to trier of fact in civil actions
10‑3‑1114
Construction of part 11
10‑3‑1115
Improper denial of claims - prohibited - definitions - severability
10‑3‑1116
Remedies for unreasonable delay or denial of benefits - required contract provision - frivolous actions - severability - definition - rules
10‑3‑1117
Required disclosures - liability - definition
10‑3‑1118
Failure-to-cooperate defense
10‑3‑1119
Policy documents - language consistent with advertisement for product - definitions
10‑3‑1201
Legislative declaration
10‑3‑1202
Definitions
10‑3‑1203
Book-entry system
10‑3‑1301
Short title
10‑3‑1302
Legislative declaration
10‑3‑1303
Definitions
10‑3‑1304
Identification of parts
10‑3‑1305
Disclosure
10‑3‑1306
Unfair and deceptive acts
10‑3‑1307
Liability
10‑3‑1401
Short title
10‑3‑1402
Purpose
10‑3‑1403
Authority of commissioner
10‑3‑1501
Purpose and scope - applicability - legislative declaration
10‑3‑1502
Definitions
10‑3‑1503
Risk management framework
10‑3‑1504
ORSA requirement
10‑3‑1505
ORSA summary report
10‑3‑1506
Exemption
10‑3‑1507
Contents of ORSA summary report
10‑3‑1508
Confidentiality
10‑3‑1509
Sanctions
10‑3‑1510
Rules
10‑3‑1511
Effective date
10‑3‑1601
Purpose and scope - applicability - legislative declaration
10‑3‑1602
Definitions
10‑3‑1603
Disclosure requirement
10‑3‑1604
Contents of corporate governance annual disclosure - rules
10‑3‑1605
Confidentiality
10‑3‑1606
Retention of third-party consultants - information sharing
10‑3‑1607
Sanctions
10‑3‑1608
Rules
10‑3‑1701
Definitions
10‑3‑1702
Plan of division - general requirements
10‑3‑1703
Plan of division - dividing insurer to survive division
10‑3‑1704
Plan of division - dividing insurer to not survive division
10‑3‑1705
Amending plan of division
10‑3‑1706
Abandoning plan of division
10‑3‑1707
Approval of plan of division - articles of incorporation and bylaws
10‑3‑1708
Commissioner approval of plan of division
10‑3‑1709
Confidentiality - records
10‑3‑1710
Certificate of division
10‑3‑1711
After division is effective
10‑3‑1712
Resulting insurers’ liability for allocated assets and debts
10‑3‑1713
Shareholder appraisal rights
10‑3‑1714
Rules
10‑3‑1715
Enforcement by commissioner
10‑3‑1716
Merger or consolidation effective with division
Green check means up to date. Up to date

Current through Fall 2024

§ 10-3-1115’s source at colorado​.gov