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Colorado Law Regarding Unfair Claim Settlement Practices

Colorado Revised Statute 10-3-1104 (1)(h): The Unfair Claim and Settlement Practices Act.

Here are some unfair claim settlement practices:

Committing or performing, either in willful violation of this part 11 or with such frequency as to indicate a tendency to engage in a general business practice, any of the following:

  • Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; or
  • (II) Failing to acknowledge and act reasonably promptly upon communications with respect to claims arising under insurance policies; or
  • (III) Failing to adopt and implement reasonable standards for the prompt investigation of claims arising under insurance policies; or
  • (IV) Refusing to pay claims without conducting a reasonable investigation based upon all available information; or
  • (V) Failing to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed; or
  • (VI) Not attempting in good faith to effectuate prompt, fair, and equitable settlements of claims in which liability has become reasonably clear; or
  • (VII) Compelling insureds to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amounts ultimately recovered in actions brought by such insureds; or
  • (VIII) Attempting to settle a claim for less than the amount to which a reasonable man would have believed he was entitled by reference to written or printed advertising material accompanying or made part of an application; or
  • (IX) Attempting to settle claims on the basis of an application which was altered without notice to, or knowledge or consent of, the insured; or
  • (X) Making claims payments to insureds or beneficiaries not accompanied by statement setting forth the coverage under which the payments are being made; or
  • (XI) Making known to insureds or claimants a policy of appealing from arbitration awards in favor of insureds or claimants for the purpose of compelling them to accept settlements or compromises less than the amount awarded in arbitration; or
  • (XII) Delaying the investigation or payment of claims by requiring an insured or claimant, or the physician of either of them, to submit a preliminary claim report, and then requiring the subsequent submission of formal proof of loss forms, both of which submissions contain substantially the same information; or
  • (XIII) Failing to promptly settle claims, where liability has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage; or
  • (XIV) Failing to promptly provide a reasonable explanation of the basis in the insurance policy in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement; or
  • (XV) Raising as a defense or partial offset in the adjustment of a third-party claim the defense of comparative negligence as set forth in section 13-21-111, C.R.S., without conducting a reasonable investigation and developing substantial evidence in support thereof. At such time as the issue is raised under this subparagraph (XV), the insurer shall furnish to the commissioner a written statement setting forth reasons as to why a defense under the comparative negligence doctrine is valid; or
  • (XVI) Excluding medical benefits under health care coverage subject to article 16 of this title to any covered individual based solely on that individual's casual or nonprofessional participation in the following activities: Motorcycling; snowmobiling; off-highway vehicle riding; skiing; or snowboarding; or
  • (XVII) Failing to adopt and implement reasonable standards for the prompt resolution of medical payment claims.

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The Kaudy Law Firm, LLC, provides legal help to injured people and victims of insurance misconduct, including bad faith, in Denver, Colorado, and communities throughout the Denver metro area, Rocky Mountain region, Front Range, Eastern Plains, the Foothills, the Western Slope, I-70 and I-25 corridors, Denver County, Arapahoe County, Douglas County, Jefferson County, Adams County, Boulder County, Summit County, Eagle County, Pitkin County, El Paso County, Weld County and Larimer County, including the cities of Aurora, Broomfield, Boulder, Fort Collins, Greeley, Colorado Springs, Lakewood, Littleton, Golden, Longmont, Loveland, Vail, Aspen, Arvada, Wheat Ridge, Castle Rock, Parker, Highlands Ranch, Thornton, Brighton and Westminster.