(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.
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.
10-3-1116. Remedies for unreasonable delay or denial of benefits - required contract provision - frivolous actions - severability - definition - rules. (1) A first-party claimant as defined in section 10-3-1115 whose claim for payment of benefits has been unreasonably delayed or denied may bring an action in a district court to recover reasonable attorney fees and court costs and two times the covered benefit.
(2) An insurance policy, insurance contract, or plan that is issued in this state and that offers health or disability benefits shall not contain a provision purporting to reserve discretion to the insurer, plan administrator, or claim administrator to interpret the terms of the policy, contract, or plan or to determine eligibility for benefits. If an insurance policy, contract, or plan contains such a provision, the provision is void.
(3) An insurance policy, insurance contract, or plan that is issued in this state shall provide that a person who claims health, life, or disability benefits, whose claim has been denied in whole or in part, and who has exhausted the person's administrative remedies:
(a) Is entitled to have the person's claim reviewed de novo in any court with jurisdiction; and
(b) Is entitled to a trial by jury.
(4) The action authorized in this section is in addition to, and does not limit or affect, other actions available by statute or common law, now or in the future. Damages awarded pursuant to this section shall not be recoverable in any other action or claim.
(5) If the court finds that an action brought pursuant to this section was frivolous as provided in article 17 of title 13, C.R.S., the court shall award costs and attorney fees to the defendant in the action.
(6) If any provision of this section, or of any subsection or portion 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.
(7) The general assembly declares that this section is a law regulating insurance.
(8) As used in this section, "issued in this state" refers to every health and disability insurance policy, insurance contract, insurance certificate, and insurance agreement existing, offered, issued, delivered, or renewed in the state of Colorado or providing health or disability benefits to a resident or domiciliary of the state of Colorado and every employee benefit plan covering a resident or domiciliary of the state of Colorado, whether or not on behalf of an employer located or domiciled in Colorado, on or after August 5, 2008, notwithstanding any contractual or statutory choice-of-law provision to the contrary.
Source: L. 2008: Entire section added, p. 2173, § 5, effective August 5. L. 2020: (2), (3), and (6) amended and (8) added, (SB 20-176), ch. 301, p. 1499, § 2, effective September 14.
Cross references: For the legislative declaration in SB 20-176, see section 1 of chapter 301, Session Laws of Colorado 2020.
Notes of Decisions
TBL Collectibles, Inc. v. Owners Ins. Co., 285 F. Supp. 3d 1170 (D. Colo. 2018).
· cites it 40× “Plaintiff filed this lawsuit on July 13, 2016, asserting three claims for relief: (1) declaratory judgment as to whether plaintiff fulfilled its post-loss obligations under the insurance policy; (2) breach of contract; and (3) unreasonable delay or denial of benefits under Colo.…”
Fisher v. State Farm Mut. Auto. Ins. Co., 419 P.3d 985 (Colo. Ct. App. 2015).
· cites it 49× “The Model Civil Jury Instructions support our conclusion that, to succeed on a claim under section 10-3-1115, C.R.S.2014, the plaintiff need not establish that the defendant insurer denied or delayed payment of the plaintiff's entire insurance claim; rather, the plaintiff must…”
Peña v. Am. Fam., 2018 COA 56 (Colo. Ct. App. 2018).
· cites it 7× “In the case now before us, Peña sued American Family under section 10-3-1115, C.R.S. 2017, for the unreasonable delay and denial of benefits due under the Uninsured Motorist Property Damage (UMPD) provisions of her policy.”
Kisselman v. Am. Fam. Mut. Ins. Co., 292 P.3d 964 (Colo. Ct. App. 2011).
· cites it 21× “56(h), requesting the district court to determine whether sections 10-3-1115 and -1116 applied to his case.”
Am. Fam. Mut. Ins. Co. v. Barriga, 2018 CO 42 (Colo. 2018).
· cites it 10× “To do so, we first consider the statutory text of sections 10-3-1115, C.R.S. (2017), and 10-3-1116 and conclude that the statutes require no such reduction.”
Am. Fam. Mut. Ins. Co. v. Hansen, 2016 CO 46 (Colo. 2016).
· cites it 7× “{19 The court of appeals also rejected American Family's argument that because the identity of the named insured was "fairly *120 debatable,” the company could not have unreasonably delayed or denied payment of a benefit under sections 10-3-1115 and -1116 as a matter of law.”
Kyle W. Larson Enter., Inc. v. Allstate Ins. Co., 305 P.3d 409 (Colo. Ct. App. 2012).
· cites it 17× “15 Roofer moved for reconsideration, arguing that the trial court erred in interpreting the legislative history of section 10-3-1115. That motion was denied.”
Vaccaro v. Am. Fam. Ins. Grp., 275 P.3d 750 (Colo. Ct. App. 2012).
· cites it 6× “" Ervin Robson Kristofco, CRS §§ 10-3-1115 and -1116: Providing Remedies to First-Party Claimants, 839 Colo.”
Andres Trucking Co. v. United Fire & Cas. Co, 2018 COA 144 (Colo. Ct. App. 2018).
· cites it 3× “ce — Regulation of Insurance Companies — Unfair Competition and Deceptive Practices — Improper Denial of Claims — Remedies for Unreasonable Delay or Denial of Benefits In this insurance case, a division of the court of appeals concludes that participation in a contractual…”
O'Sullivan v. Geico Cas. Co., 233 F. Supp. 3d 917 (D. Colo. 2017).
· cites it 4× “§ 1332 , Plaintiff Donald O’Sullivan (Plaintiff, or “O’Sullivan”) brings claims for breach of contract, for breach of the duty of good faith and fair dealing, for unreasonable delay or denial of insurance benefits in violation of Colorado Revised Statutes §§ 10-3-1115 & -1116…”
Marcus A. Fear v. GEICO Cas. Co.., 2024 CO 77 (Colo. 2024).
· cites it 16× “3d 501, 502 , respondent GEICO Casualty Company violated section 10-3-1115, C.R.S. (2024), which prohibits an insurer from unreasonably delaying or denying payment of a covered benefit, by failing to pay undisputed non-economic damages before final settlement.”
— Colo. Rev. Stat. § 10-3-1115(1) — 2 cases
Fisher v. State Farm Mut. Auto. Ins. Co., 419 P.3d 985 (Colo. Ct. App. 2015).
“The Model Civil Jury Instructions support our conclusion that, to succeed on a claim under section 10-3-1115, C.R.S.2014, the plaintiff need not establish that the defendant insurer denied or delayed payment of the plaintiff's entire insurance claim; rather, the plaintiff must…”
Kyle W. Larson Enter., Inc. v. Allstate Ins. Co., 305 P.3d 409 (Colo. Ct. App. 2012).
“15 Roofer moved for reconsideration, arguing that the trial court erred in interpreting the legislative history of section 10-3-1115. That motion was denied.”
— Colo. Rev. Stat. § 10-3-1115(1)(A) — 2 cases
— Colo. Rev. Stat. § 10-3-1115(1)(a) — 24 cases
Am. Fam. Mut. Ins. Co. v. Barriga, 2018 CO 42 (Colo. 2018).
“To do so, we first consider the statutory text of sections 10-3-1115, C.R.S. (2017), and 10-3-1116 and conclude that the statutes require no such reduction.”
Vaccaro v. Am. Fam. Ins. Grp., 275 P.3d 750 (Colo. Ct. App. 2012).
“" Ervin Robson Kristofco, CRS §§ 10-3-1115 and -1116: Providing Remedies to First-Party Claimants, 839 Colo.”
Kisselman v. Am. Fam. Mut. Ins. Co., 292 P.3d 964 (Colo. Ct. App. 2011).
“56(h), requesting the district court to determine whether sections 10-3-1115 and -1116 applied to his case.”
TBL Collectibles, Inc. v. Owners Ins. Co., 285 F. Supp. 3d 1170 (D. Colo. 2018).
“Plaintiff filed this lawsuit on July 13, 2016, asserting three claims for relief: (1) declaratory judgment as to whether plaintiff fulfilled its post-loss obligations under the insurance policy; (2) breach of contract; and (3) unreasonable delay or denial of benefits under Colo.…”
— Colo. Rev. Stat. § 10-3-1115(1)(b) — 2 cases
Kyle W. Larson Enter., Inc. v. Allstate Ins. Co., 305 P.3d 409 (Colo. Ct. App. 2012).
“15 Roofer moved for reconsideration, arguing that the trial court erred in interpreting the legislative history of section 10-3-1115. That motion was denied.”
— Colo. Rev. Stat. § 10-3-1115(1)(b)(2) — 2 cases
— Colo. Rev. Stat. § 10-3-1115(1)(b)(I) — 6 cases
Kyle W. Larson Enter., Inc. v. Allstate Ins. Co., 305 P.3d 409 (Colo. Ct. App. 2012).
“15 Roofer moved for reconsideration, arguing that the trial court erred in interpreting the legislative history of section 10-3-1115. That motion was denied.”
— Colo. Rev. Stat. § 10-3-1115(1)(b)(II)(A) — 3 cases
Kyle W. Larson Enter., Inc. v. Allstate Ins. Co., 305 P.3d 409 (Colo. Ct. App. 2012).
“15 Roofer moved for reconsideration, arguing that the trial court erred in interpreting the legislative history of section 10-3-1115. That motion was denied.”
— Colo. Rev. Stat. § 10-3-1115(1)(b)(II)(B) — 1 case
— Colo. Rev. Stat. § 10-3-1115(2) — 19 cases
Fisher v. State Farm Mut. Auto. Ins. Co., 419 P.3d 985 (Colo. Ct. App. 2015).
“The Model Civil Jury Instructions support our conclusion that, to succeed on a claim under section 10-3-1115, C.R.S.2014, the plaintiff need not establish that the defendant insurer denied or delayed payment of the plaintiff's entire insurance claim; rather, the plaintiff must…”
Kisselman v. Am. Fam. Mut. Ins. Co., 292 P.3d 964 (Colo. Ct. App. 2011).
“56(h), requesting the district court to determine whether sections 10-3-1115 and -1116 applied to his case.”
Am. Fam. Mut. Ins. Co. v. Barriga, 2018 CO 42 (Colo. 2018).
“To do so, we first consider the statutory text of sections 10-3-1115, C.R.S. (2017), and 10-3-1116 and conclude that the statutes require no such reduction.”
TBL Collectibles, Inc. v. Owners Ins. Co., 285 F. Supp. 3d 1170 (D. Colo. 2018).
“Plaintiff filed this lawsuit on July 13, 2016, asserting three claims for relief: (1) declaratory judgment as to whether plaintiff fulfilled its post-loss obligations under the insurance policy; (2) breach of contract; and (3) unreasonable delay or denial of benefits under Colo.…”
— Colo. Rev. Stat. § 10-3-1115(7) — 1 case
— Colo. Rev. Stat. § 10-3-1115(a) — 2 cases
TBL Collectibles, Inc. v. Owners Ins. Co., 285 F. Supp. 3d 1170 (D. Colo. 2018).
“Plaintiff filed this lawsuit on July 13, 2016, asserting three claims for relief: (1) declaratory judgment as to whether plaintiff fulfilled its post-loss obligations under the insurance policy; (2) breach of contract; and (3) unreasonable delay or denial of benefits under Colo.…”
— Colo. Rev. Stat. § 10-3-1115(l)(a) — 4 cases
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