Insurance Claims in Colorado

What Are Insurance Claims?

Filing an insurance claim in Colorado can be a stressful process. Every policy is different, and insurance companies may not pay you what you deserve. In many cases, hiring an insurance claim lawyer is necessary. This page breaks down the nuances of different types of insurance claims.

What Is a Property Insurance Claim?

A homeowner’s insurance policy is an agreement to protect the home from damage under specific occurrences. When you as a policyholder suffer a loss, you should find a dedicated Colorado property insurance lawyer. Your legal advocate works on your claim to ensure that you receive the benefits necessary to repair or rebuild your Colorado property.

If the insurer denies coverage or delays, policyholders should consult a property insurance attorney about a bad faith claim. If your claim goes to court and you win, you can often recover your court costs, attorney fees, and coverage benefits. There is also the possibility of recovering more money depending on the state laws under which you file your claim.

What Types Of Damage Claims Apply to Property Insurance?

Specific geographic regions impact the design of insurance policies. For example, Florida property insurance policies have more provisions for hurricanes versus earthquakes. 

According to the Rocky Mountain Insurance Information Association, Colorado is in the top ten states with catastrophe-related claims. Wildfires and floods are the most common disaster, but the state is also plagued by severe storms, tornadoes, earthquakes, and droughts. In fact, CBS 4 reported that there’s an average of $464 million in damage statewide each year. In 2017, the largest hailstorm in state history resulted in $2.3 billion in home and automobile damage. While a typical homeowners policy covers hailstorms, it typically does not cover flooding. If you live in a flood zone, the Colorado Department of Regulatory Agencies recommends purchasing flood insurance through the National Flood Insurance Program.

How to File a Property Insurance Claim in Colorado

After you suffer a loss, you must contact your insurer as soon as possible. Taking this step begins the insurance claim process and gets things moving along. You need to notify your insurance company in writing or over the phone. From there, your insurer appoints a claim representative.

What to Expect Afterwards

When a natural disaster such as wildfire damages your home, the last thing you need is your insurance company dragging their heels. Fortunately, Colorado has imposed regulatory guidelines that govern insurance company claims handling procedures. After your insurer has received your claim, they must make a decision and pay benefits due within 60 days. Failure to pay claims can result in civil penalties up to 8% annual interest on the benefits due. The insurer must continue to pay this penalty to the insured until the insurer pays the benefits due.

It is important to file a valid and complete claim in Colorado. This is because your insurer must make a reasonable investigation of the information submitted. Under Colorado law, when an investigation is incomplete, the insurer must immediately notify the insured of the reasons the claim has not been paid. In fact, the insurer must send a letter every thirty days that sets forth the reasons additional time is needed for the investigation. Your Colorado attorney can help you navigate this process to completion.

What Is an Auto Insurance Claim?

Auto insurance claims involve requesting compensation from an auto insurer after an accident. Car accidents are incredibly stressful, especially if there are uncooperative responsible parties. However, your insurer’s job is to work on your behalf to secure compensation for repairs, injuries and other expenses.

What Do You Do After a Car Accident?

According to the Larimer County Sheriff’s Office, Colorado law requires that all motor vehicle accidents must be reported immediately. Consequently, the first thing to do after an accident with injuries is call 911. If there are no injuries, exchange insurance information with the other driver(s) and call local law enforcement or Colorado State Patrol. The police may decline to make a report if there are no injuries, and the damages are less than $1,000. However, the police must make a report if you request one, or one of the parties can’t show proof of insurance.

The next step is to contact your insurance company from the accident scene. Keep in mind, It is a good idea to report even a minor fender bender since Colorado is an at-fault state. This means you can file a claim with the at-fault party’s insurance policy, regardless of your injuries.

Auto Claims Adjuster

Your auto insurance company will assign a claims adjuster to your claim report. Your adjuster acts as your representation in any mediation between you and all other involved parties. This insurance representative bears responsibility for investigating the claim and seeing that you receive compensation for any repairs or injuries.

Whether there are repair claims, personal injury claims, or you are dealing with someone who does not have insurance, your auto insurance adjuster should see you through the process. Your claims adjuster may recommend a garage to handle your vehicle repairs. They may also make arrangements for a rental vehicle if required. The most important thing to note is that your auto claim adjuster is your primary point of contact regarding the status of your claim in Colorado.

Health Insurance Claims

Colorado policyholders file health insurance claims when they seek reimbursement for medical services or treatments. When you obtain a medical service from a provider, your health insurance carrier should be notified directly. If there are any discrepancies in your claim, consider hiring a health insurance claim specialist attorney.

How Do You File a Health Claim in Colorado?

There are two ways to file a health insurance claim on your behalf. The first is the medical facility notifies your insurer for you. You may be able to walk out of the facility without spending anything, but that depends on your policy. The other way is to file a health insurance claim yourself. Taking this route can occur when a health provider you use is not in your provider network. The facility may still file the claim on your behalf, but you may need to file it yourself.

When you submit a health insurance claim in Colorado, you expect to receive timely communication and pertinent information relating to compensation from your insurer. However, this does not always happen. Colorado’s Division of Insurance (DOI) recently fined Bright Health $1 million over operational missteps. Since 2021, the DOI has received over 100 consumer and health care provider complaints about the insurer in four areas:

  • Failure to pay provider claims according to Colorado law
  • Inability to accurately process consumer payments and accounts
  • Failure to communicate with their members
  • Untimely processing of claims for physical and behavioral health coverage

In addition to the fine, Bright Health must meet the DOI compliance standards, including accurately paying past claims.

Work with an Experienced Local Insurance Lawyer in Colorado

If your health insurance provider refuses to honor a claim, seek out a qualified Colorado insurance claim attorney’s help. An insurance claim attorney can help if you have been improperly denied coverage or sent a bill for a service you never received. We can even help you connect with an attorney across Colorado state lines.

Submit a request online or call us today at (866) 345-6784 to get in touch with an experienced lawyer in your area!

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