Colorado Individual Sickness and Accident Insurance Policy Provisions

What this document is

Colorado Individual Sickness and Accident Insurance Policy Provisions - C.R.S. Title 10, Article 16, Part 2 (10-16-201 to 213 and 216 to 222) is a state statute published by leg.colorado.gov. It is one of the Colorado documents that insurance license exam questions are written from, including colorado life & health practice questions. This page summarizes it and points to the official version, which is the text to rely on.

Sections cited in practice questions

Each practice answer shows the exact passage it comes from. These are sections of this document that questions cite, with a short excerpt from the source text.

• C.R.S. tit. 10 art. 16 § 10-16-201(4)(a) (Limits on Exclusions - Medical Assistance Eligibility)

  “No policy of sickness and accident insurance issued, renewed, or reinstated shall contain any provision which limits or excludes payments under hospital or medical benefits coverage to or on behalf of the insured because the insured or any covered dependent is eligible for or receiving medical...”

• C.R.S. tit. 10 art. 16 § 10-16-201(3)(b) (Renewability - Refusal to Renew on an Individual Basis)

  “In addition, each policy shall provide, in substance, in a provision thereof or in an endorsement thereon or in a rider attached thereto, that an insurer shall not exercise its right to refuse to renew the policy on an individual basis after two years from its date of issue or, in the event the...”

• C.R.S. tit. 10 art. 16 § 10-16-202(8) (Required Provisions - Proofs of Loss)

  “Failure to furnish such proof within the time required shall not invalidate nor reduce any claim if it was not reasonably possible to give proof within such time, if such proof is furnished as soon as reasonably possible and in no event, except in the absence of legal capacity, later than one year...”

• C.R.S. tit. 10 art. 16 § 10-16-203(3) (Optional Provisions - Misstatement of Age)

  “Misstatement of age: If the age of the insured has been misstated, all amounts payable under this policy shall be such as the premium paid would have purchased at the correct age.”

• C.R.S. tit. 10 art. 16 § 10-16-202(6)(a) (Required Provisions - Notice of Claim)

  “Written notice of claim must be given to the insurer within twenty days after the occurrence or commencement of any loss covered by the policy or as soon thereafter as is reasonably possible. Notice given by or on behalf of the insured or the beneficiary to the insurer at ........ (insert the...”

• C.R.S. tit. 10 art. 16 § 10-16-202 (3) (Required provisions in individual sickness and accident policies: time limit on certain defenses)

  “(3) Provisions as follows: "Time limit on certain defenses: (a) Two years after the date of issue of this policy no misstatements, except fraudulent misstatements, made by the applicant in the application for such policy shall be used to void the policy or to deny a claim for loss incurred or...”

• C.R.S. tit. 10 art. 16 § 10-16-212 (Exemption from attachment and execution)

  “10-16-212. Exemption from attachment and execution. So much of any benefits under all policies of sickness and accident insurance as does not exceed two hundred dollars for each month during any period of disability covered by such policy shall not be liable to attachment, trustee process, or other...”

• C.R.S. tit. 10 art. 16 § 10-16-202 (5)(a) (Required provisions: reinstatement, coverage of the reinstated policy)

  “The reinstated policy shall cover only loss resulting from such accidental injury as may be sustained after the date of reinstatement and loss due to such sickness as may begin more than ten days after such date.”

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