Colorado Code
Part 2 - Sickness and Accident Insurance
§ 10-16-202. Required Provisions in Individual Sickness and Accident Policies



"(The foregoing policy provision does not affect any legal requirement for avoidance of a policy or denial of a claim during such initial two-year period, nor limit the application of section 10-16-203 in the event of misstatement with respect to age or occupation or other insurance.)"
(A policy that the insured has the right to continue in force subject to its terms by the timely payment of premium until at least age fifty, or in the case of a policy issued after age forty-four, for at least five years after its date of issue, may contain, in lieu of the foregoing, the following provision, from which the clause in parentheses may be omitted at the insurer's option, under the caption "Incontestable":
"After this policy has been in force for a period of two years during the lifetime of the insured (excluding any period during which the insured is disabled), it becomes incontestable as to the statements contained in the application.")
(b) Except for individual disability income insurance policies, no claim for loss incurred or disability, as defined in the policy, commencing one year after the date of issue of this policy shall be reduced or denied on the ground that a disease or physical condition not excluded from coverage by name or a specific description effective on the date of loss had existed prior to the effective date of coverage of this policy.
(c) If this is an individual disability income insurance policy then no claim for loss incurred or disability, as defined in this individual disability income insurance policy, commencing two years after the date of issue of the policy shall be reduced or denied on the ground that a disease or physical condition not excluded from coverage by name or a specific description effective on the date of loss had existed prior to the effective date of coverage of this policy.





















"Subject to the qualifications set forth below, if the insured suffers loss of time on account of disability for which indemnity may be payable for at least two years, the insured shall, at least once in every six months after having given notice of claim, give to the insurer notice of continuance of said disability, except in the event of legal incapacity. The period of six months following any filing of proof by the insured or any payment by the insurer on account of such claim or any denial of liability in whole or in part by the insurer shall be excluded in applying this provision. Delay in the giving of such notice shall not impair the insured's right to any indemnity which would otherwise have accrued during the period of six months preceding the date on which such notice is actually given."
"If any indemnity of this policy shall be payable to the estate of the insured, or to an insured or beneficiary who is a minor or otherwise not competent to give valid release, the insurer may pay such indemnity, up to an amount not exceeding $ ........ (insert an amount which shall not exceed $1000), to any relative by blood or connection by marriage of the insured or beneficiary who is deemed by the insurer to be equitably entitled thereto. Any payment made by the insurer in good faith pursuant to this provision shall fully discharge the insurer to the extent of such payment." "Subject to any written direction of the insured in the application or otherwise, all or a portion of any indemnities provided by this policy on account of hospital, nursing, medical, or surgical services may, at the insurer's option and unless the insured requests otherwise in writing not later than the time of filing proofs of such loss, be paid directly to the hospital or person rendering such services; but it is not required that the service be rendered by a particular hospital or person."
Source: L. 92: Entire article R&RE, p. 1660, § 1, effective July 1. L. 94: (3) amended, p. 1918, § 11, effective July 1. L. 95: (3)(b) amended and (3)(c) added, p. 726, § 2, effective May 23. L. 2013: (3) and (4)(a) amended, (HB 13-1266), ch. 217, p. 978, § 29, effective May 13.
Editor's note: This section is similar to former § 10-8-104 as it existed prior to 1992.

Structure Colorado Code

Colorado Code

Title 10 - Insurance

Article 16 - Health-Care Coverage

Part 2 - Sickness and Accident Insurance

§ 10-16-201. Form and Content of Individual Sickness and Accident Insurance Policies

§ 10-16-202. Required Provisions in Individual Sickness and Accident Policies

§ 10-16-203. Optional Provisions in Individual Sickness and Accident Insurance Policies

§ 10-16-204. Inapplicable or Inconsistent Provisions in Individual Policies of Sickness and Accident Insurance

§ 10-16-205. Order of Certain Policy Provisions in Individual Policies of Sickness and Accident Insurance

§ 10-16-206. Third-Party Ownership of Individual Sickness and Accident Insurance Policies

§ 10-16-207. Requirements of Other Jurisdictions

§ 10-16-208. Conforming to Statute

§ 10-16-209. Application for Policy

§ 10-16-210. Notice - Waiver

§ 10-16-211. Age Limit

§ 10-16-212. Exemption From Attachment and Execution

§ 10-16-213. Industrial Sickness and Accident Insurance

§ 10-16-214. Group Sickness and Accident Insurance

§ 10-16-215. Blanket Sickness and Accident Insurance

§ 10-16-216. Examinations

§ 10-16-216.5. Hearing Procedure and Judicial Review - Violations - Penalty

§ 10-16-217. Application of Part 1 of This Article and Part 2

§ 10-16-218. Judicial Review

§ 10-16-219. Benefits for Care in Tax-Supported Institutions - Behavioral Health Disorders - Mental Health Disorders - Intellectual and Developmental Disabilities

§ 10-16-220. Minimum Standards for Sickness and Accident Plans

§ 10-16-221. Statewide Health Care Review Committee - Creation - Membership - Duties - Repeal

§ 10-16-222. Termination of Policies