As used in this part 11, unless the context otherwise requires:
(1) Commissioner means the commissioner of insurance.
(2) Insurance policy or insurance contract means any contract of insurance, indemnity, medical or hospital service, suretyship, or annuity issued, proposed for issuance, or intended for issuance by any person.
(2.5) Repealed.
(3) Person means any individual, corporation, association, partnership, reciprocal exchange, interinsurer, Lloyds insurer, nonadmitted insurer, fraternal benefit society, and other legal entities engaged in the insurance business, including agents, limited insurance representatives, agencies, brokers, surplus line brokers, and adjusters. The term also includes medical service plans and hospital service plans regulated under parts 1 and 3 of article 16 of this title 10, health maintenance organizations regulated under parts 1 and 4 of article 16 of this title 10, and multiple employer welfare arrangements operating pursuant to section 10-3-903.5 (7)(d). The plans, arrangements, and organizations shall be deemed to be engaged in the business of insurance for purposes of this part 11 only.
Source: L. 73: R&RE, p. 857, � 1. C.R.S. 1963: � 72-14-2. L. 78: (2.5) added, p. 293, � 1, effective July 1. L. 81: (2.5) repealed, p. 577, � 5, effective June 4. L. 84: (3) amended, p. 331, � 1, effective July 1. L. 87: (3) amended, p. 425, � 1, effective May 1. L. 92: (3) amended, p. 1723, � 4, effective July 1. L. 95: (3) amended, p. 491, �5, effective May 16. L. 2021: (3) amended, (SB 21-063), ch. 467, p. 3363, � 2, effective September 7.
10-3-1103. Unfair methods of competition - unfair or deceptive acts or practices - prohibited. No person shall engage in this state in any trade practice which is defined in this part 11 as, or determined pursuant to section 10-3-1107 to be, an unfair method of competition or an unfair or deceptive act or practice in the business of insurance.
Source: L. 73: R&RE, p. 858, � 1. C.R.S. 1963: � 72-14-3.
10-3-1104. Unfair methods of competition - unfair or deceptive practices - rules - definitions. (1) The following are defined as unfair methods of competition and unfair or deceptive acts or practices in the business of insurance:
(a) Misrepresentations and false advertising of insurance policies: Making, issuing, circulating, or causing to be made, issued, or circulated, any estimate, circular, statement, sales presentation, omission, or comparison which:
(I) Misrepresents the benefits, advantages, conditions, or terms of any insurance policy; or
(II) Misrepresents the dividends or share of the surplus to be received on any insurance policy; or
(III) Makes any false or misleading statements as to the dividends or share of surplus previously paid on any insurance policy; or
(IV) Is misleading or is a misrepresentation as to the financial condition of any person, or as to the legal reserve system upon which any life insurer operates; or
(V) Uses any name or title of any insurance policy or class of insurance policies misrepresenting the true nature thereof; or
(VI) Is a misrepresentation for the purpose of inducing or tending to induce the lapse, forfeiture, exchange, conversion, or surrender of any insurance policy; or
(VII) Is a misrepresentation for the purpose of effecting a pledge or assignment of or effecting a loan against any insurance policy; or
(VIII) Misrepresents any insurance policy as being a security; or
(IX) Misrepresentation shall not be construed where a written comparison of policies is made factually disclosing relevant features and benefits for which the policy is issued and by which an informed decision can be made;
(b) False information and advertising generally:
(I) Making, publishing, disseminating, circulating, or placing before the public, or causing, directly or indirectly, to be made, published, disseminated, circulated, or placed before the public, in a newspaper, magazine, or other publication, or in the form of a notice, circular, pamphlet, letter, or poster, or over any radio or television station, or in any other way, an advertisement, announcement, or statement containing any assertion, representation, or statement with respect to the business of insurance, or with respect to any person in the conduct of his or her insurance business, which is untrue, deceptive, or misleading;
(II) Knowingly filing with the commissioner or other public official, or with any employee or agent of the division of insurance in the department of regulatory agencies, a written, false statement of material fact as to the financial condition of an insurer;
(III) Knowingly making any false entry of a material fact in any book, report, or other written statement of any insurer; knowingly omitting or failing to make a true entry of a material fact pertaining to the business of the insurer in any book, report, or other written statement of the insurer; or knowingly making any written, false material statement to the commissioner or any employee or agent of the division of insurance in the department of regulatory agencies;
(c) Defamation: Making, publishing, disseminating, or circulating, directly or indirectly, or aiding, abetting, or encouraging the making, publishing, disseminating, or circulating of any oral or written statement or any pamphlet, circular, article, or literature which is false, or maliciously critical, or derogatory to the financial condition of any person, and which is calculated to injure such person;
(d) Boycott, coercion, and intimidation: Entering into any agreement to commit, or by any concerted action committing, any act of boycott, coercion, or intimidation resulting in or tending to result in unreasonable restraint of, or monopoly in, the business of insurance;
(e) Stock operations and advisory board contracts: Issuing or delivering, or permitting agents, officers, or employees to issue or deliver, agency company stock or other capital stock, or benefit certificates or shares, in any corporation, or securities, or any special or advisory board contracts, or other contracts of any kind promising returns and profits as an inducement to insurance;
(f) (I) Unfair discrimination: Making or permitting any unfair discrimination between individuals of the same class and equal expectation of life in the rates charged for any contract of life insurance or of life annuity, or in the dividends or other benefits payable thereon, or in any other of the terms and conditions of such contract;
(II) Making or permitting any unfair discrimination between individuals of the same class or between neighborhoods within a municipality and of essentially the same hazard in the amount of premium, policy fees, or rates charged for any policy or contract of insurance, or in the benefits payable thereunder, or in any of the terms or conditions of such contract, or in any other manner whatever;
(III) Making or permitting to be made any classification solely on the basis of marital status or sex, unless such classification is for the purpose of insuring family units or is justified by actuarial statistics;
(IV) Making or permitting to be made any classification solely on the basis of blindness, partial blindness, or a specific physical disability unless such classification is based upon an unequal expectation of life or an expected risk of loss different than that of other individuals;
(V) Repealed.
(VI) Inquiring about or making an investigation concerning, directly or indirectly, an applicant's, an insured's, or a beneficiary's sexual orientation in:
(A) An application for coverage; or
(B) Any investigation conducted in connection with an application for coverage;
(VII) Using information about gender, marital status, medical history, occupation, residential living arrangements, beneficiaries, zip codes, or other territorial designations to determine sexual orientation;
(VIII) Using sexual orientation in the underwriting process or in the determination of insurability;
(IX) Making adverse underwriting decisions because an applicant or an insured has demonstrated concerns related to AIDS by seeking counseling from health-care professionals;
(X) Making adverse underwriting decisions on the basis of the existence of nonspecific blood code information received from the medical information bureau, but this prohibition shall not bar investigation in response to the existence of such nonspecific blood code as long as the investigation is conducted in accordance with the provisions of section 10-3-1104.5;
(XI) Reducing benefits under a health insurance policy by the addition of an exclusionary rider, unless such rider only excludes conditions which have been documented in the original underwriting application, original underwriting medical examination, or medical history of the insured, or which can be shown with clear and convincing evidence to have been caused by the medically documented excluded condition;
(XII) Denying health-care coverage subject to article 16 of this title to any individual based solely on that individual's casual or nonprofessional participation in the following activities: Motorcycling; snowmobiling; off-highway vehicle riding; skiing; or snowboarding;
(XIII) Making or permitting any unfair discrimination between individuals of the same class and of essentially the same hazard in the amount of premium, policy fees, or rates charged for any policy of sickness and accident insurance, in the benefits payable under such policy, in the terms or conditions of the policy, or in any other manner;
(XIV) Making or permitting any unfair discrimination between individuals or risks of the same class and of essentially the same hazard by refusing to insure, refusing to renew, canceling, or limiting the amount of insurance coverage on a property and casualty risk solely because of the geographic location of the risk, unless the action is the result of the application of sound underwriting and actuarial principles related to actual or reasonably anticipated loss experience;
(XV) Making or permitting any unfair discrimination between individuals or risks of the same class and of essentially the same hazards by refusing to insure, refusing to renew, canceling, or limiting the amount of insurance coverage on the residential property risk, or the personal property contained therein, solely because of the age of the residential property;
(XVI) Terminating or modifying coverage or refusing to issue or renew any property or casualty policy solely because the applicant or insured or any employee of either is mentally or physically impaired; except that this subparagraph (XVI) does not:
(A) Apply to accident and health insurance sold by a casualty insurer; or
(B) Modify any other provision of law relating to the termination, modification, issuance, or renewal of any insurance policy or contract;
(XVII) Refusing to insure a person solely because another insurer has refused to write a policy, or has canceled or has refused to renew an existing policy, in which the person was the named insured. Nothing in this subparagraph (XVII) prevents an insurer from terminating an excess insurance policy based on the failure of the insured to maintain any required underlying insurance.
(g) Rebates: Except as otherwise provided in this section and as otherwise expressly provided by law, knowingly permitting, or offering to make, or making any contract of insurance or agreement as to such contract, other than as plainly expressed in the insurance contract issued thereon, or paying, allowing, or giving, or offering to pay, allow, or give, directly or indirectly, as inducement to such insurance or annuity, any rebate of premiums payable on the contract, or any special favor or advantage in the dividends or other benefits on the contract or annuity, or any valuable consideration or inducement whatever not specified in the contract; or giving, selling, or purchasing, or offering to give, sell, or purchase, as inducement to such insurance contract or annuity or in connection with the insurance contract or annuity, any stocks, bonds, or other securities of any insurance company or other corporation, association, or partnership, or any dividends or profits accrued on the stocks, bonds, or other securities, or anything of value whatsoever not specified in the contract;
(h) 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:
(I) 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.
(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;
(i) Failure to maintain complaint handling procedures: Failing of any insurer to maintain a complete record of all the complaints which it has received since the date of its last examination. This record shall indicate the total number of complaints, their classification by line of insurance, the nature of each complaint, the disposition of these complaints, and the time it took to process each complaint. For purposes of this paragraph (i), complaint shall mean any written communication primarily expressing a grievance.
(j) Misrepresentation in insurance applications: Making false or fraudulent statements or representations on or relative to any application for an insurance policy, for the purpose of obtaining a fee, commission, money, or other benefit from any person;
(k) Requiring, directly or indirectly, any insured or claimant to submit to any polygraph test concerning any application for or any claim under any policy of insurance;
(l) Violation of or noncompliance with any insurance law in part 6 of article 4 of this title;
(m) Failure to make promptly a full refund or credit of all unearned premiums to the person entitled thereto upon termination of insurance coverage;
(n) Requiring or attempting to require or otherwise induce a health-care provider, as defined in section 13-64-403 (12)(a), C.R.S., to utilize arbitration agreements with patients as a condition of providing medical malpractice insurance to such health-care provider;
(o) Failure to comply with all the provisions of section 10-3-1104.5 regarding HIV testing;
(p) Violation of or noncompliance with any provision of part 13 of this article;
(q) Increasing the premiums unilaterally or decreasing the coverage benefits on renewal of a policy of insurance, increasing the premium on new policies, or failing to issue an insurance policy to barbers, cosmetologists, estheticians, nail technicians, barbershops, or beauty salons, as regulated in article 105 of title 12, regardless of the type of risk insured against, based solely on the decision of the general assembly to stop mandatory inspections of the places of business of such insureds;
(r) Repealed.
(s) Certifying pursuant to section 10-16-107.2 or issuing, soliciting, or using a policy form, endorsement, or rider that does not comply with statutory mandates. Such solicitation or certification shall be subject to the sanctions described in sections 10-2-704, 10-2-801, 10-2-804, 10-3-1107, 10-3-1108, and 10-3-1109.
(t) Certifying pursuant to section 10-4-419 or issuing, soliciting, or using a claims-made policy form, endorsement, or disclosure form that does not comply with statutory mandates. Such solicitation or certification shall be subject to the sanctions described in sections 10-3-1107, 10-3-1108, and 10-3-1109.
(u) Certifying pursuant to section 10-4-633 or issuing, soliciting, or using an automobile policy form, endorsement, or notice form that does not comply with statutory mandates. Such solicitation or certification shall be subject to the sanctions described in sections 10-3-1107, 10-3-1108, and 10-3-1109.
(v) Failure to comply with all provisions of section 10-16-108.5 concerning fair marketing of health benefit plans and section 10-16-105 concerning guaranteed issuance of individual and small employer health benefit plans;
(w) Failure to comply with the provisions of section 10-16-105.1 concerning the renewability of health benefit plans;
(x) Violation of the provisions of part 8 of article 1 of title 25, C.R.S., concerning patient records;
(y) Violating any provision of the Consumer Protection Standards Act for the Operation of Managed Care Plans, part 7 of article 16 of this title, by those subject to said part 7;
(z) Willfully violating any provision of section 10-16-113.5;
(aa) Certifying pursuant to section 10-10-109 (3) or 10-10-109 (4), issuing, soliciting, or using a credit insurance policy form, certificate of insurance, notice of proposed insurance, application for insurance, endorsement, or rider that does not comply with Colorado law. Such certification, issuance, solicitation, or use shall be subject to the sanctions described in sections 10-3-1107, 10-3-1108, and 10-3-1109.
(bb) Certifying pursuant to section 10-15-105 (1), issuing, soliciting, or using a preneed funeral contract form or a form of assignment that does not comply with Colorado law. Such certification, issuance, solicitation, or use shall be subject to the sanctions described in sections 10-3-1107, 10-3-1108, and 10-3-1109.
(cc) Violation of the provisions of section 10-16-122 (4) concerning an unauthorized transfer of a covered person or subscriber's prescription;
(dd) Failing to comply with the provisions of section 10-4-628 (2)(a)(V) or 10-16-201 (5);
(ee) Willfully or repeatedly violating section 10-11-108 (1)(c) or (1)(d), including a willful or repeated violation through the creation or operation of an improper affiliated business arrangement;
(ff) Violation of the Physician and Dentist Designation Disclosure Act, article 38 of title 25, C.R.S.;
(gg) Violation of section 10-16-705 (6.5) or (10.5);
(hh) Unfair compensation practices: Basing the compensation of claims employees or contracted claims personnel, including compensation in the form of performance bonuses or incentives, on any of the following:
(I) The number of policies canceled;
(II) The number of times coverage is denied;
(III) The use of a quota limiting or restricting the number or volume of claims; or
(IV) The use of an arbitrary quota or cap limiting or restricting the amount of claims payments without due consideration of the merits of the claim;
(ii) Violation of section 8-43-401.5, C.R.S.;
(jj) Violation of part 6 of article 43 of title 8, C.R.S.;
(kk) Violation of section 10-7-703 of the Insurable Interest Act, part 7 of article 7 of this title;
(ll) Engaging in stranger originated life insurance;
(mm) Paying a fee or rebate or giving or promising anything of value to a jailer, peace officer, clerk, deputy clerk, an employee of a court, district attorney or district attorney's employees, or a person who has power to arrest or to hold a person in custody as a result of writing a bail bond;
(nn) Unless the indemnitor consents in writing otherwise, failure to post a bail bond within twenty-four hours after receipt of full payment or a signed contract for payment, and if the bail bond is not posted within twenty-four hours after receipt of full payment or a signed contract for payment, failure to refund all moneys received, release all liens, and return all collateral within seven days after receipt of good funds;
(oo) Failure to report, preserve without use, retain separately, or return after payment in full, collateral taken as security on any bail bond to the principal, indemnitor, or depositor of the collateral;
(pp) Soliciting bail bond business in or about any place where prisoners are confined, arraigned, or in custody;
(qq) Failure to pay a final, nonappealable judgment award for failure to return or repay collateral received to secure a bond;
(rr) Certifying pursuant to section 8-44-102, C.R.S., or issuing, soliciting, or using a workers' compensation form, endorsement, rider, letter, or notice that does not comply with statutory mandates. The solicitation or certification is subject to the sanctions described in sections 10-3-1107, 10-3-1108, and 10-3-1109.
(ss) A violation of section 10-16-704 (3)(d) or (5.5);
(tt) A violation of part 15 of article 16 of this title 10.
(2) Nothing in subsection (1)(f) or (1)(g) of this section shall be construed as including within the definition of discrimination or rebates any of the following practices:
(a) In the case of any contract of life insurance or life annuity, paying bonuses to policyholders or otherwise abating their premiums in whole or in part out of surplus accumulated from nonparticipating insurance, if any such bonuses or abatement of premiums shall be fair and equitable to policyholders and for the best interests of the company and its policyholders;
(b) In the case of life insurance policies issued on the industrial debit plan, making allowance to policyholders who have continuously for a specified period made premium payments directly to an office of the insurer in an amount which fairly represents the saving in collection expenses;
(c) Readjustment of the rate of premium for a group insurance policy based on the loss or expense thereunder, at the end of the first or any subsequent policy year of insurance thereunder, which may be made retroactive only for such policy year;
(d) Requests by a person that an applicant or insured take an HIV related test when such request has been prompted by either the health history or current condition of the applicant or insured or by threshold coverage amounts which are applied to all persons within the risk class, as long as such test is conducted in accordance with the provisions of section 10-3-1104.5.
(e) Offering or providing, by or through an employee, affiliate, or third-party representative of an insurer or insurance producer, a value-added product or service at no cost or reduced cost, when the product or service is not specified in the insurance policy, if the product or service:
(I) Relates to the insurance coverage; and
(II) Is primarily aimed to achieve one or more of the following:
(A) Provide loss mitigation or loss control;
(B) Reduce claim costs or claim settlement costs;
(C) Provide education about liability risk or risk of loss to individuals or property;
(D) Monitor or assess risk, identify sources of risk, or develop strategies for eliminating or reducing risk;
(E) Enhance health;
(F) Promote financial wellness through items such as educational or financial planning services;
(G) Provide post-loss services;
(H) Encourage behavioral changes to improve the health or reduce the risk of death or disability of a customer; or
(I) Assist in the administration of employee or retiree benefit insurance coverage.
(2.1) The cost to an insurer or insurance producer offering a product or service to a customer pursuant to subsection (2)(e) of this section must be reasonable in comparison to that customer's premiums or insurance coverage.
(2.2) If an insurer or insurance producer is offering a product or service pursuant to subsection (2)(e) of this section, the insurer or insurance producer shall provide a customer with contact information to assist the customer with questions regarding the product or service.
(2.3) To ensure consumer protection while implementing the permitted practices set forth in subsection (2) of this section, the commissioner may adopt rules to implement and enforce subsections (2) to (2.7) of this section.
(2.4) The availability of a product or service offered pursuant to subsection (2)(e) of this section must be:
(a) Based on documented, objective criteria that is maintained by the insurer or insurance producer and must be produced upon request by the division; and
(b) Offered in a manner that is not unfairly discriminatory.
(2.5) (a) If an insurer or insurance producer does not have sufficient evidence but has a good faith belief that a product or service meets the criteria set forth in subsections (2)(e)(II)(A) to (2)(e)(II)(I) of this section, the insurer or insurance producer shall provide the product or service in a manner that is not unfairly discriminatory as part of a pilot or testing program for no more than one year.
(b) (I) An insurer or insurance producer shall notify and receive approval from the division for a pilot or testing program prior to launching the program.
(II) The division shall approve or deny a pilot or testing program no later than thirty days after receiving notification pursuant to subsection (2.5)(b)(I) of this section.
(2.6) (a) An insurer or insurance producer may:
(I) Offer or give a noncash gift, item, or service, including a meal or charitable donation, to or on behalf of a customer in connection with the marketing, sale, purchase, or retention of an insurance contract if the cost does not exceed an amount determined to be reasonable by the commissioner per policy year per term; or
(II) Offer or give a noncash gift, item, or service, including a meal or charitable donation, to or on behalf of a customer, including a commercial or institutional customer, in connection with the marketing, sale, purchase, or retention of an insurance contract if:
(A) The cost is reasonable in comparison to the premium or proposed premium; and
(B) The cost of the gift, item, or service is not included in any amount charged to another person or entity.
(b) (I) Any offer or gift made pursuant to this subsection (2.6) must be offered in a manner that is not unfairly discriminatory.
(II) An insurer or insurance producer shall not require a customer to purchase, continue, or renew an insurance policy in exchange for a gift, item, or service received pursuant to this subsection (2.6).
(2.7) Except as applied to an insurer or insurance producer's offer of a value-added product or service, an insurer or insurance producer shall not:
(a) Offer or provide insurance as an inducement to the purchase of another policy; or
(b) Use the words free or no cost or words of similar import in an advertisement.
(3) Repealed.
(4) The following is defined as an unfair practice in the business of insurance: For an insurer to deny, refuse to issue, refuse to renew, refuse to reissue, cancel, or otherwise terminate a motor vehicle insurance policy, to restrict motor vehicle insurance coverage on any person, or to add any surcharge or rating factor to a premium of a motor vehicle insurance policy solely because of:
(a) A conviction under section 18-13-122 (3), or section 44-3-901 (1)(c), or any counterpart municipal charter or ordinance offense or because of any driver's license revocation resulting from such conviction. This subsection (4)(a) includes, but is not limited to, a driver's license revocation imposed under section 42-2-125 (1)(m) prior to its repeal in 2021.
(b) The licensee's inability to operate a motor vehicle due to physical incompetence if the licensee obtains an affidavit from a rehabilitation provider or licensed physician acceptable to the department of revenue.
(5) It shall not be an unfair practice in the business of insurance for an insurer to pay an assignee if the insurer believes in good faith that the claim is subject to a written assignment from the insured. The insurer shall remain responsible to the insured for such amounts pursuant to the applicable policy terms in the event the person paid did not hold a written assignment and did not provide services or goods to the insured at the insured's request.
(6) As used in this section, unless the context otherwise requires:
(a) Customer includes a policyholder, potential policyholder, certificate holder, potential certificate holder, insured, potential insured, or applicant.
(b) Insurance producer has the meaning set forth in section 10-2-103 (6).
Source: L. 73: R&RE, p. 858, � 1. C.R.S. 1963: � 72-14-4. L. 75: (1)(f)(III) added, p. 341, � 1, effective July 1. L. 78: (1)(f)(IV) added, p. 295, � 1, effective March 21; (3) added, p. 293, � 2, effective March 24. L. 79: IP(1)(h) amended and (1)(l) added, p. 359, � 5, effective June 22; (1)(h)(XV) added, p. 383, � 1, effective July 1. L. 80: (1)(f)(V) added, p. 751, � 2, effective April 10. L. 81: (3) repealed, p. 577, � 5, effective June 4. L. 88: (1)(m) and (1)(n) added, pp. 340, 625, �� 3, 4, effective July 1. L. 89: (1)(f)(VI) to (1)(f)(X), (1)(o), and (2)(d) added, pp. 448, 449, �� 2-4, effective April 12; (1)(p) added p. 451, � 2, effective July 1. L. 90: (1)(q) added, p. 770, � 29, effective July 1. L. 92: (1)(r) added, p.1503, � 1, effective April 16; (1)(t) and (1)(u) added, p. 1555, � 52, effective May 20; (1)(f)(XI) added, p. 1750, � 3, effective May 29; (1)(s) added, p. 1744, � 3, effective June 2. L. 93: (1)(s) amended, p. 1390, � 6, effective January 1, 1995. L. 94: (1)(v) added, p. 1920, � 13, effective July 1. L. 96: (1)(w) added, p. 459, � 2, effective July 1. L. 97: (1)(x) added, p. 350, � 4, effective April 19; (1)(y) added, p. 1332, � 4, effective July 1; (4) added, p. 1044, � 6, effective August 6; (1)(f)(XII) and (1)(h)(XVI) added, p. 68, �� 1, 2, effective October 1. L. 98: (4)(a) amended, p. 817, � 8, effective August 5. L. 99: (5) added, p. 312, � 2, effective August 4; (1)(z) added, p. 1056, � 3, effective June 1, 2000. L. 2000: (4)(b) amended, p. 1635, � 7, effective June 1; (1)(aa) and (1)(bb) added, p. 464, � 2, effective August 2. L. 2001: (1)(r) amended, p. 1051, � 36, effective July 1; (1)(cc) added, p. 1231, � 3, effective January 1, 2002. L. 2002: (1)(f)(XII) and (1)(h)(XVI) amended, p. 65, � 1, effective January 1, 2003. L. 2003: (1)(u) amended, p. 1571, � 4, effective July 1. L. 2004: (1)(l) amended, p. 902, � 21, effective May 21; (1)(h)(XVII) added, p. 1102, � 2, effective July 1. L. 2005: (1)(dd) added, p. 221, � 3, effective April 14. L. 2006: (1)(ee) added, p. 269, � 4, effective July 1. L. 2008: (1)(ff) added, p. 2017, � 2, effective September 1. L. 2009: (1)(gg) added, (HB 09-1061), ch. 197, p. 886, � 2, effective August 5. L. 2010: (1)(hh) added, (SB 10-076), ch. 228, p. 987, � 1, effective May 17; (1)(ii) added, (SB 10-011), ch. 302, p. 1433, � 5, effective May 27; (1)(b) amended and (1)(f)(XIII), (1)(f)(XIV), (1)(f)(XV), (1)(f)(XVI), and (1)(f)(XVII) added, (HB 10-1220), ch. 197, p. 851, �� 6, 7, effective July 1; (1)(jj) added, (SB 10-178), ch. 290, p. 1350, � 2, effective July 1. L. 2011: (1)(kk) and (1)(ll) added, (SB 11-182), ch. 227, p. 976, � 2, effective May 27. L. 2012: (1)(mm), (1)(nn), (1)(oo), (1)(pp), and (1)(qq) added, (HB 12-1266), ch. 280, p. 1507, � 37, effective July 1. L. 2013: (1)(v) and (1)(w) amended, (HB 13-1266), ch. 217, p. 986, � 42, effective May 13; (1)(r) amended, (HB 13-1115), ch. 338, p. 1970, � 4, effective May 28. L. 2014: (4)(a) amended, (SB 14-129), ch. 387, p. 1937, � 4, effective June 6; (1)(rr) added, (SB 14-137), ch. 78, p. 317, � 2, effective August 6. L. 2015: (1)(q) amended, (SB 15-106), ch. 122, p. 384, � 20, effective May 1; (1)(ff) amended, (HB 15-1191), ch. 95, p. 274, � 8, effective August 5. L. 2018: (4)(a) amended, (HB 18-1025), ch. 152, p. 1077, � 5, effective October 1. L. 2019: (1)(q) amended, (HB 19-1172), ch. 136, p. 1651, � 33, effective October 1; (1)(ss) added, (HB 19-1174), ch. 171, p. 1982, � 2, effective January 1, 2020. L. 2021: (4)(a) amended, (HB 21-1314), ch. 460, p. 3099, � 8, effective January 1, 2022. L. 2022: (1)(tt) added, (HB 22-1122), ch. 312, p. 2233, � 2, effective August 10. L. 2025: (1)(g) and IP(2) amended and (2)(e), (2.1), (2.2), (2.3), (2.4), (2.5), (2.6), (2.7), and (6) added, (SB 25-058), ch. 84, p. 348, � 1, effective August 6.
Editor's note: (1) Subsection (1)(f)(V) provided for the repeal of subsection (1)(f)(V), effective July 1, 1987. (See L. 1980, p. 751.)
(2) Subsection (1)(r)(II) provided for the repeal of subsection (1)(r), effective March 31, 2015. (See L. 2013, p. 1970.)
(3) Section 2(2) of chapter 84 (SB 25-058), Session Laws of Colorado 2025, provides that the act changing this section applies to conduct occurring on or after August 6, 2025.
Cross references: For the legislative declaration contained in the 2000 act enacting subsections (1)(aa) and (1)(bb), see section 1 of chapter 135, Session Laws of Colorado 2000.
10-3-1104.5. HIV testing - legislative declaration - definitions - requirements for testing - limitations on disclosure of test results - penalty. (1) The general assembly declares that a balance must be maintained between the need for information by those conducting the business of insurance and the public's need for fairness in practices for testing for the human immunodeficiency virus, including the need to minimize intrusion into an individual's privacy and the need to limit disclosure of the results of such testing.
(2) As used in this section, unless the context otherwise requires:
(a) AIDS means acquired immunodeficiency syndrome.
(b) Applicant means the individual proposed for coverage.
(c) HIV means human immunodeficiency virus.
(d) HIV infection means infection with the human immunodeficiency virus or any other related virus identified as a probable causative agent of AIDS.
(e) HIV related test means any laboratory test or series of tests for any virus, antibody, antigen, or etiologic agent whatsoever thought to cause or to indicate the presence of AIDS.
(f) Person means any individual, corporation, association, partnership, fraternal benefit society, or any other entity engaged in the insurance business, except insurance agents and brokers. Such term shall also include medical service plans and hospital service plans regulated under parts 1 and 3 of article 16 of this title and health maintenance organizations regulated under parts 1 and 4 of article 16 of this title. Such plans and health maintenance organizations shall be deemed to be engaged in the business of insurance for purposes of this section.
(3) No person shall request or require that an applicant submit to an HIV related test unless that person:
(a) Obtains the applicant's prior written informed consent; and
(b) Reveals, in the written consent form, and explains the use of the HIV related test result to the applicant and entities to whom test results may be disclosed pursuant to paragraphs (a) and (b) of subsection (4) of this section; and
(c) Provides the applicant with:
(I) Printed material prior to testing which contains factual information describing AIDS; its causes, symptoms, and transmission; and the tests used to detect HIV infection and what a person should do if the result of the HIV related test is positive; or
(II) Information on how to obtain relevant counseling from a qualified practitioner having extensive training and experience in addressing the fears, questions, and concerns of persons tested for HIV infection; and
(d) Administers the HIV related test based upon the following test protocol, as a minimum:
(I) Two positive ELISA tests and a western blot test with bands present at p24, p31, and either gp41 or gp160; or
(II) An equally reliable screening or confirmatory test protocol designated by the commissioner, with the approval of the department of public health and environment; and
(e) Discloses the results of testing in the manner prescribed by subsection (4) of this section.
(4) (a) On the basis of the applicant's written informed consent as specified in subsection (3) of this section, a person may disclose an individual applicant's HIV related test results to its reinsurers or to those contractually retained medical personnel, laboratories, and insurance affiliates, excluding agents and brokers, which are involved in underwriting decisions regarding the individual's application if disclosure is necessary to make underwriting decisions regarding such application.
(b) Other than the disclosures permitted by paragraph (a) of this subsection (4), no person shall disclose HIV related test results which identify the individual applicant with the test results obtained to anyone without first obtaining separate written informed consent for such disclosure from the applicant; except that, if the result of the HIV related test of an applicant is positive or indeterminate, such person may report the test finding to the medical information bureau but only if a nonspecific blood test result code is used which does not indicate that the applicant was tested for HIV infection.
(c) Nothing in this subsection (4) shall be construed to prohibit reporting as required by the provisions of section 25-4-405, C.R.S.
(5) A person shall notify the applicant in writing of an adverse underwriting decision based upon the results of such applicant's blood test but shall not disclose the specific results of such blood test to such applicant. The person shall also inform the applicant that the results of the blood test will be sent to the physician designated by the applicant at the time of application and that such physician should be contacted for information regarding the HIV related test. If a physician was not designated at the time of application, the person shall request that the applicant name a physician to whom a copy of the blood test can be sent.
(6) Notwithstanding any other provisions to the contrary, any person who fails to comply with all the provisions of this section regarding the disclosure of HIV-related test results commits a class 2 misdemeanor.
Source: L. 89: Entire section added, p. 446, � 1, effective April 12. L. 92: (2)(f) amended, p. 1724, � 5, effective July 1. L. 94: (3)(d)(II) amended, p. 2723, � 318, effective July 1. L. 2016: (4)(c) amended, (SB 16-146), ch. 230, p. 914, � 4, effective July 1. L. 2021: (6) amended, (SB 21-271), ch. 462, p. 3148, � 115, effective March 1, 2022.
Cross references: For the penalty for a class 2 misdemeanor, see � 18-1.3-501.
10-3-1104.6. Genetic information - limitations on disclosure of information - liability - definitions - legislative declaration. (1) The general assembly hereby finds and determines that recent advances in genetic science have led to improvements in the diagnosis, treatment, and understanding of a significant number of human diseases. The general assembly further declares that:
(a) Genetic information is the unique property of the individual to whom the information pertains;
(b) Any information concerning an individual obtained through the use of genetic services may be subject to abuses if disclosed to unauthorized third parties without the willing consent of the individual to whom the information pertains;
(c) To protect individual privacy and to preserve individual autonomy with regard to the individual's genetic information, it is appropriate to limit the use and availability of genetic information;
(d) The intent of this section is to prevent genetic information from being used to deny access to health-care insurance or medicare supplement insurance coverage.
(2) For the purposes of this section:
(a) Entity means any sickness and accident insurance company, health maintenance organization, nonprofit hospital, medical-surgical and health service corporation, or other entity that provides health-care insurance or medicare supplement insurance coverage and is subject to the jurisdiction of the commissioner of insurance.
(b) Family member means an individual who is related to another individual by blood, adoption, or marriage within the first, second, third, or fourth degree.
(c) (I) Genetic information means information about an individual's genetic test, the genetic tests of family members of the individual, and the manifestation of a disease or disorder in family members of the individual. Genetic information includes any request for, or receipt of, genetic services with respect to an individual, or participation by an individual or the family member of an individual in clinical research that includes genetic services.
(II) With regard to an individual who is pregnant, genetic information includes genetic information of the fetus carried by the pregnant individual. With regard to an individual or family member using reproductive technology, genetic information includes genetic information of any embryo legally held by an individual or family member.
(III) Genetic information does not include information about the sex or age of an individual.
(d) Genetic services means a genetic test, genetic counseling, which includes obtaining, interpreting, or assessing genetic information, or genetic education.
(e) (I) Genetic test means any analysis of human DNA, RNA, chromosomes, proteins, or metabolites that detects genotypes, mutations, or chromosomal changes.
(II) Genetic test does not include:
(A) An analysis of proteins or metabolites that is directly related to a manifested disease, disorder, or pathological condition that could reasonably be detected by a health-care professional with appropriate training and expertise in the field of medicine involved; or
(B) An analysis of proteins or metabolites that does not detect genotypes, mutations, or chromosomal changes.
(f) Underwriting purposes means any of the following:
(I) Rules for, or determination of, eligibility for enrollment or continued eligibility in a policy or for benefits under the policy;
(II) The computation of premium or contribution amounts under the policy;
(III) The application of any preexisting condition exclusion under the policy; and
(IV) Other activities related to the creation, renewal, or replacement of a contract of health insurance or health benefits.
(3) (a) Genetic information shall be confidential and privileged. Any release, for purposes other than diagnosis, treatment, or therapy, of genetic information that identifies the person tested with the test results released requires specific written consent by the person about whom the genetic information pertains or the parent or guardian of that person.
(b) (I) Any entity that receives genetic information may not seek, use, or keep the information for any nontherapeutic purpose or for any underwriting purpose connected with the provision of health-care insurance or medicare supplement insurance coverage.
(II) If an entity obtains genetic information incidental to a request or requirement for, or purchase of, other information concerning an individual, the request or requirement for, or purchase of, such information shall not be considered a violation of this paragraph (b) if it is not in violation of paragraph (a) of this subsection (3).
(c) (I) An entity shall not request or require an individual or family member of the individual to undergo a genetic test unless otherwise authorized by applicable state or federal law.
(II) Nothing in this paragraph (c) shall be construed to preclude an entity from obtaining and using the results of a genetic test in making a determination regarding payment, as defined in 45 CFR 164.501, as may be amended, and consistent with paragraphs (a) and (b) of this subsection (3).
(4) Notwithstanding the provisions of subsection (3) of this section, in the course of a criminal investigation or a criminal prosecution, and to the extent allowed under the federal or state constitution, any peace officer, district attorney, or assistant attorney general, or a designee thereof, may obtain genetic information regarding the identity of any individual who is the subject of the criminal investigation or prosecution for use exclusively in any criminal investigation or prosecution without the consent of the individual being tested.
(5) Notwithstanding the provisions of subsection (3) of this section, any research facility may use genetic information for scientific research purposes if the identity of any individual to whom the information pertains is not disclosed to any third party; except that the individual's identity may be disclosed to the individual's physician if the individual consents to the disclosure in writing.
(6) This section does not limit the authority of a court or any party to a parentage proceeding to use genetic information for purposes of determining parentage pursuant to section 13-25-126, C.R.S.
(7) This section does not limit the authority of a court or any party to a proceeding that is subject to the limitations of part 5 of article 64 of title 13, C.R.S., to use genetic information for purposes of determining the cause of damage or injury.
(8) This section does not limit the authority of the state board of parole to require any offender who is involved in a sexual assault to submit to blood tests and to retain the results of such tests on file as authorized under section 17-2-201 (5)(g), C.R.S.
(9) This section does not limit the authority granted the state department of public health and environment, the state board of health, or county, district, or municipal public health agencies pursuant to section 25-1-122, C.R.S.
(10) Any violation of this section is an unfair practice as defined in section 10-3-1104 (1), and is subject to the provisions of sections 10-3-1106 to 10-3-1113.
(11) Any individual who is injured by an entity's violation of this section may recover in a court of competent jurisdiction the following remedies:
(a) Equitable relief, which may include a retroactive order, directing the entity to provide health insurance or medicare supplement insurance coverage, whichever is appropriate, to the injured individual under the same terms and conditions as would have applied had the violation not occurred; and
(b) The greater of:
(I) An amount equal to any actual damages suffered by the individual as a result of the violation; or
(II) Ten thousand dollars per violation.
(12) The prevailing party in an action under this section may recover costs and reasonable attorney fees.
Source: L. 2009: Entire section added, (HB 09-1338), ch. 353, p. 1840, � 2, effective July 1. L. 2010: (9) amended, (HB 10-1422), ch. 419, p. 2066, � 14, effective August 11.
10-3-1104.7. Genetic testing - legislative declaration - definitions - limitations on disclosure of information - liability. (1) The general assembly hereby finds and determines that recent advances in genetic science have led to improvements in the diagnosis, treatment, and understanding of a significant number of human diseases. The general assembly further declares that:
(a) Genetic information is the unique property of the individual to whom the information pertains;
(b) Any information concerning an individual obtained through the use of genetic techniques may be subject to abuses if disclosed to unauthorized third parties without the willing consent of the individual to whom the information pertains;
(c) To protect individual privacy and to preserve individual autonomy with regard to the individual's genetic information, it is appropriate to limit the use and availability of genetic information;
(d) The intent of this section is to prevent information derived from genetic testing from being used to deny access to group disability insurance or long-term care insurance coverage.
(2) For the purposes of this section:
(a) Entity means any entity that provides group disability insurance or long-term care insurance coverage and is subject to the jurisdiction of the commissioner of insurance.
(b) Genetic testing means any laboratory test of human DNA, RNA, or chromosomes that is used to identify the presence or absence of alterations in genetic material which are associated with disease or illness. Genetic testing includes only such tests as are direct measures of such alterations rather than indirect manifestations thereof.
(3) (a) Information derived from genetic testing shall be confidential and privileged. Any release, for purposes other than diagnosis, treatment, or therapy, of genetic testing information that identifies the person tested with the test results released requires specific written consent by the person tested.
(b) Any entity that receives information derived from genetic testing may not seek, use, or keep the information for any nontherapeutic purpose or for any underwriting purpose connected with the provision of group disability insurance or long-term care insurance coverage.
(4) Notwithstanding the provisions of subsection (3) of this section, in the course of a criminal investigation or a criminal prosecution, and to the extent allowed under the federal or state constitution, any peace officer, district attorney, or assistant attorney general, or a designee thereof, may obtain information derived from genetic testing regarding the identity of any individual who is the subject of the criminal investigation or prosecution for use exclusively in the criminal investigation or prosecution without the consent of the individual being tested.
(5) Notwithstanding the provisions of subsection (3) of this section, any research facility may use the information derived from genetic testing for scientific research purposes so long as the identity of any individual to whom the information pertains is not disclosed to any third party; except that the individual's identity may be disclosed to the individual's physician if the individual consents to such disclosure in writing.
(6) This section does not limit the authority of a court or any party to a parentage proceeding to use information obtained from genetic testing for purposes of determining parentage pursuant to section 13-25-126, C.R.S.
(7) This section does not limit the authority of a court or any party to a proceeding that is subject to the limitations of part 5 of article 64 of title 13, C.R.S., to use information obtained from genetic testing for purposes of determining the cause of damage or injury.
(8) This section does not limit the authority of the state board of parole to require any offender who is involved in a sexual assault to submit to blood tests and to retain the results of such tests on file as authorized under section 17-2-201 (5)(g), C.R.S.
(9) This section does not limit the authority granted the state department of public health and environment, the state board of health, or local departments of health pursuant to section 25-1-122, C.R.S.
(10) Notwithstanding any provision of this section to the contrary, the only requirements that shall apply to an insurer in connection with life insurance or individual disability insurance are as follows:
(a) Except as otherwise specifically authorized or required by another section of state or federal law, an insurer shall not require the performance of or perform a genetic test without first receiving the specific, written, informed consent of the subject of the test who has the capacity to consent or, if the person subject to the test lacks the capacity to consent, of a person authorized by law to consent on behalf of the subject of the test. Written consent shall be in a form prescribed by the commissioner.
(b) The results of a genetic test performed pursuant to this subsection (10) are privileged and confidential and shall not be released to any person except as specifically authorized under applicable state or federal law.
(11) Any violation of this section is an unfair practice, as defined in section 10-3-1104 (1), and is subject to the provisions of sections 10-3-1106 to 10-3-1113.
(12) Any individual who is injured by an entity's violation of this section may recover in a court of competent jurisdiction the following remedies:
(a) Equitable relief, which may include a retroactive order, directing the entity to provide group disability insurance or long-term care insurance coverage, whichever is appropriate, to the injured individual under the same terms and conditions as would have applied had the violation not occurred; and
(b) The greater of:
(I) An amount equal to any actual damages suffered by the individual as a result of the violation; or
(II) Ten thousand dollars per violation.
(13) The prevailing party in an action under this section may recover costs and reasonable attorney fees.
Source: L. 94: Entire section added, p. 1944, � 1, effective June 2; (9) amended, p. 2614, � 22, effective July 1. L. 2002: (10) and (12) amended, p. 990, � 1, effective June 1. L. 2003: (12)(b)(I) amended, p. 1982, � 7, effective May 22. L. 2009: (1)(d), (2)(a), (3)(b), and (12)(a) amended, (HB 09-1338), ch. 353, p. 1839, � 1, effective July 1.