Claim Notice Pack (Policyholder) - Colorado

CLAIM NOTICE PACK (POLICYHOLDER) — COLORADO

Practice Note: C.R.S. §§ 10-3-1115 and 10-3-1116(1) provide a remedy for a qualifying first-party claimant when payment of a covered benefit is unreasonably delayed or denied. A person asserting a claim against an insured under a liability policy is excluded, as are the specified nonparticipating providers; workers' compensation, title insurance, and life insurance have separate exclusions. For a third-party liability occurrence, identify the insured's own claimed policy benefit, such as a defense benefit, before invoking this remedy. Other claim-handling deadlines and remedies require separate current-rule review.

DOCUMENT 1: INITIAL CLAIM NOTICE LETTER

[INSURED LETTERHEAD]

[__/__/____]

VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED
AND VIA EMAIL TO: [________________________________]

Claims Department
[________________________________] (Carrier Name)
[________________________________] (Street Address)
[________________________________] (City, State, ZIP)

Re: Notice of Claim / Notice of Occurrence
Policy No.: [________________________________]
Policy Type: [________________________________] (e.g., CGL, Property, D&O, EPLI, Professional Liability, Auto)
Policy Period: [__/__/____] to [__/__/____]
Named Insured: [________________________________]
Date of Loss / Occurrence: [__/__/____]
Claim No. (if assigned): [________________________________]

Dear Claims Department:

This letter constitutes formal written notice of a claim and/or occurrence under the above-referenced policy, submitted on behalf of [________________________________] ("Insured"). This notice is provided pursuant to the policy's notice provisions and all applicable Colorado law, including the Colorado Insurance Code (C.R.S. Title 10) and the Division of Insurance claims-handling regulations (3 CCR 702-5).

1. Description of the Loss or Occurrence

Date of Loss / Occurrence: [__/__/____]

Location of Loss: [________________________________]

Description of Incident:
[________________________________]
[________________________________]
[________________________________]
[________________________________]

Parties Involved / Claimant(s):

• [________________________________]
• [________________________________]
• [________________________________]

Type of Loss (check all that apply):

• ☐ Property damage (wind, hail, fire, water, other)
• ☐ Bodily injury / personal injury
• ☐ Third-party liability claim / lawsuit
• ☐ Employment practices claim
• ☐ Directors & officers claim
• ☐ Professional liability / errors & omissions claim
• ☐ Business interruption / loss of income
• ☐ Auto / vehicle accident
• ☐ Other: [________________________________]

Suit or Demand Received: ☐ Yes ☐ No
If yes, date received: [__/__/____]
Court/agency: [________________________________]
Case number: [________________________________]

2. Policy Identification and Coverage Trigger

Coverage Trigger Statement:

• ☐ The occurrence took place on [__/__/____], within the policy period.
• ☐ The claim was first made against the Insured on [__/__/____], within the policy period, and the alleged wrongful act occurred after the retroactive date of [__/__/____].
• ☐ The Insured became aware of circumstances reasonably likely to give rise to a claim on [__/__/____] and provides this notice of circumstances within the policy period.

3. Additional Policies That May Apply

Notice is being provided simultaneously to all potentially applicable carriers. This notice is not an election regarding priority of coverage.

4. Requests

The Insured requests the following:

☐ Claim Number and Adjuster Assignment — Please assign a claim number and designated adjuster and provide their contact information promptly.

☐ Complete Copy of Policy — Please provide a complete, certified copy of the policy, including all endorsements and declarations.

☐ Defense and Indemnity — The Insured tenders defense and requests indemnification under the policy. Please confirm acceptance and identify assigned defense counsel.

☐ Advancement of Defense Costs — If the policy provides for advancement, the Insured requests immediate advancement.

☐ Written Coverage Position — Please provide a written determination promptly. For a covered property or casualty first-party claim, identify when Regulation 5-1-14's valid-and-complete-claim, policy-compliance, and reasonable-dispute conditions are satisfied before calculating its 60-day period.

5. Statutory Notice — C.R.S. §§ 10-3-1115 and 10-3-1116

The Insured respectfully reminds the carrier of its obligations under Colorado law:

• C.R.S. § 10-3-1115(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.
• C.R.S. § 10-3-1116(1): A first-party claimant 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, court costs, and two times the covered benefit.
• 3 CCR 702-5, Regulation 5-1-14: The 60-day decision/payment requirement applies to a qualifying property or casualty first-party claim after receipt of a valid and complete claim, subject to a reasonable-dispute and insured-compliance gate. The Commissioner may assess a $100-per-day civil penalty after notice and hearing for a qualifying payment delay; that amount is not a payment automatically owed to the policyholder.

An unreasonable delay or denial of this claim will expose the carrier to statutory damages.

6. Cooperation and Preservation

The Insured will cooperate fully in the investigation of this claim. The Insured requests that the carrier:

• Preserve all documents and communications related to this claim
• Provide all coverage-related communications in writing
• Refrain from destroying any materials related to this policy or claim

7. Reservation of Rights (Insured)

The Insured expressly reserves all rights, remedies, and defenses under the policy, under Colorado law, and at equity, including but not limited to:

• The right to challenge any reservation of rights or coverage defense
• The right to pursue statutory remedies under C.R.S. §§ 10-3-1115 and 10-3-1116
• The right to pursue common-law bad faith remedies
• All rights under the notice-prejudice rule as applied in Colorado
• The right to file a complaint with the Colorado Division of Insurance

Nothing herein constitutes a waiver of any right of the Insured.

8. Delivery Confirmation

This notice is sent via:

• ☐ Certified mail, return receipt requested (Tracking No.: [________________________________])
• ☐ Email to: [________________________________]
• ☐ Carrier claims portal (Confirmation No.: [________________________________])
• ☐ Hand delivery (Date/time: [________________________________])
• ☐ Overnight courier (Tracking No.: [________________________________])

Date of transmission: [__/__/____]

Sincerely,

________________________________________
[________________________________] (Name)
[________________________________] (Title)
[________________________________] (Company/Insured Entity)
[________________________________] (Address)
[________________________________] (Phone)
[________________________________] (Email)

cc: [Coverage Counsel, if any]

DOCUMENT 2: SWORN PROOF OF LOSS

SWORN STATEMENT IN PROOF OF LOSS

State of Colorado
County of [________________________________]

The undersigned, being duly sworn, states:

Claimant and Policy Information

Loss Information

Ownership and Interest

The insured property was owned by: [________________________________]

The insured's interest in the property was: ☐ Owner ☐ Tenant ☐ Mortgagee ☐ Other: [________________________________]

At the time of loss, the property was occupied by: [________________________________]

Changes in title, use, or occupancy since policy inception: ☐ None ☐ Describe: [________________________________]

Encumbrances and Liens

Other Insurance

Itemization of Loss

Additional Amounts Claimed

Sworn Declaration

The above statements are true and correct to the best of my knowledge and belief. I understand that any material misstatement or omission in this proof of loss may void coverage under the policy. I have not misrepresented, concealed, or omitted any material fact. I submit this proof of loss without waiving any rights under the policy or Colorado law.

________________________________________
Signature of Insured / Authorized Representative

[________________________________] (Printed Name)
[________________________________] (Title)

Date: [__/__/____]

Notarization

State of Colorado
County of [________________________________]

The foregoing instrument was acknowledged before me this [____] day of [________________], 20[____], by [________________________________].

☐ Personally known to me
☐ Proved to me on the basis of satisfactory evidence

________________________________________
Notary Public Signature

Printed Name: [________________________________]
My Commission Expires: [__/__/____]

[NOTARY SEAL]

Supporting Documentation Checklist

☐ Photographs / video of damage or loss
☐ Police report / fire report / incident report (Report No.: [________________])
☐ Repair estimates from licensed contractors (minimum two recommended)
☐ Receipts and invoices for emergency repairs and mitigation
☐ Inventory of damaged or lost personal property with values
☐ Proof of ownership (receipts, appraisals, photos)
☐ Medical bills and records (if bodily injury)
☐ Income documentation for business interruption claims
☐ Lease or mortgage statements
☐ Hail/storm reports from NOAA or local weather service (common in Colorado)
☐ Prior inspection or appraisal reports
☐ Correspondence with the insurer
☐ Other: [________________________________]

DOCUMENT 3: FOLLOW-UP DEMAND FOR CLAIM ACKNOWLEDGMENT

[INSURED LETTERHEAD]

[__/__/____]

VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED
AND VIA EMAIL TO: [________________________________]

Claims Department
[________________________________] (Carrier Name)
[________________________________] (Street Address)
[________________________________] (City, State, ZIP)

Re: DEMAND FOR ACKNOWLEDGMENT AND COMPLIANCE — OVERDUE RESPONSE
Policy No.: [________________________________]
Insured: [________________________________]
Date of Loss: [__/__/____]
Date of Initial Notice: [__/__/____]
Claim No.: [________________________________] (if assigned)

Dear Claims Department:

On [__/__/____], the undersigned submitted formal notice of a claim under the above-referenced policy. As of today, [____] days have elapsed since that notice, and the Insured has not received:

• ☐ Written acknowledgment of the claim
• ☐ Assignment of a claim number
• ☐ Identification of the assigned adjuster
• ☐ Necessary claim forms and instructions
• ☐ A copy of the policy as requested
• ☐ A written coverage determination

Statutory and Regulatory Violations

This failure to respond violates multiple provisions of Colorado law:

1. 3 CCR 702-5, Regulation 5-1-14: For qualifying property or casualty first-party claims, section 4(A)(1) requires a decision and/or payment within 60 days after a valid and complete claim, unless a reasonable dispute exists and provided the insured complied with the policy. Under section 4(B)(3), if an investigation remains incomplete and the claim is unpaid after the section 4(A)(1) period, the insurer must immediately give reasons and then send a reasoned letter every 30 days while unpaid. Section 4(A)(1)(b) describes possible Commissioner-imposed payments to the insured; section 4(A)(1)(c) separately permits the Commissioner, after notice and hearing, to assess a $100-per-day civil penalty against the insurer. That civil penalty is not an automatic policyholder recovery.

2. C.R.S. § 10-3-1115(1)(a): A person engaged in the business of insurance shall not unreasonably delay or deny payment of a claim for benefits owed to a first-party claimant. Your failure to acknowledge or process this claim constitutes unreasonable delay.

3. C.R.S. § 10-3-1104(1)(h): Unfair claims settlement practices include:

• Failing to acknowledge and act reasonably promptly upon communications with respect to claims
• Failing to adopt and implement reasonable standards for the prompt investigation of claims
• Not attempting in good faith to effectuate prompt, fair, and equitable settlements when liability is reasonably clear
• Compelling insureds to institute litigation to recover amounts due by offering substantially less than amounts ultimately recovered

4. C.R.S. § 10-3-1116(1) — Statutory Remedy: If this delay continues, the Insured is entitled to bring an action in district court for two times the covered benefit, plus reasonable attorney fees and court costs.

Demand

The Insured hereby demands that within fifteen (15) calendar days of your receipt of this letter, you:

1. Provide written acknowledgment of the claim with an assigned claim number
2. Identify the assigned adjuster with direct contact information
3. Provide all necessary claim forms and instructions
4. Provide a complete copy of the policy, including all endorsements
5. Confirm the status of the investigation and timeline for coverage determination

Notice of Intent to File DOI Complaint

If the Insured does not receive a substantive response within the time specified above, the Insured intends to file a formal complaint with the Colorado Division of Insurance:

Colorado Division of Insurance
Colorado Department of Regulatory Agencies (DORA)
1560 Broadway, Suite 1300
Denver, CO 80202
Consumer Services: (303) 894-7490 / (800) 930-3745
Email: [email protected]
Online Consumer Portal: https://doi.colorado.gov/for-consumers/file-a-complaint

The Insured reserves the right to pursue all remedies available under Colorado law, including but not limited to statutory damages under C.R.S. §§ 10-3-1115/1116, common-law bad faith, and any other applicable remedies.

Sincerely,

________________________________________
[________________________________] (Name / Title)
[________________________________] (Insured Entity)
[________________________________] (Contact Information)

DOCUMENT 4: DOCUMENT PRODUCTION COVER LETTER

[INSURED LETTERHEAD]

[__/__/____]

[________________________________] (Adjuster Name)
[________________________________] (Carrier Name)
[________________________________] (Street Address)
[________________________________] (City, State, ZIP)

Re: Document Production — Claim No. [________________________________]
Policy No.: [________________________________]
Insured: [________________________________]
Date of Loss: [__/__/____]

Dear [________________________________]:

Enclosed please find documents in support of the above-referenced claim. Please confirm receipt of these documents in writing.

Document Index

Total Documents Enclosed: [____]
Total Pages: [____]

Privilege Log (if applicable)

Requests

1. Please confirm receipt of the enclosed documents in writing
2. Please advise if you require any additional documentation
3. Please provide a timeline for review and coverage determination; identify when the valid-and-complete-claim conditions, if applicable, were met
4. Do not contact any third parties identified in these documents without first notifying the Insured's counsel

The production of these documents does not waive any privilege, right, or defense of the Insured.

Sincerely,

________________________________________
[________________________________] (Name / Title)
[________________________________] (Insured Entity)

Enclosures: As indexed above

DOCUMENT 5: NOTICE TO ALL POTENTIALLY LIABLE INSURERS

[INSURED LETTERHEAD]

[__/__/____]

VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED

[________________________________] (Carrier Name)
Claims Department
[________________________________] (Address)
[________________________________] (City, State, ZIP)

Re: Notice of Claim — Multiple Policies May Apply
Insured: [________________________________]
Date of Loss / Occurrence: [__/__/____]

Dear Claims Department:

This letter constitutes formal notice of a claim under each policy identified below. The Insured holds multiple insurance policies that may provide coverage for the loss described herein. This notice is sent simultaneously to all potentially applicable carriers.

Policies Noticed

Description of Loss

[Incorporate by reference or repeat the loss description from Document 1.]

"Other Insurance" Considerations

This simultaneous notice to all carriers does not constitute:

• An election as to which policy is primary, contributing, or excess
• An acknowledgment that any "other insurance" clause controls
• A waiver of the Insured's right to full indemnification under any applicable policy
• A concession regarding allocation among carriers

Requests to Each Carrier

Each carrier receiving this notice is requested to:

1. Acknowledge receipt of this notice promptly
2. Assign a claim number and adjuster
3. Provide a complete copy of the applicable policy
4. Provide a written coverage position promptly, applying Regulation 5-1-14's 60-day rule only if its property/casualty, valid-and-complete-claim, compliance, and reasonable-dispute gates are met
5. Identify any "other insurance" clause and its position on priority
6. Coordinate with co-carriers as appropriate

The Insured reserves all rights under each policy and under Colorado law, including statutory remedies under C.R.S. §§ 10-3-1115/1116.

Sincerely,

________________________________________
[________________________________] (Name / Title)
[________________________________] (Insured Entity)

cc: All carriers listed above; coverage counsel

DOCUMENT 6: CLAIMS DIARY / TIMELINE TEMPLATE

Colorado Regulatory Deadlines Reference

Claims Activity Log

Bad Faith / Unreasonable Delay Documentation Tracker

Record each instance of carrier conduct that may constitute unreasonable delay or denial under C.R.S. § 10-3-1115:

Key Violations to Track Under C.R.S. § 10-3-1104(1)(h):

• Failing to acknowledge and act reasonably promptly on communications
• Failing to adopt reasonable standards for prompt investigation
• Not attempting good faith settlement when liability is reasonably clear
• Compelling insureds to institute litigation by offering substantially less than ultimately recovered
• Refusing to pay claims without conducting a reasonable investigation
• Failing to affirm or deny coverage within a reasonable time

DOCUMENT 7: COMMON CLAIM TYPES ADDENDA

Addendum A — Property Damage Claims Checklist (Colorado-Specific)

☐ Date and cause of damage identified
☐ Emergency mitigation measures documented
☐ Building and contents inventoried with pre-loss values
☐ At least two repair/replacement estimates from licensed Colorado contractors
☐ Proof of ownership for high-value items
☐ Code upgrade costs estimated (if applicable)
☐ Debris removal costs documented
☐ ALE / loss of use expenses tracked with receipts
☐ Hail damage specifically documented — Colorado is a high-hail-damage state; obtain independent inspection
☐ Wildfire damage documentation — photos, evacuation orders, air quality reports
☐ NOAA storm reports obtained for weather-related claims
☐ Proof of loss submitted within policy deadline
☐ Scope of loss reviewed against policy coverages

Addendum B — Liability / Third-Party Claims Checklist

☐ Complaint, demand letter, or claim documentation attached to notice
☐ Tender of defense clearly stated
☐ All potentially applicable policies identified and noticed
☐ Conflict of interest evaluated — independent counsel may be required
☐ Reservation of rights letter requested from insurer
☐ Cooperation obligations reviewed and complied with
☐ Settlement authority and consent requirements identified
☐ Excess carrier notified if claim may exceed primary limits
☐ Litigation hold implemented

Addendum C — Auto / Vehicle Claims Checklist

☐ Police report obtained (Report No.: [________________])
☐ Photos of all vehicles and scene taken
☐ Other driver's insurance information obtained
☐ Witness statements collected
☐ Medical treatment documented (if BI claim)
☐ Vehicle damage estimate / total loss valuation obtained
☐ Third-party total-loss rule check only: Regulation 5-2-15 § 5(B)(3)'s three-business-day payment period requires a third-party claimant's written acceptance and insurer receipt of transferable vehicle title; do not use it for this policyholder claim without matching facts
☐ Rental car / transportation expenses tracked
☐ UM/UIM coverage evaluated
☐ Med-Pay / PIP coverage evaluated
☐ Diminished value claim considered

Addendum D — Business Interruption Claims Checklist

☐ Period of restoration defined and documented
☐ Pre-loss financial records compiled (12-24 months recommended)
☐ Lost revenue calculated with supporting methodology
☐ Continuing expenses documented
☐ Extra expense documentation maintained
☐ Mitigation efforts documented
☐ CPA or forensic accountant engaged (if warranted)
☐ Extended period of indemnity reviewed
☐ Civil authority coverage evaluated
☐ Contingent business interruption assessed

Addendum E — Professional Liability / E&O Claims Checklist

☐ Claim reported within claims-made policy's reporting period
☐ Claims-made trigger date confirmed
☐ Retroactive date verified
☐ Prior knowledge/prior acts exclusion reviewed
☐ Related claims analysis completed
☐ Consent to settle provision identified
☐ Defense costs within or outside limits identified
☐ Tail / extended reporting period options reviewed
☐ Regulatory investigation coverage evaluated

DOCUMENT 8: COLORADO PRACTICE NOTES

Key Statutes and Regulations

Key Case Law

Colorado Unreasonable Delay/Denial Statute — Key Points

1. Who Can Sue: A qualifying "first-party claimant" asserting benefits owed directly to or on behalf of an insured, subject to the express exclusions for a person claiming against the insured under a liability policy, a nonparticipating provider performing services, and the listed coverage types. C.R.S. § 10-3-1115(1)(b), (5)-(7).
2. Standard: Delay or denial is "unreasonable" when it is "without a reasonable basis." The insurer need not act in bad faith; mere unreasonableness suffices.
3. Remedies: Two times the covered benefit, plus reasonable attorney fees and court costs. C.R.S. § 10-3-1116(1).
4. Statute of Limitations: Two years from the date the policyholder realizes injury from the unreasonable delay or denial.
5. Individual Liability: The Colorado Supreme Court has held that statutory bad faith claims can only be brought against the insurance company, not individual adjusters.
6. Not Required to Exhaust Administrative Remedies: A policyholder may file suit without first filing a DOI complaint.

Notice-Prejudice Rule — Colorado Summary

1. Occurrence Policies: Colorado applies the notice-prejudice rule to occurrence-based, first-party property insurance policies. The insurer can deny coverage for late notice only if it proves it was prejudiced by the delay. Vaccaro v. American Family, 275 P.3d 750 (Colo. App. 2012).
2. Claims-Made Policies: The notice-prejudice rule generally does not apply to the reporting deadline in claims-made policies, where timely reporting is considered part of the coverage grant.
3. Burden on Insurer: The insurer bears the burden of demonstrating actual prejudice.

Colorado Division of Insurance — Contact Information

Colorado Division of Insurance
Colorado Department of Regulatory Agencies (DORA)
1560 Broadway, Suite 1300
Denver, CO 80202

Consumer Services: (303) 894-7490 / (800) 930-3745 (toll-free outside Denver metro)
Email: [email protected]
Online Consumer Portal: https://doi.colorado.gov/for-consumers/file-a-complaint
Website: https://doi.colorado.gov
Hours: Monday-Friday, 8:00 AM - 5:00 PM MT

Colorado-Specific Timeline Summary

Colorado Weather and Natural Disaster Claims — Special Considerations

Colorado experiences frequent hail, wildfire, and severe weather events. Practitioners should be aware of:

• Catastrophe Exceptions: Under 3 CCR 702-5, an insurer may request a deviation or exemption from the 60-day timeline in the event of a significant catastrophe. Monitor whether the insurer has obtained such a deviation.
• Appraisal Clauses: Many Colorado property policies include appraisal clauses. Demanding appraisal does not toll the insurer's statutory obligations.
• Contractor Referral Issues: Colorado has scrutinized assignment of benefits and contractor referral arrangements. Ensure the policyholder maintains control of the claim.

SOURCES AND REFERENCES

1. C.R.S. § 10-3-1115 and § 10-3-1116 — https://law.justia.com/codes/colorado/2021/title-10/article-3/part-11/section-10-3-1116/
2. C.R.S. § 10-3-1104 — Colorado Unfair Claims Settlement Practices
3. 3 CCR 702-5 — Regulations 5-1-14 and 5-2-15 — https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=12295&fileName=3%20CCR%20702-5
4. Colorado Division of Insurance — File a Complaint — https://doi.colorado.gov/for-consumers/file-a-complaint
5. Etherton v. Owners Insurance Co., 829 F.3d 1209 (10th Cir. 2016) — https://caselaw.findlaw.com/court/us-10th-circuit/1742896.html
6. Colorado Bad Faith Insurance Guide — https://sjjlawfirm.com/2022/11/29/colorado-policyholders-a-claim-for-unreasonable-delay-or-denial-of-benefits-is-a-fight-worth-having/
7. Colorado Supreme Court on Notice-Prejudice Rule — https://www.policyholderpulse.com/colorado-notice-prejudice-rule-first-party-occurrence-policies/
8. Colorado Claims Handling Requirements — https://www.propertyinsurancecoveragelaw.com/blog/how-to-file-a-complaint-with-the-colorado-insurance-commissioner-office-about-your-delaying-denying-and-bad-treating-insurance-company/

This template is provided for informational purposes only and does not constitute legal advice. It is intended for use by licensed attorneys representing policyholders in Colorado insurance claims. Each claim requires professional evaluation of the specific facts, policy language, and applicable law. Users should verify all statutory citations and regulatory references, as laws and regulations are subject to change. This template was last updated on 2026-02-26.

Prepared for use on the ezel.ai platform.