Protect Neutral Determinations In Health Insurance
The act clarifies 2008 legislation prohibiting discretionary clauses in certain plans and insurance policies and providing for the de novo standard of review (roughly translated as "anew" or "from a clean slate") in any court by:
- Declaring that the legislation should be construed broadly to effectuate its remedial purpose, notwithstanding any contractual or statutory choice-of-law provision to the contrary;
- Nullifying any contract provision that purports to give an insurer or its agent discretionary authority to determine the insured person's entitlement to benefits in any specific circumstance; and
- Separating the provision requiring de novo review of policy disputes from the provision allowing a claimant to demand a jury trial, to clarify that these are separate issues.
The act applies to all plans and policies existing, offered, issued, delivered, or renewed in Colorado or providing health or disability benefits to a resident or domiciliary of Colorado on or after the applicable effective date of the act.
(Note: This summary applies to this bill as enacted.)