State RegulationsCO specificDifficulty 2/5
A Colorado carrier requests additional information on a submitted claim and sends the required written explanation within 30 days. Absent fraud, under C.R.S. § 10-16-106.5, all other claims must be paid, denied, or settled within:
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
C.R.S. § 10-16-106.5 requires a carrier that needs additional information on a claim to send a written explanation within 30 days; absent fraud, all other claims must be paid, denied, or settled within 90 calendar days. The carrier therefore may not hold the claim beyond the 90-calendar-day outside limit even while information is outstanding.
Why the other options are wrong
- A) 60 calendar days is not the outside resolution period under the prompt-pay statute.
- B) 120 calendar days exceeds the statutory 90-calendar-day outside limit.
- D) 180 calendar days is far beyond the 90-calendar-day outside limit for claims absent fraud.
Memory hook
Need more info? Explain in 30 days; resolve within 90.