May 27, 2018

Colorado Supreme Court: Insurers Have Duty Not to Unreasonably Withhold or Delay Payments, Even Where Other Parts of Claim in Dispute

The Colorado Supreme Court issued its opinion in State Farm Mutual Automobile Insurance Co. v. Fisher on Monday, May 21, 2018.

Insurance—Underinsured Motorist Benefits—Unreasonable Delay/Denial of Payment.

The supreme court held that under C.R.S. § 10-3-1115 insurers have a duty not to unreasonably delay or deny payment of covered benefits, even though other components of an insured’s claim may still be reasonably in dispute. Here, an insurer issued multiple underinsured motorist insurance policies that covered a driver who was injured by an underinsured motorist. Though the insurer agreed that its policies covered the driver’s medical expenses, it refused to pay them because the insurer disputed other amounts (including lost wages) that the driver sought under the policies. A jury found that the insurer violated C.R.S. § 10-3-1115, which provides that an insurer “shall not unreasonably delay or deny payment of a claim for benefits owed to or on behalf of any first-party [insured] claimant.” Because the court of appeals properly upheld the driver’s jury award, the court affirmed its judgment.

Summary provided courtesy of Colorado Lawyer.

Bills Signed Changing Revenge Pornography Crimes, Amending Laws Related to Bicycles Approaching Intersections, and More

On Thurdsay, May 3, 2018, Governor Hickenlooper signed seven bills into law. To date, he has signed 211 bills and sent two to the Secretary of State without a signature. The bills signed Thursday include a bill changing the laws concerning revenge pornography crimes, a bill requiring state agencies to conduct analyses to determine which businesses are not complying with their rules, a bill permitting municipalities to adopt rules concerning bicycles approaching intersections, and more. The bills signed Thursday are summarized here.

  • SB 18-132 – “Concerning a Waiver of Federal Law to Permit Insurance Carriers to Offer Catastrophic Health Plans to Any Individual Residing in Colorado, and, in Connection Therewith, Making an Appropriation,” by Sen. Jim Smallwood and Rep. Chris Kennedy. The bill requires the commissioner of insurance to conduct an actuarial analysis to determine if the sale of catastrophic health plans to Colorado residents 30 years of age and older and not meeting a hardship requirement would result in a reduction in advanced premium tax credits received by Colorado residents or increase the average premiums of individual health plans.
  • SB 18-144 – “Concerning the Regulation of Bicycles Approaching Intersections,” by Sen. Andy Kerr and Reps. Yeulin Willett & Chris Hansen. The bill permits a municipality or county to adopt a local ordinance or resolution regulating the operation of bicycles approaching intersections with stop signs or illuminated red traffic control signals. Under a local regulation, a bicyclist approaching a stop sign must slow to a reasonable speed and, when safe to do so, may proceed through the intersection without stopping. A bicyclist approaching an illuminated red traffic control signal must stop at the intersection and, when safe to do so, may proceed through the intersection.
  • SB 18-177 – “Concerning Procedures when Certain Private Schools Cease Operations,” by Sens. Kevin Priola & Nancy Todd and Reps. Jeff Bridges & Lang Sias. Under existing law, private occupational schools and certain private degree-granting schools are required to provide a bond or other form of surety that is used to facilitate transfer or to provide tuition and fee reimbursement for students in the event that the school closes. When a private occupational school closes, that school’s records must be maintained by the private occupational school board in the Division of Private Occupational Schools. The bill allows the Department of Education to make a claim on a surety bond for reimbursement of actual administrative costs associated with a school closure.
  • HB 18-1193 – “Concerning the Advanced Placement Incentives Pilot Program, and, in Connection Therewith, Making an Appropriation,” by Reps. James Wilson & Barbara McLachlin and Sens. Ray Scott & Rachel Zenzinger. The bill extends the pilot program three years. It requires the Department of Education to report the number of students in the pilot program who enrolled in advanced placement courses during the prior school year and to collect disaggregated data from the advanced placement exam vendor to capture the performance of students who are participating in the pilot program on the end-of-course advanced placement exams.
  • HB 18-1250 – “Concerning an Analysis to Improve Compliance with Departmental Rules by Regulated Businesses,” by Reps. Tracy Kraft-Tharp & Lang Sias and Sen. Kevin Priola. The bill equires each state agency to conduct an analysis of noncompliance with its rules to identify rules with the greatest frequency of noncompliance, rules that generate the greatest amount of fines, how many first-time offenders were given the opportunity to cure a minor violation, and what factors contribute to noncompliance by regulated businesses. The analysis will guide each department on how to improve its education and outreach to regulated businesses on compliance with the department’s rules.
  • HB 18-1257 – “Concerning a Correction to House Bill 16-1316 by Reinserting the Word ‘Not,'” by Rep. Paul Rosenthal and Sen. John Cooke. House Bill 16-1316 amended the venue statute for transferring child welfare proceedings between counties and inadvertently struck the word ‘not’ in one sentence. Due to this error, courts are not allowed to transfer child welfare proceedings between counties after adjudication even though the intent of House Bill 16-1316 was to allow post-adjudication transfers. The bill reinserts the word ‘not’ to allow such transfers.
  • HB 18-1264 – “Concerning Measures to Clarify the Scope of Revenge Porn Criminal Offenses,” by Reps. Dominique Jackson & Terri Carver and Sens. John Cooke & Rhonda Fields. Currently, Colorado criminalizes posting nude images of another person for harassment purposes or for pecuniary gain. The bill adds images of sex acts that may not include nude images, removes the requirement that the defendant intend to inflict serious emotional distress removes as an exception to the crimes that the image relates to a newsworthy event, and clarifies that the images subject to the crimes may be disclosed by law enforcement personnel, human or social services personnel, prosecutors, and court personnel in the course of their normal business.

For a complete list of the governor’s 2018 legislative actions, click here.

Bills Signed Enacting Uniform Trust Code, Creating Civil Rape Shield Law, Helping Preserve Family Units with Parents with Disabilities, and More

On Wednesday, April 25, 2018, Governor Hickenlooper signed nine bills into law. On Thursday, April 26, 2018, he signed five bills into law. To date, he has signed 183 bills and sent one bill to the Secretary of State without a signature. The bills signed Wednesday and Thursday include a bill enacting the Colorado Uniform Trust Code, a bill enacting a civil rape shield statute, a bill amending family preservation safeguards for parents with disabilities, a bill requiring free-standing emergency rooms to post certain consumer notices, and more. The bills signed Wednesday and Thursday are summarized here.

  • SB 18-071 – “Concerning an Extension of the Repeal of the State Substance Abuse Trend and Response Task Force, and, in Connection Therewith, Making an Appropriation,” by Sens. Cheri Jahn & Larry Crowder and Rep. Daneya Esgar. The state substance abuse trend and response task force is scheduled to be repealed effective July 1, 2018. The bill extends the repeal for 10 years to September 1, 2028.
  • SB 18-146 – “Concerning a Requirement that a Freestanding Emergency Department Inform a Person who is Seeking Medical Treatment about the Health Care Options that are Available to the Person, and, in Connection Therewith, Making an Appropriation,” by Sens. John Kefalas & Jim Smallwood and Reps. Lang Sias & Jonathan Singer. The bill requires a freestanding emergency department (FSED), whether operated by a hospital at a separate, off-campus location or operating independently of a hospital system, to provide any individual that enters the FSED seeking treatment a written statement of patient information, which an FSED staff member or health care provider must explain orally.
  • SB 18-154 – “Concerning a Requirement for a Local Juvenile Services Planning Committee to Devise a Plan to Manage Dually Identified Crossover Youth,” by Sen. Rhonda Fields and Rep. Joseph Salazar. The bill requires local juvenile services planning committees to devise a plan to manage dually identified crossover youth. A dually identified crossover youth is a youth involved in both the juvenile justice system and the child welfare system. The plan must contain descriptions and processes.
  • SB 18-169 – “Concerning Offenses Against Witnesses in Noncriminal Proceedings,” by Sen. Bob Gardner and Rep. Terri Carver. The clarifies that the offenses of intimidating a witness or victim and retaliation against a witness or victim apply to witnesses in criminal, civil, and administrative proceedings.
  • SB 18-180 – “Concerning the Colorado Uniform Trust Code,” by Sen. Bob Gardner and Reps. Cole Wist & Matt Gray. The bill enacts the Colorado Uniform Trust Code and repeals many sections of the Colorado Probate Code.
  • SB 18-187 – “Concerning Transferring Marijuana Fibrous Waste for the Purpose of Producing Industrial Fiber Products,” by Sens. Vicki Marble & Jack Tate and Rep. Jeni James Arndt. The bill gives the state licensing authority rule-making authority to address conditions under which a medical or retail marijuana licensee is authorized to transfer marijuana fibrous waste to a person for the purpose of producing only industrial fiber products.
  • HB 18-1104 – “Concerning Family Preservation Safeguards for Parents with Disabilities,” by Rep. Jessie Danielson and Sens. Dominick Moreno & Kent Lambert. The bill establishes that family protection safeguards for a parent or prospective parent with a disability are critical to family preservation and the best interests of the children of Colorado. These safeguards include that a parent’s disability must not serve as a basis for denial or restriction of parenting time or parental responsibilities in a domestic law proceeding, that a parent’s disability must not serve as a basis for denial of participation in a public or private adoption, or for denial of foster care or guardianship, and that the benefits of providing supportive parenting services must be considered by a court when determining parental responsibilities, parenting time, adoption placements, foster care, and guardianship.
  • HB 18-1132 – “Concerning the Amount that the Department of Corrections is Required to Reimburse a County or City and County for the Confinement and Maintenance in a Local Jail of any Person who is Sentenced to a Term of Imprisonment in a Correctional Facility,” by Rep. Dafna Michaelson Jenet and Sen. Larry Crowder. Under current law, the General Assembly establishes in its annual general appropriations bill the amount that the Department of Corrections is required to reimburse any county or city and county for a portion of the expenses and costs incurred by that county or city and county for the confinement and maintenance in a local jail of any person who is sentenced to a term of imprisonment in a correctional facility. The bill states that, to assist the General Assembly in determining such rate of reimbursement, each county and each city and county shall report to the joint budget committee the average cost of confining and maintaining persons in a local jail for more than 72 hours after each such person has been sentenced to the custody of the department.
  • HB 18-1147 – “Concerning the Continuation of the Regulation of People who Modify the Weather, and, in Connection Therewith, Implementing the Sunset Review Recommendations of the Department of Regulatory Agencies,” by Reps. Joann Ginal & Kim Ransom and Sen. Don Coram. The bill continues the regulation of people who modify the weather.
  • HB 18-1211 – “Concerning Controlling Medicaid Fraud,” by Reps. Cole Wist & Mike Foote and Sens. Irene Aguilar & Jim Smallwood. The bill establishes the medicaid fraud control unit in the department of law. The unit is responsible for investigation and prosecution of medicaid fraud and waste, as well as patient abuse, neglect, and exploitation. Prior to initiating a criminal prosecution, the unit must consult with the district attorney of the judicial district where the prosecution would be initiated.
  • HB 18-1237 – “Concerning the Continuation of the Requirements Regarding the Preparation of a Cost-Benefit Analysis as Administered by the Department of Regulatory Agencies, and, in Connection Therewith, Implementing the Recommendations Contained in the 2017 Sunset Report by the Department of Regulatory Agencies,” by Reps. Tracy Kraft-Tharp & Kevin Van Winkle and Sen. Tim Neville. The bill implements the recommendations of the Department of Regulatory Agencies’ sunset review and report on requirements and procedures regarding the preparation of a cost-benefit analysis.
  • HB 18-1243 – “Concerning Enactment of a Civil Rape Shield Law,” by Reps. Mike Foote & Cole Wist and Sens. Don Coram & Rhonda Fields. Under Colorado criminal law there is a rape shield law that presumes that evidence of a victim’s sexual conduct is irrelevant and not admissible except for evidence of the victim’s prior or subsequent sexual conduct with the defendant or evidence of specific instances of sexual activity showing the source or origin of semen, pregnancy, disease, or any similar evidence of sexual intercourse offered for the purpose of showing that the act or acts were or were not committed by the defendant. The bill creates a similar presumption in a civil proceeding involving alleged sexual misconduct. If a party wants to introduce sexual conduct evidence, it must file a confidential motion with the court at least 63 days prior to trial. Prior to ruling on the motion, the court shall conduct an in camera hearing and allow the parties and alleged victim to attend and be heard.
  • HB 18-1275 – “Concerning the Repeal of the Craig Hospital License Plate Donation Requirement,” by Rep. Jeff Bridges and Sen. Daniel Kagan. Current law requires an applicant to make a donation to Craig Hospital in order to be issued a special Craig Hospital license plate. The bill repeals the $20 donation requirement.
  • HB 18-1282 – “Concerning a Requirement that a Health Care Provider Include Certain Identifying Information on all Claims for Reimbursement for Health Care Services,” by Reps. Susan Lontine & Lang Sias and Sens. Jim Smallwood & John Kefalas. The bill requires an off-campus location of a hospital to apply for, obtain, and use on claims for reimbursement for health care services provided at the off-campus location a unique national provider identifier, commonly referred to as NPI. The off-campus location’s NPI must be used on all claims related to health care services provided at that location, regardless of whether the claim is filed through the hospital’s central billing or claims department or through a health care clearinghouse. It also requires all medicaid providers that are entities to obtain and use a unique NPI for each site at which they deliver services and for each provider type that the department of health care policy and financing has specified.

For a complete list of Governor Hickenlooper’s 2018 legislative decisions, click here.

Colorado Court of Appeals: Plaintiff Not Allowed to Treat Denial of Liability as Denial of Coverage

The Colorado Court of Appeals issued its opinion in Pena v. American Family Mutual Insurance Co. on Thursday, April 19, 2018.

Uninsured Motorist—Denial of Liability—Denial of Coverage—CRCP 12(b)(5) Dismissal.

Peña was involved in a three-car collision. Both Peña and Garner, another driver involved in the accident, were insured by defendant American Family Mutual Insurance Company (American Family). Peña sent a letter to American Family asserting a claim under the uninsured motorist provisions of her policy. American Family denied Peña’s claim, asserting that Garner was not responsible for the damage to her vehicle and Garner had coverage at the time of the accident, so Peña’s uninsured motorist property damage (UMPD) provision would not apply.

Peña sued Garner and American Family in separate actions. In this action, she sued American Family under C.R.S. § 10-3-1115 for the unreasonable delay and denial of benefits due under the UMPD provisions of her policy. American Family moved to dismiss, arguing that Peña’s complaint failed, as a matter of law, to state a claim upon which relieve could be granted because Peña’s UMPD coverage applied only if American Family, as Garner’s insurer, denied coverage, rather than liability, for Garner in connection with the accident. The district court agreed with this interpretation of Peña’s policy and the distinction made between denial of coverage and denial of liability. But because American Family had only denied liability and the issue of liability had not yet been determined, the court concluded that Peña’s UMPD coverage did not apply at that point and the lawsuit was premature. The district court dismissed the case without prejudice.

On appeal, Peña contended that the district court erred in dismissing her case. She argued that the district court erred in not considering whether American Family unreasonably delayed or denied her claim before dismissing her action. Because American Family denied liability but not coverage, her policy’s UMPD provision was inapplicable, and there were no benefits that could have been delayed or denied. Peña had no claim as a matter of law. The district court’s determination that Peña’s lawsuit was premature was in error because Peña will never have a claim against American Family under her policy for unpaid UMPD benefits from the accident; Garner’s insurer has not denied coverage, which is the circumstance that would trigger Peña’s UMPD coverage. If Garner is ultimately found liable, Peña will have a claim against American Family under the liability provisions of his policy.

The judgment was affirmed.

Summary provided courtesy of Colorado Lawyer.

Bills Signed Requiring Commercial Drivers to Receive Training in Human Trafficking Prevention, Modifying Water Court Process for Substitute Water Rights, and More

On Thursday, April 12, 2018, Governor Hickenlooper signed 23 bills into law. To date, he has signed 149 bills and sent one to the Secretary of State without a signature. Some of the bills signed Thursday include a bill allowing a water court process for mitigation measures, a bill requiring commercial drivers to receive training on prevention of human trafficking, a bill authorizing insurers’ agents to access the electronic motor vehicle title database, and more. The bills signed Thursday are summarized here.

  • SB 18-011 – “Concerning Treatment of Students who are Excused by their Parents from Participating in State Assessments,” by Sens. Chris Holbert & Andy Kerr and Reps. Tracy Kraft-Tharp & Paul Lundeen. The bill clarifies procedures for parents who excuse their children from taking state assessments and students whose parents excuse them from testing shall still be allowed to receive rewards designed for students who complete the assessments.
  • SB 18-079 – “Concerning Classifying Sake as a Vinous Liquor for the Purposes of the ‘Colorado Liquor Code,'” by Sen. Lucia Guzman and Rep. Dan Pabon. The bill classifies sake as a vinous liquor (wine) for the purposes of the “Colorado Liquor Code.”
  • SB 18-087 – “Concerning In-state Tuition at Institutions of Higher Education for Certain Foreign Nationals Legally Settled in Colorado,” by Sen. Stephen Fenberg and Reps. Dafna Michaelson Jenet & Faith Winter. The bill contains a legislative declaration about the circumstances facing special immigrants and refugees and the benefit of access to education.
  • SB 18-106 – “Concerning Obsolete Statutory Provisions Related to a Local Government’s Pledging of Sales or Use Tax Revenues to Pay for Revenue Bonds Issued for the Purpose of Financing Capital Improvements,” by Sen. Jack Tate and Rep. Don Thurlow. Current law specifies that a county, city, or incorporated town may include the creation of a sales and use tax capital improvement fund (special fund) when the county, city, or incorporated town seeks voter approval to levy a sales or use tax. The creation of the special fund does not have a purpose for a county, city, or incorporated town post-TABOR because the question of using sales or use tax revenues for financing capital improvements is asked when the county, city, or incorporated town seeks voter approval for the bond issuance. Thus, the language regarding the creation of the fund is unnecessary.
  • SB 18-110 – “Concerning the Repeal of the Requirement that Each State Agency Annually Report the Amount of Federal Money it Received in the Prior Fiscal Year,” by Sen. Jack Tate and Rep. Jeni James Arndt. During the 2017 legislative session, the statutory revision committee put forth House Bill 17-1058, which, in part, repealed a requirement that the state controller submit to the general assembly a report of all federal money received by state agencies during the prior fiscal year. State agencies are still required to submit an annual report to the state controller of all federal moneys received by the state agency in the prior fiscal year for the state controller’s use in preparing the report for the general assembly.The bill repeals the state agency reporting requirement as the state controller is no longer required to prepare a report for the general assembly.
  • SB 18-127 – “Concerning the Repeal of the Department of Revenue’s Requirement to Publish an Historical Explanation of Income Tax Rate Modifications Enacted in the State on Every Income Tax Return Form,” by Sen. Beth Martinez Humenik and Rep. Dan Thurlow. The bill repeals the requirement that the Executive Director of the Department of Revenue publish an historical explanation of income tax rate modifications enacted in the state on every income tax return form.
  • SB 18-129 – “Concerning the Nonsubstantive Reorganization of the Law Exempting from State Sales Tax Certain Drugs and Medical and Therapeutic Devices,” by Sen. Dominick Moreno and Rep. Jeni James Arndt. The bill makes several modifications to the laws exempting certain drugs and medical devices from sales tax.
  • SB 18-136 – “Concerning Fees for Advising Clients About the Selection of an Individual Health Benefit Plan,” by Sen. Tim Neville and Reps. Tracy Kraft-Tharp & Lang Sias. The bill allows an insurance producer or broker advising a client on individual health benefit plans to charge the client a fee if the producer or broker does not receive a commission related to the individual health benefit plan selected by the client and if the producer or broker discloses in writing the fee to the client.
  • SB 18-161 – “Concerning Repeal of the Behavioral Health Transformation Council,” by Sen. Jim Smallwood and Reps. Tracy Kraft-Tharp & Lois Landgraf. The bill repeals the behavioral health transformation council.
  • SB 18-162 – “Concerning Substitute Child Care Providers,” by Sen. Beth Martinez Humenik and Reps. Janet Buckner & James Wilson. The bill creates a license within the Department of Human Services for a substitute placement agency that places or that facilitates or arranges placement of substitute child care providers in licensed child care facilities providing less than 24-hour care.
  • SB 18-170 – “Concerning a Water Court Process by Which an Owner of a Storage Water Right Allowing Water to be Stored in New Reservoir Capacity may Release Water into an Identified Stream Reach in a Manner that Protects the Water Releases while Complying with Mitigation Measures Identified in a Fish and Wildlife Mitigation Plan Approved by the Colorado Water Conservation Board,” by Sen. Jerry Sonnenberg and Reps. Chris Hansen & Hugh McKean. The bill establishes a water court process by which an owner of a water storage right allowing water to be stored in a newly constructed reservoir or an enlarged existing reservoir may comply with the mitigation measures identified in a mitigation plan by contracting with the board.
  • SB 18-172 – “Concerning Testing of Horse Racing Licensees for the Presence of Prohibited Substances,” by Sen. Bob Gardner and Rep. Pete Lee. The bill adds to the responsibilities of the Colorado racing commission the protection of all participants, human and animal, involved in horse racing.
  • SB 18-176 – “Concerning Changes to the Requirements for Meeting Dates for the Board of the Southwestern Water Conservation District,” by Sen. Don Coram and Reps. Barbara McLachlin & Marc Catlin. The bill requires the Board of the Southwestern Water Conservation District to meet once every three months and makes amendments to the terms of the board members and board president.
  • SB 18-182 – “Concerning the Authority to Allocate a Portion of the Source Market Fee to Statutorily Authorized Purse Funds,” by Sens. Don Coram & Lucia Guzman and Reps. Marc Catlin & Jeni James Arndt. Current law requires persons outside of Colorado who accept wagers from residents of Colorado on simulcast horse racing events to be licensed in Colorado and to pay a source market fee into the racing cash fund. The bill authorizes the Director of the Division of Racing Events to allocate a portion of the source market fee to be paid to any horse purse trust fund established pursuant to existing law, if necessary, to maintain a sustainable and competitive purse structure in Colorado.
  • SB 18-183 – “Concerning Authorizing Agents of Insurers to Access the Electronic System that Insurers Access for Owner and Lienholder Information of a Motor Vehicle,” by Sen. Jack Tate and Reps. Jeni James Arndt & Larry Liston. Current law authorizes the creation and maintenance of an electronic system that vehicle towers, insurers, and salvage pools may use to access motor vehicle title records if the vehicle is insured or possessed by those entities. The bill allows an agent of an insurer to use the system in the same circumstances.
  • SB 18-184 – “Concerning a New Permit for the Short-term Extraction of Construction Materials,” by Sen. Don Coram and Reps. Hugh McKean & Daneya Esgar. The bill creates a new class of limited impact construction materials permits for one-time activities that produce construction materials as a by-product and are not intended to be ongoing mining operations and authorizes an application fee of $400 for the permit and an annual fee of $200.
  • HB 18-1017 – “Concerning the Adoption of an Interstate Compact to Allow a Person Authorized to Practice Psychology in a Compact State in Which the Person is not Licensed, and, in Connection Therewith, Making an Appropriation,” by Rep. Dafna Michelson Jenet and Sens. Bon Gardner & Stephen Fenberg. The bill enacts the ‘Psychology Interjurisdictional Compact Act’ allowing psychologists licensed in any compact state to provide telepsychology services to clients in any other compact state, or temporary in-person client services in any compact state not exceeding 30 days in a calendar year.
  • HB 18-1018 – “Concerning a Requirement that Education to Prevent Human Trafficking be Included in the Training to Obtain a Commercial Driver’s License,” by Reps. Terri Carver & Dominique Jackson and Sens. Rachel Zenzinger & John Cooke. The bill requires that the training to obtain a commercial driver’s license to drive a combination vehicle contain education to prevent human trafficking if the training is conducted in a driving school. The department must also publish information about human trafficking for commercial driver’s license holders and trainees.
  • HB 18-1049 – “Concerning the Department of Human Services’ Authority to Continue to Lease Portions of the Grand Junction Regional Center Campus to Third-party Behavioral Health Providers,” by Rep. Dan Thurlow and Sen. Ray Scott. The Department of Human Services currently leases portions of the Grand Junction regional center campus to third-party behavioral health providers. The bill authorizes the Department to continue such leases until June 30, 2020, and each party to such lease may terminate the lease early provided that the terminating party provide the other party with 90 days notice before vacating the property or requiring the property to be vacated.
  • HB 18-1056 – “Concerning the Statewide Standard Health History Form that Members of the Fire and Police Pension Association Complete when Commencing Employment,” by Reps. Kevin Van Winkle & Dave Williams and Sen. John Cooke. Every member of the fire and police pension association (FPPA), at the commencement of employment, is required to complete a health history on a statewide standard health history form. The bill clarifies several aspects of the form.
  • HB 18-1078 – “Concerning Court Programs for Defendants who have Served in the Armed Forces,” by Reps. Lois Landgraf & Tony Exum and Sen. Bob Gardner. Under current law, the chief judge of a judicial district may establish an appropriate program for the treatment of veterans and members of the military. The bill states that, in establishing any such program, the chief judge, in collaboration with the probation department, the district attorney, and the state public defender, shall establish program guidelines and eligibility criteria. The bill requires a court, in determining whether to issue an order to seal criminal records of a petitioner who has successfully completed a veterans treatment program, to consider such factor favorably in making the determination.
  • HB 18-1154 – “Concerning Consumer Protections Relating to a Solicitation to Provide a Copy of a Public Record for a Fee,” by Reps. Edie Hooten & Kevin Van Winkle and Sen. Cheri Jahn. The bill requires a person who solicits a fee for providing a copy of a deed or deed of trust to give a copy of the document that will be used for the solicitation to each county clerk and recorder where the solicitation is to be distributed; not charge a fee of more than 4 times the amount charged by the county clerk and recorder; and include specified disclosures.
  • HB 18-1239 – “Concerning Continuation under the Sunset Law of the Environmental Management System Permit Program, and, in Connection Therewith, Implementing the Recommendations of the Sunset Report by the Department of Regulatory Agencies by Allowing the Program to Repeal,” by Rep. Lois Landgraf and Sen. Ray Scott. The bill implements the recommendations of the sunset review and report on the environmental management system permit program by allowing the program to repeal.

For a complete list of Governor Hickenlooper’s 2018 legislative decisions, click here.

Colorado Court of Appeals: Excess Insurer Must Step Into Shoes of Insured and Plead Primary Bad Faith

The Colorado Court of Appeals issued its opinion in Preferred Professional Insurance Co. v. The Doctors Co. on Thursday, April 5, 2018.

Medical Malpractice—Primary Insurance Policy—Excess Insurance Policy—Equitable Subrogation —Bad Faith.

A medical malpractice suit was filed against Dr. Singh and other parties. The Doctors Company (TDC), the primary insurer, defended Dr. Singh in the suit as required by its primary liability policy. Preferred Professional Insurance Company’s (PPIC) insurance policy was an “excess policy,” which would cover any losses that exceeded TDC’s $1 million coverage up to an additional $1 million. As an excess insurer, PPIC did not have any duty to defend Dr. Singh in the suit. The plaintiff in the medical malpractice suit offered to settle the case with Dr. Singh for $1 million, the amount of TDC’s policy limits. Dr. Singh conveyed his desire to accept the settlement offer to both insurers, but TDC declined to settle the case. PPIC told Dr. Singh he should accept, and it paid the $1 million settlement. PPIC then filed suit against TDC for equitable subrogation to recover the amount paid. The district court granted summary judgment in PPIC’s favor without addressing TDC’s argument that PPIC was required to prove that TDC refused to settle in bad faith.

On appeal, TDC contended that the district court erred as a matter of law because an equitable subrogation claim brought by an excess insurer against the primary insurer to recover the amount paid in settlement can only be derivative of the insured’s rights. Thus, PPIC’s refusal to plead and present evidence that TDC acted in bad faith in declining to settle required dismissal of PPIC’s claim. An excess insurer seeking recovery under equitable subrogation for a primary insurer’s failure to settle a case against their mutual insured “steps in the shoes of the insured” and must plead and prove the primary insurer’s bad faith. Here, without an assertion that TDC acted in bad faith, PPIC’s equitable subrogation claim is not legally viable.

The order granting summary judgment for PPIC was reversed and the case was remanded for entry of judgment of dismissal in TDC’s favor.

Summary provided courtesy of Colorado Lawyer.

Why Everyone Needs a Long-Term Care Plan

In my previous blog I explained why I began, at age 26, a career in helping people plan for one of the biggest risks in life: needing chronic care for an extended period of time. Now, twenty-one years into my profession, I can absolutely say that everyone needs a plan for extended care, not necessarily LTC insurance!

According to the most recent data from the U.S. Department of Health and Human Services, 52.3% of persons turning 65 will need long-term care. Certainly, some care needs are just a few weeks or months. In other cases, the care event can last 10 years or more. In fact, 29.2% of those incurring LTC expenditures are expected to spend more than $250,000. The Alzheimer’s Association reports that caregivers for people with Alzheimer’s or other dementias provided approximately 18.2 billion hours of informal, unpaid assistance in 2016 valued at $230 billion – nearly 50% of Walmart’s revenue in 2016! Who are these caregivers? 80% of home care for people with Alzheimer’s and other dementias is provided by unpaid caregivers, most often family members. In my experience, family caregivers overwhelmingly agree that the emotional and physical consequences they experience are far more devastating than the financial costs.

Without planning, you or your client’s loved ones may be forced to make tough decisions. Do we make a placement into a nursing home or is someone willing and able to provide informal home care? Can we afford the best facility in the area or can we bring in 24/7 home care? Planning for extended care helps to mitigate the devastating emotional, physical and financial consequences of a long-term care event. Critical components of a long-term care plan include:

  • Who will be my caregiver if I am to remain at home? Will this person be physically and emotionally able to take care of me? Will he/she leave a career to be my caregiver? Sometimes the bigger question is who do I not want to set aside his or her life to care for me.
  • What type of care might I need? Care at home, an assisted living facility or a skilled nursing facility?
  • Where might I receive care? Will my children living in another community or state wish to move me closer to them? Would one of my adult children want me to move in with them, or would one of my adult children care to move in with me?
  • When is it likely to happen? What if I need care in my 50s, 60s, or 70s? Might I avoid dreaded diseases such as Alzheimer’s or Parkinson’s but live long enough to become frail and fragile and need help as a normal part of aging?
  • Why might I need extended care? Are there reasons to believe that I am more likely or less likely to need help than the average person? How much can I rely on family history?
  • How will I/we finance and coordinate care needs? If retirement funds and income are diverted to pay for care, how will our ability to meet ongoing obligations to loved ones be affected? Who will make decisions on my behalf?

LTC Planning Goals

I find that my clients’ planning goals often align nearly perfectly with my own personal reasons for owning some form of insurance against chronic care:

  1. If I need extended care, keep me at home for as long as possible without destroying the lives of my loved ones around me. Let them be my care manager, not my 24/7 caregiver.
  2. Preserve the retirement plan and other assets for my spouse and children and other worthwhile charitable pursuits.
  3. Keep intact our other planning devices such as the estate plan, charitable giving plan, tax avoidance plan, business succession plan, the special needs of a disabled child, etc.

What about those who are single, divorced, or widowed? Most wish to stay at home without running out of money. And if an assisted living facility or nursing necessary, who wouldn’t want the best facility possible?

Without a plan for care, someone, not just the person needing care, will suffer the consequences. Often times the person in charge of making decisions may become confused and frustrated regarding options and choices. Someone in the family may feel that there is no choice but to get involved to make sure the loved one is safe and getting good care. And because the children typically do not contribute equally physically, emotionally, or financially, resentment and hard feelings can erupt.

The Role of Insurance

Simply put, the myriad insurance products on the market today (life insurance with accelerated benefits, hybrid asset-based policies, traditional LTC insurance, short-term care insurance, hybrid LTC annuities) provide funds to help meet the planning goals detailed above. In other words, proceeds from the insurance policy provide cash flow so that a loved one can stay at home as long as possible or afford the best facility around. Because a third party is helping to pay for care, the spouse/partner/family has the freedom to make the best choices for all concerned. And if there is a surviving spouse or partner, the money provided by the insurance policy means more money to live on and a better lifestyle.

My next blog will focus on why affluent clients need a plan for care, and local care costs. Until then, if there is anything I can do for you or your clients, please visit www.AaronEisenach.com or call 303-659-0755.

Thank you,

Aaron R Eisenach, CLTC

AaronEisenach.com

 

Aaron R. Eisenach has specialized in long-term care planning and insurance-based solutions for 20 years. His passion for this topic stems from losing both his father and grandfather to Alzheimer’s Disease. As an insurance wholesaler, Mr. Eisenach represents ICB, Inc., the nation’s first general agency specializing in LTC insurance. As an educator, he provides workshops to consumers and teaches state-mandated continuing education courses to Colorado insurance agents selling LTC products. As a broker, Mr. Eisenach is the proprietor of AaronEisenach.com and partners with financial advisors and agents who trust him to work with their clients. He is the immediate past president of the Producers Advisory Council at the Colorado Division of Insurance, serves as president of the nonprofit LTC Forum of Colorado, Inc, and has appeared on 9News and KMGH Channel 7. He recently served as an expert witness in a court case and was a contributing author to the American College curriculum on long-term care insurance.

Bills Signed Regarding Appropriating Retail Marijuana Sales Tax to Schools, Clarifying Standard for Deceptive Trade Practices, and More

On Thursday, March 15, 2018, the governor signed 15 bills into law. To date, he has signed 55 bills this legislative session. Many of Thursday’s bills involved the relocation of statutes from Title 12. Some of the other bills signed include a bill to clarify which entities are eligible to apply for special event beverage licenses, a bill appropriating retail marijuana sales tax to schools, a bill changing the date of special district elections to May every-other year, and more. The bills signed Thursday are summarized here.

  • HB 18-1027 – “Concerning the Nonsubstantive Relocation of Laws Related to the Regulation of the Lottery from Title 24, Colorado Revised Statutes, to a New Title 44 as Part of the Organizational Recodification of Title 12,” by Rep. Cole Wist and Sen. Daniel Kagan. The bill creates Title 44 and relocates the sections of Title 12 related to the regulation of the lottery to Title 44.
  • HB 18-1028 – “Concerning Clarification of the Standard Required for Applications for a Court Order to Require Compliance with Investigations of Deceptive Trade Practices,” by Reps. Tracy Kraft-Tharp & Cole Wist and Sens. Lois Court & Jack Tate. The bill would allow a judge to issue a court order if compliance with an investigation is necessary to investigate a deceptive trade practice.
  • HB 18-1039 – “Concerning Changing Regular Special District Elections to May of Each Odd-numbered Year, and, in Connection Therewith, Adjusting the Length of Terms Served by Directors Elected in 2020 and 2022 in Order to Implement the New Election Schedule,” by Rep. Kim Ransom and Sen. Bob Gardner. The bill moves regular special district elections to the Tuesday following the first Monday of May in odd-numbered years, rather than the Tuesday immediately succeeding the first Monday of May in every even-numbered year, starting in 2023.
  • HB 18-1087 – “Concerning Department of Public Safety Authority to Repeal Rules Relating to Defunct Boards,” by Rep. Dan Thurlow and Sens. Don Coram & Daniel Kagan. The victims compensation and assistance coordinating committee and the victims assistance and law enforcement advisory board in the department of public safety were repealed in 2009. The bill gives the executive director of the department of public safety the authority to repeal rules relating to those repealed boards.
  • HB 18-1096 – “Concerning the Eligibility of Certain Entities to Apply for a Special Event Permit to Sell Alcohol Beverages,” by Rep. Matt Gray and Sen. Kevin Priola. The bill adds to the list of organizations authorized to obtain a special event permit to sell alcohol beverages for a limited period an organization that is incorporated under Colorado law for educational purposes.
  • HB 18-1100 – “Concerning the Continuous Appropriation of Money in the Educator Licensure Cash Fund,” by Rep. Millie Hamner and Sen. Kent Lambert. The bill extends the continuous appropriation of money to the State Board of Education and the Department of Education (Department) for its expenses incurred in the administration of the “Colorado Educator Licensing Act of 1991” for three more years.
  • HB 18-1101 – “Concerning Modification of the Manner in which Gross Retail Marijuana Tax Revenue that is Transferred from the General Fund to the State Public School Fund as Required by Current Law is Appropriated from the State Public School Fund,” by Rep. Millie Hamner and Sen. Kent Lambert. Beginning in the 2018-19 fiscal year, the bill requires 12.59% of the gross retail marijuana sales tax revenue remaining in the general fund after a required allocation of 10% of the revenue to local governments to be transferred to the state public school fund, and continuously appropriates that revenue for the same state fiscal year in which it is transferred from the state public school fund to the department of education to help meet the state share of total program funding for school districts and institute charter schools.
  • HB 18-1140 – “Concerning Public Official Personal Surety Bonds, and, in Connection Therewith, Repealing Obsolete Provisions and Authorizing the Purchase of Insurance in Lieu of Public Official Personal Surety Bonds,” by Rep. Hugh McKean and Sen. Dominick Moreno. The bill repeals obsolete provisions related to personal surety bonds and authorizes a public entity to purchase insurance in lieu of a public official personal surety bond and states the requirements for the insurance.
  • SB 18-036 – “Concerning the Nonsubstantive Relocation of Laws Related to the Regulation of Tobacco Sales to Minors from Title 24, Colorado Revised Statutes, to a New Title 44 as Part of the Organizational Recodification of Title 12, and, in Connection Therewith, Making an Appropriation,” by Sen. Daniel Kagan and Rep. Cole Wist. The bill creates Title 44, then relocates the sections of Title 24 regarding the regulation of tobacco sales to minors to Title 44.
  • SB 18-091 – “Concerning Modernizing Terminology in the Colorado Revised Statutes Related to Behavioral Health,” by Sen. Beth Martinez Humenik and Rep. Dan Thurlow. The bill is a follow-up and clean-up to Senate Bill 17-242, which updated and modernized terminology in the Colorado Revised Statutes related to behavioral health, including mental health disorders, alcohol use disorders, and substance use disorders.
  • SB 18-092 – “Concerning Updating Statutory References to ‘County Departments of Social Services,'” by Sen. Beth Martinez Humenik and Rep. Edie Hooten. The bill modernizes outdated references in statute to “County Department(s) of Social Services,” or similar terms, to “County Department(s) of Human or Social Services.” Counties throughout the state have different ways of referring to the department in the county that does human or social services work, so it is necessary for statute to reflect that not all county departments go by one label.
  • SB 18-094 – “Concerning the Repeal of a Duplicate Definitions Section in Article 60 of Title 27, Colorado Revised Statutes,” by Sen. Beth Martinez Humenik and Rep. Edie Hooten. The bill repeals section 27-60-102.5, Colorado Revised Statutes, which is a duplicate definitions section for general provisions related to behavioral health found in article 60 of title 27, Colorado Revised Statutes. The bill leaves in place section 27-60-100.3, Colorado Revised Statutes, enacted by Senate Bill 17-242.
  • SB 18-100 – “Concerning Disclosure of Additional Mandatory Charges by Motor Vehicle Rental Companies,” by Sen. Tim Neville and Reps. Tracy Kraft-Tharp & Kevin Van Winkle. The bill requires a motor vehicle rental company to disclose to a potential customer, in any vehicle rental cost quote and in the rental agreement, additional mandatory charges applicable to the motor vehicle rental.
  • SB 18-103 – “Concerning the Issuance of Performance-based Incentives for Film Production Activities in the State,” by Sens. Nancy Todd & Jim Smallwood and Reps. Tracy Kraft-Tharp & Timothy Leonard. The bill strengthens the requirements necessary to earn performance-based incentives for film production activities in the state in various ways.
  • SB 18-164 – “Concerning the Repeal of Reporting Requirements for Certain Unfunded Programs in the Department of Human Services Until Such Time as Funding is Received,” by Sen. Dominick Moreno and Rep. Dan Thurlow. The bill directs that reporting requirements for programs established in the department of human services that have not received funding in several years be placed on hold until such time as the program receives funding.

For all of the governor’s 2018 legislative decisions, click here.

Colorado Court of Appeals: Arbitration Clause in Health Insurance Contract Displaced by C.R.S. § 10-3-1116

The Colorado Court of Appeals issued its opinion in Meardon v. Freedom Life Insurance Co. of America on Thursday, March 8, 2018.

Health Insurance Policy—Mandatory Arbitration—Conformity Clause—Federal Arbitration Act—C.R.S. § 10-3-1116(3)—McCarran-Ferguson Act—Federal Supremacy—Preemption—Reverse Preemption.

Defendants Freedom Life Insurance Company of America and Robert J. Pavese (collectively, Freedom Life) denied health insurance benefits claimed by plaintiff  Meardon under a health insurance policy (policy) issued to her by Freedom Life. The policy contained a mandatory arbitration clause to resolve disputes. The policy also contained a “conformity clause” stating that a policy provision that conflicts with the laws of the policyholder’s state is amended to conform to the minimum requirements of such laws. Freedom Life moved to compel arbitration and to dismiss the case, relying on the mandatory arbitration clause. The trial court denied the motion, relying on C.R.S. § 10-3-1116(3), which allows denied claims to be contested in court before a jury.

On appeal, Freedom Life contended that (1) C.R.S. § 10-3-1116(3) cannot be applied because it is preempted by the Federal Arbitration Act (FAA); (2) even if the FAA does not preempt the statute, the arbitration clause remains in effect for those claims that fall outside the statute; and (3) Meardon must arbitrate her claims to “exhaust her administrative remedies” under C.R.S. § 10-3-1116(3). The plain words of the statute conflict with the mandatory arbitration clause. This conflict triggered the policy’s conformity clause, the application of which invalidated the arbitration clause for those claims covered by C.R.S. § 10-3-1116(3). Further, the FAA does not preempt C.R.S. § 10-3-1116(3) because the McCarran-Ferguson Act preempts the FAA under the doctrine of reverse-preemption.

Freedom Life alternatively contended that only those claims covered by C.R.S. § 10-3-116(3) are exempted from the arbitration clause and the remaining claims must be arbitrated. Because the parties did not seek a ruling from the trial court on this specific issue, the court of appeals was unable to determine which claims are subject to the arbitration clause.

The court’s order denying arbitration of those claims covered by C.R.S. § 10-3-1116(3) was affirmed. The case was remanded for the trial court to determine which claims are covered by C.R.S. § 10-3- 1116(3) and which are subject to the policy’s arbitration clause.

Summary provided courtesy of Colorado Lawyer.

Bills Signed Regarding Continuation of Family Medical Benefits After Death of State Worker, Creating a Crime of Cruelty to Police Horse, and More

On Wednesday, March 7, 2018, the governor signed 10 bills into law. To date, he has signed 40 bills this legislative session. The bills signed Wednesday included a bill to continue family medical benefits after the death of a state employee, a bill adding free-standing emergency rooms to Colorado’s safe haven laws, a bill creating the crime of cruelty to a working police horse, a bill removing the 30-day waiting period for importation of alcoholic beverages, and more. The bills signed Wednesday are summarized here.

  • HB 18-1010 – “Concerning Youth Committed to the Department of Human Services, and, in Connection Therewith, Requiring the Department to Report Certain Data and Adding Members to the Youth Restraint and Seclusion Working Group,” by Reps. Pete Lee & James Wilson and Sen. Don Coram. The bill requires the Department of Human Services to annually collect recidivism data and calculate the recidivism rates and educational outcomes for juveniles committed to the custody of the department who complete their parole sentences and discharge from department supervision.
  • HB 18-1024 – “Concerning the Nonsubstantive Relocation of Laws Related to the Regulation of Racing from Title 12, Colorado Revised Statutes, to a New Title 44 as Part of the Organizational Recodification of Title 12,” by Rep. Pete Lee and Sen. Daniel Kagan. The bill creates Title 44 and moves statutes related to the regulation of racing from title 12 to the new title.
  • HB 18-1026 – “Concerning the Nonsubstantive Relocation of the Law Creating the Liquor Enforcement Division and State Licensing Authority Cash Fund from Title 24, Colorado Revised Statutes, to a New Title 44 as Part of the Organizational Recodification of Title 12,” by Rep. Leslie Herod and Sens. John Cooke & Bob Gardner. The bill creates Title 44 and moves statutes creating the liquor enforcement division and state licensing authority cash fund from title 24 to the new title.
  • HB 18-1041– “Concerning Adding Certified Police Working Horses to the Crime of Cruelty to a Service Animal or a Certified Police Working Dog,” by Rep. Marc Catlin and Sen. Don Coram. The bill adds a definition for “certified police working horse” to statute and adds certified police working horses to the crime of cruelty to a service animal or a certified police working dog.
  • HB 18-1048 – “Concerning the Expenditure of Money from the Hesperus Account by the Board of Trustees of Fort Lewis College,” by Rep. Barbara McLaughlin and Sen. Don Coram. The bill eliminates the requirement that spending from the Fort Lewis College Hesperus account is subject to an appropriation by the general assembly.
  • HB 18-1105 – “Concerning the Unlicensed Sale of Vehicles,” by Reps. Larry Liston & Jovan Melton and Sen. Jack Tate. The bill clarifies that money received as fines for certain violations may be deposited in the auto dealers license fund.
  • SB 18-025 – “Concerning Modernization of Election Procedures for the Urban Drainage and Flood Control District to Conform with the Current Requirements of State Law,” by Sen. Kevin Priola and Rep. James Coleman. The bill makes several changes to statutory provisions related to flood control district elections.
  • SB 18-050 – “Concerning Including Staff of Free-standing Emergency Facilities as Part of Colorado’s Safe Haven Laws,” by Sen. Jim Smallwood and Reps. James Coleman & Marc Catlin. The bill expands Colorado’s safe haven laws to include staff members of community clinic emergency centers as persons allowed to take temporary physical custody of infants 72 hours old or younger when the infant is voluntarily surrendered by its parent or parents.
  • SB 18-124 – “Concerning the Removal of the Thirty-day Waiting Period Related to the Sale of Imported Alcohol Beverages,” by Sen. Owen Hill and Rep. Dan Pabon. Current law requires a manufacturer or importer of imported alcohol beverages to file a statement and notice of intent to import with the state licensing authority at least 30 days before the import or sale of the imported alcohol beverages. The bill removes the 30-day waiting period requirement.
  • SB 18-148 – “Concerning the Continuation of Certain Benefits Through the ‘State Employee Group Benefits Act’ for Dependents of a State Employee who Dies in a Work-related Death,” by Sens. Beth Martinez Humenik & Dominick Moreno and Reps. Polly Lawrence & Tony Exum. The bill specifies that dependents of an employee who dies in a work-related death are automatically qualified for the continuation of dental or medical benefits through the act for 12 months from the end of the month in which the work-related death occurred, so long as the dependents had dental or medical benefits pursuant to the act at the time of the employee’s work-related death.

For all of the governor’s 2018 legislative actions, click here.

Colorado Court of Appeals: District Court Erred in Summarily Dismissing Conversion and Unjust Enrichment Claims

The Colorado Court of Appeals issued its opinion in Scott v. Scott on Thursday, February 22, 2018.

Torts—Conversion—Unjust Enrichment—Life Insurance Proceeds—Motion to Dismiss under C.R.C.P. 12(b)(5) and (6)—Attorney Fees and Costs.

Roseann’s marriage to Melvin Scott was dissolved. Their separation agreement provided that Melvin’s life insurance policies were to be maintained until Roseann remarried, and at that time the beneficiaries could be changed to the children of the parties. Upon emancipation of the children, if Roseann had remarried, Melvin could change the beneficiary to whomever he wished. A Prudential life insurance policy was the policy at issue in this case.

After the divorce, Melvin married Donna and remained married to her until his death. Roseann never remarried. A few years before Melvin died and decades after his divorce from Roseann, Melvin changed the named beneficiary on his life insurance policies to Donna. Melvin died and Donna received the proceeds from his life insurance policies. Roseann sent a demand letter to Donna, requesting the proceeds pursuant to the separation agreement. The proceeds were placed in a trust account pending the outcome of this litigation.

Roseann sued Donna in Mesa County District Court, alleging civil theft, conversion, and unjust enrichment/constructive trust. Donna did not answer but removed the case to federal district court based on administration of the veteran life insurance policies by the federal government. She then moved to dismiss Roseann’s claims under a theory of federal preemption. Ultimately, the federal court agreed with the preemption argument and dismissed Roseann’s claims with prejudice as to the veteran policies but remanded the remaining claims to the Mesa County District Court for resolution regarding the Prudential policy.

Donna filed a motion in the district court to dismiss under C.R.C.P. 12(b)(5) and (6), arguing that Roseann’s claims failed to state a claim upon which relief could be granted and that she had failed to join Melvin’s estate, a necessary party. The district court granted the motion and a subsequent motion for attorney fees and costs.

On appeal, the court of appeals first examined whether Roseann had stated claims sufficient to withstand the plausibility standard required to survive a motion to dismiss under C.R.C.P. 12(b)(5). To state a claim for civil theft, a plaintiff must allege the elements of criminal theft, which requires the specific intent of the defendant to permanently deprive the owner of the benefit of his property. Roseann made a single, conclusory allegation, repeating the language in the statute, that Donna acted with the requisite intent to state a claim for civil theft. The court concluded that, without more, the allegation was not entitled to the assumption of truth, and the district court did not err in dismissing the civil theft claim.

Conversion, unlike civil theft, does not require that the convertor act with the specific intent to permanently deprive the owner of his property. Even a good faith recipient of funds who receives them without knowledge that they belonged to another can be held liable for conversion. Here, Roseann adequately alleged that Donna’s dominion and control over the Prudential policy proceeds were unauthorized because of the separation agreement language and Donna’s refusal to return the allegedly converted funds. Roseann pleaded each element of conversion sufficiently for that claim to be plausible and withstand a request for dismissal under C.R.C.P. 12(b)(5).

Similarly, the court concluded it was error to dismiss Roseann’s claim for unjust enrichment and constructive trust. In general, a person who is unjustly enriched at the expense of another is subject to liability in restitution. Here, Roseann alleged that Donna received a benefit that was promised to Roseann in the separation agreement and it would be inequitable for Donna to retain the funds. Roseann asked the court to impose a constructive trust on the assets. While this may be a difficult case in that two arguably innocent parties are asserting legal claims to the same insurance proceeds, resolution should be left to the fact finder and not resolved under a C.R.C.P. 12(b)(5) motion to dismiss.

It was not clear whether the district court had dismissed the claims for failure to join a necessary party under C.R.C.P. 12(b)(6), so the court addressed this issue as well. Here, the court held that Melvin’s estate was not a necessary party because Donna has possession of the proceeds at issue, and thus complete relief can be accorded between Roseann and Donna. In addition, the life insurance proceeds were never a part of Melvin’s estate assets and therefore the estate has no interest in those proceeds. Further, this is not an action for enforcement of the separation agreement, but is essentially an action in tort. The district court erred by dismissing the case under C.R.C.P. 12(b)(6).

Lastly, Roseann contended that Donna is not entitled to attorney fees and costs because the court erred in granting Donna’s motion to dismiss. The court agreed.

The judgment was affirmed in part and reversed in part, and the case was remanded with directions. The award of attorney fees and costs was vacated.

Summary provided courtesy of Colorado Lawyer.

Colorado Court of Appeals: Written Rejection of Enhanced UM/UIM Coverage Not Required

The Colorado Court of Appeals issued its opinion in Airth v. Zurich American Insurance Co. on Thursday, January 25, 2018.

Motor Vehicle Insurance—Uninsured/Underinsured—Summary Judgment.

Airth was seriously injured in an accident while operating a semi truck owned by his employer, Sole Transport LLC, d/b/a Solar Transport Company (Solar). He was struck by a negligent, uninsured driver. Solar had uninsured/underinsured motorist (UM/UIM) insurance coverage of $50,000 for its employees through a policy issued by Zurich American Insurance Co. Airth brought a claim for declaratory relief, seeking to reform Solar’s policy to provide UM/UIM coverage of $1 million. He alleged he was entitled to the higher amount because Zurich had failed, as required by C.R.S. § 10-4-609, to (1) offer Solar UM/UIM coverage in an amount equal to its bodily injury liability coverage ($1 million), and (2) produce a written rejection by Solar of such an offer. On cross-motions for summary judgment, the district court entered judgment for Zurich ruling, as a matter of law, that (1) Zurich’s documents adequately offered Solar UM/UIM coverage in an amount equal to the bodily injury liability limits of the policy, and (2) there is no requirement that the rejection of UM/UIM limits in an amount equal to liability limits be in writing.

On appeal, Airth contended that both of the district court’s rulings were incorrect and the court therefore erred in granting Zurich’s summary judgment motion and denying Airth’s cross-motion. C.R.S. § 10-4-609(1)(a) prohibits an insurer from issuing an automobile liability policy unless a minimum amount of UM/UIM coverage is included in the policy, except where the named insured rejects UM/UIM coverage in writing. C.R.S. § 10-4-609(2) requires an insurer, before a policy is issued or renewed, to offer the insured the right to obtain UM/UIM coverage in an amount equal to the insured’s bodily injury liability limits. The facts here were undisputed. Before renewing Solar’s policy, Zurich sent a package of documents pertaining to Solar’s rights related to UM/UIM coverage and Solar’s counsel affirmed that he had read all the documents. This included an opportunity to reject UM/UIM coverage or to select a higher than minimum level of UM/UIM coverage. Airth argued that none of this constituted an “offer” of the ability to obtain higher UM/UIM coverage, because the documents did not contain a premium quote or a way to estimate the premium for purchasing UM/UIM coverage commensurate with a bodily injury liability limit of $1 million. The Colorado Court of Appeals agreed that this would be the case if it were applying the meaning of the term “offer” as used in contract law. But the Colorado Supreme Court has attributed a different meaning to “offer” as it is used in C.R.S. § 10-4-609; the dispositive question is whether, under the totality of the circumstances, the insured was adequately informed that higher UM/UIM coverage was available. Here, that standard was met by the documents Zurich provided to Solar.

Airth also argued that Zurich was not entitled to summary judgment because there was no evidence that anyone from Solar read or understood the document. This argument overlooks that attestation of Solar’s counsel.

Airth further argued that reversal is required because the documents were signed and dated a month after the policy went into effect. The operative question is whether the insurer gave the insured the opportunity to purchase statutorily-compliant coverage before the insured needed it. The record reflects that Solar had received and responded to the notification and offer before the accident that injured Airth.

Airth also contended that the district court erred in determining that the statute only requires a written rejection with respect to the minimum UM/UIM coverage available and not to the additional coverage available. The court agreed with the district court’s conclusion that a written rejection is required only if the insured declines the minimum amount of UM/UIM coverage, which was not the case here.

The judgment was affirmed.

Summary provided courtesy of Colorado Lawyer.