Colorado Injury Insurance Claim Guide

An injury claim is a negotiation that happens mostly on paper. The insurer evaluates risk; you supply proof. The steps below are the ones nearly every claim passes through, whether or not a lawyer is involved.

First-party and third-party claims are different conversations

A first-party claim is one you make under your own policy: MedPay, collision, or uninsured and underinsured motorist coverage. You have a contract with that company, and it owes you duties of good faith; it can also require your cooperation. A third-party claim is one you make against someone else's liability policy. That insurer's duty runs to its own policyholder, not to you.

The difference shapes everything: what you are required to share, what you are wise to share, and what rights you have if the claim is mishandled. Colorado has statutes on unreasonable delay or denial of covered benefits (C.R.S. 10-3-1115 and 10-3-1116) that mostly concern first-party claims.

The adjuster's early moves

Expect contact within days. A third-party adjuster will typically ask for a recorded statement, a signed medical authorization, and photos. Early on, the adjuster is building a file about liability (who caused it) and damages (how bad it is). Comments made while you are in pain or on medication can end up quoted back months later.

Treatment, maximum medical improvement and why waiting matters

A claim generally cannot be valued until you know the full extent of the injury. Many people and their lawyers wait until treatment ends or until a doctor says you have reached maximum medical improvement, meaning further treatment is not expected to change things much. Settling earlier means guessing about future costs, and a release usually prevents you from coming back for more.

The balancing point is the filing deadline. Waiting for treatment cannot run past the time limit for filing suit, which is why the deadlines deserve attention from the start.

The demand package

When treatment is complete or close to it, the claim is usually presented in a demand: a letter plus supporting documents that lays out what happened, why the other party is responsible, and what the losses are. A complete demand typically includes:

• A short liability summary with the police or incident report, photos and witness statements.
• Medical records and itemized bills for every provider, in date order.
• Proof of lost income from an employer letter or tax records.
• Out-of-pocket costs with receipts.
• A description of how the injury affected daily life, ideally supported by a journal or statements from people who know you.

Our damages guide explains each category of loss and how it is usually documented.

Offers, counteroffers and liens

The first offer is usually low. That is not personal; it is how negotiation starts. Responses typically point to specific evidence the adjuster discounted. Before agreeing to any number, find out what liens exist. Health insurers, Medicare, Medicaid, and some providers may be entitled to repayment from the settlement, and those amounts can be negotiated too.

the offer arrives before treatment is finished

ask how they valued future care; most early offers do not include it.

the adjuster says the offer expires on Friday

deadlines set by an adjuster are negotiating tools; the legal deadline is the statute of limitations.

the liability limits are lower than your losses

ask a lawyer about your own UIM coverage and any other responsible parties before accepting.

The release: read every line

Settlement almost always requires signing a release. It usually ends the claim permanently, against the named people and often others, for known and unknown injuries. Check who is released, what claims are included, how liens will be paid, and when the money is due. If something is unclear, ask before signing; after is too late.