DENVER — The Colorado Department of Regulatory Agencies (DORA), Division of Insurance seems to have arbitrarily mandated that health insurance companies pay for injuries to participants of riots and civil disobedience, among other illegal gatherings and actions. The move worries some that the new coverage will force spikes in premiums to law-abiding citizens.
In a bulletin released late Monday, DORA redefined the term “community protests” to protect those who are involved in illegal acts from losing their health coverage if they are injured.
“Any injury, illness, condition, or disability sustained by a covered person participating in a community protest must be covered in accordance with the provisions of the health coverage plan and cannot be denied under any such illegal act or riot exclusion,” the bulletin reads.
The bulletin further declares that covered persons participating in community protest are not engaging in:
- Illegal acts;
- Participation in a riot;
- Civil disobedience;
- Civil commotion;
- Civil insurrection;
- Any civilian conflict involving armed forces of any authority;
- Rebellion; or
- Unlawful assembly.
The bulletin does not identify when a protest becomes civil disobedience, a riot or the other events outlined. Requests for comments from Complete Colorado to DORA were not immediately returned.
“It seems like they come up with more and more that insurance companies are supposed to pay for, but yet they want to reduce cost,” said Scott Rankin a broker for Leading Edge Financial in Greeley. Rankin has worked in the Colorado health insurance market for 32 years. “But those two things live in opposite paradigms. You can’t cover more and pay less.”
Rankin said in all group policies that he sells, and likely most individual ones, there is usually a clause in the certificate of insurance that says “benefits will not be given for any illness or injury that is the result of a war, service in the armed forces, a nuclear explosion, nuclear accident, release of nuclear energy, a riot, or civil disobedience.”
He said that clause is similar to other insurance payout clauses that prohibit payout if the party is involved in a crime or other similar event.
“They are trying to force change,” he said. “It’s a pretty blatant disregard for what’s in the certificate. This really surprises me because they are just casting a net over everyone and saying you’re not participating in a riot if you are participating in a community protest.”
House District 51 Rep. Hugh McKean, R-Loveland, agreed. McKean was also shocked by the decision that he said he had no idea was coming.
“So far we’ve seen that there are a whole variety of people participating in both the peaceful protests, and then we’ve seen a very different kind at night, which has been punctuated by vandalism and violence,” McKean said, adding DORA should not be lumping everyone into one group.
The new regulation appears to give authority for people to participate in riots without fear of being denied medical payments if injured, the men said.
“I don’t know that there is any recourse the insurance companies have but to comply,” Rankin said. “Increasingly over the last few years, they have taken the liberty to make these kinds of rulings more frequently than they had in the past, stretching their power.”
Both men said the regulation will cost law abiding citizens the most because they will be forced to pay higher rates to cover the illegal acts of others. McKean said he planned to look into the issue to see if there was something the legislature could do.
“It’s a blanket instruction that does not realistically take into account what the activity is,” McKean said. “It’s just another way of putting insurance companies on the hook and driving up the rates for the rest of us.”