Automobile Insurance Liability Policy Disclosure Requests

Steps for Completing This Form

  1. Begin by using the list of insurance companies below to determine if the Division of Insurance is the REGISTERED AGENT of the commercial automobile or personal automobile liability insurer. You will need this information to complete the form. In accordance with § 10-3-1117, C.R.S., requests for automobile liability information must be sent through an insurer’s registered agent. It is important to identify the specific company the request is to be sent to as companies within groups of companies may have different registered agents.  
  2. If the registered agent IS the Division of Insurance, you must complete this online form and it will be electronically forwarded directly to the designated insurance company. 
  3. If the Division of Insurance IS NOT the registered agent, you may complete the form, print it and send it to the registered agent identified in the list.
  4. You can complete the online form either as the claimant or the claimant’s attorney. Fill in all required fields. 
  5. NOTE: The thirty (30) day timeline begins when the Automobile Insurance Liability Limits Request Form is received by the insurer.

START HERE by searching this list to determine if the Division of Insurance is or is not the registered agent. Use this information later in the online form.

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Auto Insurance Liability Limits Requests Form

In accordance with § 10-3-1117, C.R.S. and Colorado Division of Insurance Bulletin B-1.33, requests for automobile liability information must be sent through an insurer’s registered agent. It is important to identify the specific company the request is to be sent to as companies within groups of companies may have different registered agents.  

Who is completing this form?
Information on the Requesting Claimant
Information on Requesting Claimant's Attorney (If Applicable)
Is the response to this information request to be sent to the claimant, or the claimant's attorney?
Is the Division of Insurance the registered agent of the insurer?

If you do not know, please see the list at the top of this page.

Attestation of Understanding & Responsibility

 

 

For questions about this form and this process, please call the Division of Insurance at 303-894-7499 or email us at DORA_DOI_AutoLiabilityLimits@state.co.us.