Coverage description
An Insurance Services Office (ISO) standard form. It provides Colorado auto medical payments coverage for reasonable medical and funeral expenses of insureds injured in an auto accident, for services within three years, and lets an insured assign payments to licensed health care providers.
Editions
Edition dates as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed |
|---|---|---|---|---|
| 10 13Oct 2013Latest | 124 | 60 | 4 | Apr 2022 to Jul 2026 |
| 01 11Jan 2011 | 9 | 5 | 1 | May 2022 to Jun 2026 |
What the filings show
- Edition in use: in the past 12 months, 43 companies filed the 10 13 edition and 3 companies filed 01 11.
- CA 99 10 (Drive Other Car Coverage - Broadened Coverage for Named Individuals) is filed alongside it most often, in 128 of the same filings (96%).
Filed under
Data from admitted P&C filings with state insurance departments, submitted Oct 2021 to Jul 2026, excluding withdrawn and rejected filings. One filing can cover several affiliated companies.
Carriers filing this form
The 10 carrier groups with the most filings that include CA 04 40, out of 28 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Liberty Mutual Group3 group companies filed it, led by State Automobile Mutual Insurance Company and Milbank Insurance Company | 15 | 1 | 10 1301 11 | Jun 17, 2026 |
| OLD Republic Group4 group companies filed it, led by BITCO General Insurance Corporation and BITCO National Insurance Company | 13 | 1 | 10 13 | May 11, 2026 |
| Arch Insurance Group3 group companies filed it, led by Arch Indemnity Insurance Company and Arch Insurance Company | 12 | 1 | 10 13 | Apr 8, 2026 |
| Scor GroupGeneral Security National Insurance Company | 10 | 1 | 10 13 | Jun 9, 2026 |
| Nationwide Corporation Group9 group companies filed it, led by Allied Insurance Company of America and Nationwide Mutual Insurance Company | 7 | 1 | 10 13 | Apr 7, 2026 |
| Alliance Insurance GroupFarmers Alliance Mutual Insurance Company | 5 | 1 | 10 13 | May 19, 2026 |
| Berkshire Hathaway Group8 group companies filed it, led by GEICO Casualty Company and GEICO Choice Insurance Company | 5 | 1 | 10 13 | Jul 6, 2026 |
| Grange Insurance GroupGrange Insurance Association | 5 | 1 | 10 13 | Jun 26, 2026 |
| Selective Insurance Group4 group companies filed it, led by Selective Insurance Company of America and Selective Insurance Company of South Carolina | 5 | 1 | 10 13 | Jun 25, 2026 |
| Sompo Group2 group companies filed it, led by Sompo America Fire and Marine Insurance Company and Sompo America Insurance Company | 5 | 1 | 10 13 | Jun 18, 2026 |
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States
Number of filings that include CA 04 40 in each state, Oct 2021 to Jul 2026. Darker states have more filings.
Often filed with
Standard-style form numbers that appear in the same filings most often.
- CA 99 10Drive Other Car Coverage - Broadened Coverage for Named Individuals128 filings
- CA 01 13Colorado Changes125 filings
- CA 99 44Loss Payable Clause124 filings
- CA 04 37Colorado Individually Owned Motor Vehicles123 filings
- CA 23 94Silica or Silica- Related Dust Exclusion for Covered Autos Exposure123 filings
- CA 99 17Individual Named Insured123 filings
- CA 21 50Colorado Uninsured Motorists Coverage - Bodily Injury122 filings
- CA 20 01Lessor - Additional Insured and Loss Payee121 filings
- CA 00 01Business Auto Coverage Form120 filings
- CA 20 15Mobile Equipment120 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Jul 8, 2026 | Colorado Farm Bureau Insurance Company | CO | 10 13 | SFBC-135011078 |
| Jul 6, 2026 | GEICO Advantage Insurance Companyand 7 more | CO | 10 13 | GECC-135002717 |
| Jun 30, 2026 | Accredited Surety and Casualty Company, Inc. | CO | 10 13 | ACSA-135005169 |
| Jun 26, 2026 | Grange Insurance Association | CO | 10 13 | GRIA-135000193 |
| Jun 25, 2026 | Selective Insurance Company of Americaand 3 more | CO | 10 13 | SELC-134998854 |
| Jun 24, 2026 | Great American Alliance Insurance Companyand 3 more | CO | 10 13 | GACX-134993563 |
| Jun 19, 2026 | Addison Insurance Companyand 1 more | CO | 10 13 | UNFG-134905846 |
| Jun 18, 2026 | Sompo America Fire and Marine Insurance Companyand 1 more | CO | 10 13 | SMPJ-134972831 |
| Jun 17, 2026 | Society Insurance, a mutual company | CO | 10 13 | SCTY-134960697 |
| Jun 17, 2026 | State Automobile Mutual Insurance Company | CO | 10 13 | STAT-134983292 |
| Jun 17, 2026 | Milbank Insurance Companyand 2 more | CO | 01 11 | STAT-134983846 |
| Jun 17, 2026 | State Automobile Mutual Insurance Company | CO | 10 13 | STAT-134983865 |
Most filed ISO CA forms
- CA DS 03 Business Auto Declarations
- CA DS 21 Motor Carrier Declarations
- CA 00 01 Business Auto Coverage Form
- CA 28 03 Abuse Or Molestation Exclusion For Covered Autos Liability Exposure
- CA 23 17 Truckers - Uniform Intermodal Interchange Endorsement Form UIIE - 1
- CA 04 43 Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subrogation) - Automatic When Required By Written Contract Or Agreement
- CA 04 44 Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subrogation)
- CA 04 49 Primary and Noncontributory - Other Insurance Condition
- CA 20 01 Lessor - Additional Insured And Loss Payee
- CA 20 48 Designated Insured For Covered Autos Liability Coverage
- CA 00 20 Motor Carrier Coverage Form
- CA 20 71 Auto Loan/Lease Gap Coverage
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