---
title: "Compare a late-notice refusal with the policy clause"
url: "https://ailawframework.com/practice/insurance-law/assess-whether-section-54-stops-an-insurer-refusing-a-claim/united-states"
type: "task_jurisdiction_version"
site: "AI Law Framework"
id: "A22-O20261018-1-US"
practice_area: "Insurance Law"
tier: "red"
lawyer_review: "required"
jurisdictions: ["US"]
last_reviewed: "2026-10-22"
---

# Compare a late-notice refusal with the policy clause

> Copy the notice clause, the date of the loss, the date notice was given, and the words of the refusal. Write no sentence of an advice that a statute saves the claim.

Canonical page: https://ailawframework.com/practice/insurance-law/assess-whether-section-54-stops-an-insurer-refusing-a-claim/united-states  
Last reviewed: 2026-10-22

Site index for agents: https://ailawframework.com/llms.txt

## Key facts

| Fact | Value |
| --- | --- |
| Practice area | [Insurance Law](https://ailawframework.com/practice/insurance-law.md) |
| Human involvement | Red: Lawyer writes; AI may check, clarify or collect data |
| How AI is used | Copy the notice clause, the date of the loss, the date notice was given, and the words of the refusal. Write no sentence of an advice that a statute saves the claim. |
| What the lawyer must review | There is no federal statute in the sources opened that does the work of an Australian section 54. 15 U.S.C. § 1012 leaves insurance to state law unless a federal act specifically relates to the business of insurance. NAIC model MO-900 is a model. It is not a notice-prejudice statute, and it disclaims a private cause of action. You read the state notice rule before you say whether late notice defeats the claim. |
| Written for | United States |
| Applies to | [Assess whether section 54 stops an insurer refusing a claim](https://ailawframework.com/practice/insurance-law/assess-whether-section-54-stops-an-insurer-refusing-a-claim.md) |

## Checking plan

- What the AI does: Copy the notice clause, the date of the loss, the date notice was given, and the words of the refusal. Write no sentence of an advice that a statute saves the claim.
- Basis: Checked against the linked sources on 22 October 2026. Confirm the current instrument before reliance.

## Notes

- Do not apply the Insurance Contracts Act 1984 (Cth). It is not United States law.
- California Insurance Code § 331 is a concealment rule. It is not a notice-prejudice rule.
- A model time limit, including the 15-calendar-day claim-form sentence, applies only where a state has enacted it.

## Sources

- [15 U.S.C. § 1012, McCarran-Ferguson Act: regulation by State law](https://www.law.cornell.edu/uscode/text/15/1012) (checked 2026-10-22)
- [NAIC Unfair Claims Settlement Practices Act, model MO-900](https://content.naic.org/sites/default/files/model-law-900.pdf) (checked 2026-10-22)
- [California Insurance Code § 331, concealment](https://california.public.law/codes/ca_ins_code_section_331) (checked 2026-10-22)

*Practice guidance for planning and review. Confirm current primary sources and the requirements of the actual matter. This is general information, not legal advice.*