Checklist · Insurance Law
What a Code denial or short payment tells the customer
Checklist of paragraph 81 of the General Insurance Code of Practice: what the insurer tells the customer in writing if a claim is denied or not paid in full.
- Kind
- Checklist. Steps or checks to work through and tick off.
- Where it applies
- Australia
- AI use
- Yellow You and the tool draft together, with you directing. You check every statement you rely on.
- Law stated as at
- 22 October 2026
- Status
- Maintained. Checked on 22 October 2026 against the authority it cites, for Australia.
- Version
- 1
- Source
- Written for this library
When to use it
Use when preparing the written decision on a claim covered by the Code, where the claim is denied or not paid in full. The reasons themselves are written by the insurer's lawyer.
Used for these tasks
Each task page says how far AI may help with the task and what the lawyer must review.
How AI may be used
AI may check a draft decision letter against the paragraph 81 list. It must not write the reasons or say which part of the claim is not accepted.
AI may
- Check a draft for each item in paragraph 81 and mark any item that is missing
- List the reports in the file that paragraph 81(d) may require the letter to offer
- Enter the complaints-process address from the insurer's own complaints page in the file
AI must not
- Must not write the reasons for the decision
- Must not say which aspects of the claim are not accepted
- Must not describe the loss in the customer's words
The lawyer checks
- The letter is in writing and covers each of paragraph 81(a) to (e)
- Any report that is offered can actually be given within 10 business days if the customer asks
- The decision is consistent with the policy and the Act, not only with the Code
Method: how the Green, Yellow and Red levels are decided. This is guidance for planning, not legal advice.
Read the full text
The full text is available after you log in. It is free. When you log in you can:
- read the whole precedent, with its drafting notes beside it;
- copy it, or download it as a Word file or Markdown;
- add it to your firm’s knowledge base, so colleagues can find it;
- let the AI tools you connect read it from that knowledge base.
The summary, the law it rests on and the AI-use guidance above stay public. Privacy.
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All precedents for Insurance Law · Tasks and AI use in this area