---
title: "What a Code denial or short payment tells the customer"
url: "https://ailawframework.com/precedents/insurance-law/code-denial-contents"
type: "precedent"
site: "AI Law Framework"
id: "a22-code-denial-contents"
area_id: "A22"
kind: "checklist"
ai_level: "yellow"
version: 1
task_ids: ["A22-T1-R14"]
law_stated_as_at: "2026-10-22"
---

# 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.

Canonical page: https://ailawframework.com/precedents/insurance-law/code-denial-contents  
Law stated as at: 2026-10-22

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

## Key facts

- Kind: Checklist. Steps or checks to work through and tick off.
- Practice area: [Insurance Law](https://ailawframework.com/precedents/insurance-law.md)
- Jurisdictions: Australia
- AI level: Yellow. You and the tool draft together, with you directing. You check every statement you rely on.
- Law stated as at: 2026-10-22
- Status: Maintained. Checked on 2026-10-22 against the authority it cites, for Australia.

## 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

- [Draft a coverage-position letter from the approved issues table](https://ailawframework.com/practice/insurance-law/draft-a-coverage-position-letter-from-the-approved-issues-table.md)

## 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

## Authorities

- [General Insurance Code of Practice (October 2023 update) paragraphs 81, 82 and 15](https://insurancecouncil.com.au/wp-content/uploads/2023/11/2023-COP_UPDATE_October_FINAL.pdf)

## Full text and drafting notes

The full text and the drafting notes are not part of this public page. Signed-in firm accounts can read them at https://ailawframework.com/precedents/insurance-law/code-denial-contents and through the signed-in MCP connector https://ailawframework.com/mcp/firm.

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