Letter · Insurance Law
Request to an insurer for reasons, the information relied on and expert reports (General Insurance Code of Practice)
A short letter asking a general insurer that has denied or part-paid a claim for its written reasons, the information it relied on and copies of service supplier and external expert reports, citing the Code of Practice timeframes.
- Kind
- Letter. A letter or email you adapt and send.
- Where it applies
- Australia
- AI use
- Green AI can do most of the drafting. A lawyer still reviews the result.
- Law stated as at
- 18 October 2026
- Status
- Maintained. Checked on 18 October 2026 against the 3 authorities it cites, for Australia.
- Version
- 1
- Source
- Written for this library
When to use it
Use promptly after a retail general insurance claim is denied or not paid in full, before preparing an internal dispute resolution complaint or an AFCA complaint. Check that the insurer subscribes to the Code and that the policy is retail insurance.
How AI may be used
AI may complete this letter inside the template from the claim details and the insurer's decision letter; the lawyer checks at setup that the Code paragraphs are current and that the request fits retail claims.
AI may
- Fill the insured, policy, claim and decision details from the decision letter
- List the reports and assessments mentioned in the decision letter so each is requested by name
- Diarise the 10 business day response date and a follow-up
AI must not
- Must not add arguments about the merits of the claim, which belong in the complaint
- Must not cite Code paragraphs that have not been checked against the current version
- Must not use this letter for a wholesale policy without checking which parts of the Code apply
The lawyer checks
- The insurer subscribes to the Code and the policy is retail insurance (or the relevant parts apply to it)
- The Code version and paragraph numbers are current
- The request names every report and document referred to in the decision
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 for signed-in accounts. It is free. When you sign 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.
More in Insurance Law
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