---
title: "Request to an insurer for reasons, the information relied on and expert reports (General Insurance Code of Practice)"
url: "https://ailawframework.com/precedents/insurance-law/request-for-reasons-information-and-reports-code-of-practice"
type: "precedent"
site: "AI Law Framework"
id: "a22-request-for-reasons-information-and-reports-code-of-practice"
area_id: "A22"
kind: "letter"
ai_level: "green"
version: 1
law_stated_as_at: "2026-10-18"
---

# 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…

Canonical page: https://ailawframework.com/precedents/insurance-law/request-for-reasons-information-and-reports-code-of-practice  
Law stated as at: 2026-10-18

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

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.

## Key facts

- Kind: Letter. A letter or email you adapt and send.
- Practice area: [Insurance Law](https://ailawframework.com/precedents/insurance-law.md)
- Jurisdictions: Australia
- AI level: Green. AI can do most of the drafting. A lawyer still reviews the result.
- Law stated as at: 2026-10-18
- Status: Maintained. Checked on 2026-10-18 against the 3 authorities it cites, for Australia.

## 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

## Authorities

- [General Insurance Code of Practice (current version, Insurance Council of Australia), para 81 (written reasons when a claim is denied or not paid in full) and para 82 (information and reports within 10 business days)](https://insurancecouncil.com.au/cop/)
- [General Insurance Code of Practice, Part 12, paras 160 to 163 (access to information relied on; grounds for refusal; external experts' reports)](https://insurancecouncil.com.au/cop/)
- [General Insurance Code of Practice, para 12 (parts that do not apply to wholesale insurance)](https://insurancecouncil.com.au/cop/)

## 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/request-for-reasons-information-and-reports-code-of-practice 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.*