You did it the right way. You complied with the claims process. You sent the polite chase emails. You sent a Letter of Demand. And the insurer is still dragging — extending the assessment, asking for the same documents twice, “escalating internally” without movement. Three months in, you’re staring at unpaid bills, no payout, and the slow realisation that delay is the strategy.
This is where a Final Demand changes the dynamic. It’s not another polite chase. It’s the formal one-page document the insurer’s legal team reads, because the next step it triggers — an AFCA complaint or court action — has real cost consequences for them.
The legal framework
The General Insurance Code of Practice imposes hard timeframes: a decision within 4 months for straightforward claims (12 months for exceptional circumstances), and 30 days to respond to internal disputes (ASIC RG 271). Section 13 of the Insurance Contracts Act 1984 (Cth) requires utmost good faith — and unreasonable delay can itself breach that duty. Once an insurer is in breach of the Code’s timeframes, you have grounds at AFCA for both the underlying claim AND the delay itself.
Common stalling tactics and the legal response
- “We’re still gathering information.” The Code limits how long this can run. Once you’re past the 4-month mark without a Code-recognised exception, they’re in breach.
- Repeat document requests. Code requires them to ask for everything they need at the start of the assessment. Repeat asks are bad faith.
- “Awaiting external expert.” They have to actually instruct one and pay them. You can request the instruction date.
- “Internal dispute is being reviewed.” RG 271 caps this at 30 days. Past that, you can lodge with AFCA without further internal exhaustion.
- Silence. The Code requires updates every 20 business days at minimum.
What the document does
The Final Demand cites every Code clause and ICA section the insurer is breaching, the elapsed time, every chase you’ve sent, and a final deadline (usually 7 days) to either pay, settle, or accept that you’ll lodge with AFCA and seek interest, costs, and a finding of breach of utmost good faith. AFCA can award interest from the date the claim should have been paid — that’s real money for the insurer.
What Claim Done delivers
Wizard takes about ten minutes. AI drafts the Final Demand citing the right Code timeframes, ICA sections, and AFCA jurisdiction. Flat $79, PDF the same day.
What to expect after sending
The most common outcome is a settlement offer or formal decision within the 7 days — insurers know AFCA delay-and-good-faith claims are expensive. If not, lodge with AFCA immediately citing both the delay and the underlying claim. AFCA can award interest, compensation for non-financial loss, and the underlying claim amount.