Plan and implement loss investigations

Unit of competency Outline

Date retreived
22/07/2026 3:26 PM AWST

Whilst all efforts are made to provide accurate and timely information from the relevant source/documentation, please be aware that the information supplied may not be the most current version. The accuracy of the detail has not been confirmed by the Department and therefore should not be relied upon without first confirming the contents.

Unit of competency

National Code
FNSILA511

State Code
OCZ32

TGA Status
Current

DTWD Status
Approved

Current Release Number
1.00

Current Release Date
02/02/2021

View on TGA

State Implementation and Classification

Approved Date

22/04/2021

Field of Education

081103 - Insurance And Actuarial Studies

Original Release Date

22/04/2021

Nominal Hours

135

Description

This unit describes the skills and knowledge required to perform activities, including interacting with clients, authorities and specialists, to plan and implement loss investigations. The unit applies to individuals who, within their level of responsibility, use specialised knowledge and organisational skills to coordinate a range of activities required to conduct loss investigations and to ensure thorough and accurate completion of these activities. These individuals use high level analytical, liaison and planning skills to interact with others. Work functions in the occupational areas where this unit may be used are subject to regulatory requirements. Users are advised to check with the relevant state and territory regulatory authorities to confirm those requirements.

Notes

Elements and Performance Criteria

1. Analyse, negotiate and confirm assignment

1.1 Access and analyse terms of engagement and instructions for assignment, and determine whether provided information is sufficient
1.2 Determine conflicts of interest and confirm assignment is within scope of own knowledge and expertise
1.3 Negotiate, confirm and document terms of engagement and instructions according to client and organisational policies, regulatory and legislative requirements, codes of practice and level of authority
1.4 Advise required parties of decisions to accept or reject terms of engagement, instructions and reasons for decisions as required

2. Plan loss investigation

2.1 Assess validity of loss situation and claim against reported circumstances, available evidence and information
2.2 Determine insurance cover for loss, damage or injury as required and review policy conditions to confirm loss falls within policy coverage
2.3 Establish contractual and other obligations of each party according to circumstances under enquiry
2.4 Document required facts and information according to organisational policies and guidelines
2.5 Determine viable course of action and choose investigative activities
2.6 Assess proposed investigative activities for compliance with codes of practice, regulatory and legislative requirements, and organisational policies and guidelines

3. Implement loss investigation

3.1 Collect facts and information required to confirm circumstances of loss, damage or injury
3.2 Identify information deficiencies and obtain additional information as required
3.3 Identify fraud indicators
3.4 Establish confidential channels of communication with clients and other parties as required
3.5 Establish and maintain professional and cordial relationships with required parties during investigation
3.6 Establish and maintain comprehensive records of investigative activities, methodology and allocated time during investigation

4. Provide interim guidance to involved parties

4.1 Identify and determine requirements for urgent action to protect client interests
4.2 Inform involved parties of loss mitigation actions and preservation of evidence as required
4.3 Inform client of their potential exposure and initial estimate of reserve

5. Verify and clarify information

5.1 Review facts and information gathered and assess for thoroughness and consistency
5.2 Clarify conflicting evidence or information

6. Organise and preserve evidence

6.1 Collate and organise evidence gathered, and record according to organisational policies and guidelines
6.2 Preserve required evidence according to codes of practice, regulatory and legislative requirements, and organisational policies and guidelines
6.3 Maintain confidentiality and security of information according to legislative, industry and organisational requirements

7. Communicate with authorities

7.1 Liaise with authorities as required
7.2 Receive clearance or authorisation for investigative activities from authorities as required and document outcomes

8. Appoint specialists

8.1 Determine need to appoint specialist and convey request to client and other parties as required
8.2 Engage and brief appointed specialists as required

No information

Replaces

State Code	National Code	Title	Type
AUS06	FNSILA501	Plan and implement loss investigation	Unit of competency

State Code	National Code	Title	Type
BGX8	FNS51420	Diploma of Loss Adjusting	Qualification