Unit of competency Outline
Date retreived
22/07/2026 3:07 PM AWST
22/07/2026 3:07 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.
Plan and implement loss investigation
Plan and implement loss investigation
Unit of competency
National Code
FNSILA501A
FNSILA501A
State Code
D4218
D4218
TGA Status
Replaced
Replaced
DTWD Status
Replaced
Replaced
State Implementation and Classification
Approved Date
29/07/2014
Field of Education
081103 - Insurance And Actuarial Studies
Original Release Date
29/07/2014
Nominal Hours
120
Description
This unit describes the performance outcomes, skills and knowledge required to use high level analytical, liaison and planning skills to interact with clients, authorities and specialists in coordinating loss investigations that determine the extent of loss, damage or injury.This unit is applicable to individuals working within enterprises and job roles subject to licensing, legislative, regulatory or certification requirements including legislation administered by the Australian Securities and Investments Commission (ASIC).
Notes
Elements and Performance Criteria
1. Receive instructions from client
- 1.1. Comprehensive terms of reference or instructions that meet the requirements of the relevant parties are established prior to engagement
- 1.2. Relevant parties are promptly advised of decisions to accept or reject terms of reference or instructions and the reasons for such decisions
- 1.3. Acceptable terms and instructions that are within client or organisation policy and legislative guidelines, codes of practice and personal authorities are negotiated, confirmed and clearly documented
2. Establish relevant facts
- 2.1. Facts, evidence and information relevant to the circumstances of loss, damage or injury, are collected thoroughly, systematically and accurately
- 2.2. Information deficiencies are identified and additional information is sought from appropriate sources
- 2.3. Validity of loss situation and/or claim is assessed fairly and impartially against reported circumstances, available evidence, facts and information
- 2.4. Insurance cover for loss, damage or injury where applicable is determined and policy conditions are reviewed to ensure loss falls within policy coverage
- 2.5. Contractual and/or other obligations of each party to the circumstances under enquiry are established
- 2.6. Fraud indicators are identified accurately and consistently
- 2.7. All relevant facts, evidence and information are organised and documented confidentially into a coherent body of case knowledge
3. Plan and implement loss investigation
- 3.1. Available facts, evidence and information are analysed to determine viable course of action and appropriate investigative activities
- 3.2. Investigative activities are assessed for appropriateness to loss situation and compliance with relevant legislation, codes of practice, insurers, client, organisation or other guidelines
- 3.3. Requirements for urgent action to protect client interests are identified and determined
- 3.4. Appropriate and confidential channels of communication are established with clients and other relevant parties
- 3.5. Professional and cordial relationships are established and maintained with all relevant parties during the investigation
- 3.6. Comprehensive records are established and maintained of investigative activities, methodology and time spent during investigations
4. Preserve evidence
- 4.1. All evidence gathered is progressively collated and recorded promptly and accurately
- 4.2. Evidence gathered is preserved by appropriate means for subsequent assessment and enquiry
5. Liaise with authorities
- 5.1. Liaison with all appropriate authorities is established whenever and wherever required
- 5.2. When and where required, clearance or authorisation for investigative activities is received from appropriate authorities and recorded promptly
6. Verify and document information
- 6.1. Facts, evidence and information gathered is regularly reviewed and assessed for thoroughness and consistency
- 6.2. All appropriate methods within client, organisation, legislative, code of practice or other guidelines are employed to clarify conflicting evidence or information
- 6.3. Investigative actions, procedures and outcomes are documented and recorded promptly and accurately
7. Appoint specialists
- 7.1. The need to appoint specialist assistance is identified and determined promptly and accurately and conveyed to the client and other relevant parties
- 7.2. Appointed specialists are engaged as required and thoroughly briefed
RANGE STATEMENT
The range statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised wording, if used in the performance criteria, is detailed below. Essential operating conditions that may be present with training and assessment (depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts) may also be included.
Terms of reference or instructions may include:
date and location of loss (local or remote)
estimate of loss
instructions for investigating loss/damage/injury
insurer's reference
name of insured and initial contact
negotiating settlements date of receipt of instructions
other parties involved
period of insurance
policy cover
policy number
type.
Terms of reference or instructions may be:
electronic
verbal
written.
Relevant parties may include:
broker or agent
client
consultants
government or statutory authorities
insured
insurer
legal or other practitioners
manufacturers
medical
mortgagee
principal
subcontractor
suppliers
third party
trustee.
Client or organisation policy and legislative guidelines may include:
Australasian Institute of Chartered Loss Adjusters (AICLA) Charter of Objects and Professional Conduct
claims
clerical
codes of practice
complaints and dispute resolution procedures
information technology and administrative systems
loss
loss recovery
policies and procedures in relation to risks.
Investigative activities include:
consultation
credit and character checks
desktop and other research
financial
forensic, mechanical, electrical, metallurgical, chemical and other tests
interviews
legal procedures
physical examinations
surveying
surveys
valuations.
Relevant legislation may include:
building or construction
Consumer Credit Code
contracts law
environmental
hazardous materials
industry codes of practice
Insurance Agents and Brokers Act
Insurance Contracts Act
motor vehicle
occupational health and safety (OHS)
Privacy Act
secrecy laws
Trade Practices Act.
Means of preserving evidence may include:
documentation
electronic
forensic, medical, mechanical, chemical and other means
photographic
physical.
Appropriate authorities may include:
fire services
industry and professional associations
local governments
medical and legal professionals
police
statutory authorities
unions and union representatives.
Methods to clarify conflicting evidence or information include:
consultation
credit and character checks
desktop and other research
financial
forensic, mechanical, electrical, metallurgical, chemical and other tests
interviews
legal procedures
physical examinations
surveying
surveys
valuations.
Documentation may include:
interview records
legal, government, professional, other documents
meeting notes
minutes
official, general, other correspondence
reasons for adopting/incorporating certain evidence/information preferred over other evidence/information
records of telephone conversations
reference to all evidence/information considered
reports from others such as loss adjusters/assessors/ insurers/medical providers and others
the basis on which the decision was determined
time sheets.
Specialist assistance may include:
accountants
arborists
architects
building consultants
chemists
consultants
engineers
forensic
hydrologists
jewellers
legal
medical
metallurgists
meteorologists
private and other investigators
quantity and other surveyors
valuers.
The range statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised wording, if used in the performance criteria, is detailed below. Essential operating conditions that may be present with training and assessment (depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts) may also be included.
Terms of reference or instructions may include:
date and location of loss (local or remote)
estimate of loss
instructions for investigating loss/damage/injury
insurer's reference
name of insured and initial contact
negotiating settlements date of receipt of instructions
other parties involved
period of insurance
policy cover
policy number
type.
Terms of reference or instructions may be:
electronic
verbal
written.
Relevant parties may include:
broker or agent
client
consultants
government or statutory authorities
insured
insurer
legal or other practitioners
manufacturers
medical
mortgagee
principal
subcontractor
suppliers
third party
trustee.
Client or organisation policy and legislative guidelines may include:
Australasian Institute of Chartered Loss Adjusters (AICLA) Charter of Objects and Professional Conduct
claims
clerical
codes of practice
complaints and dispute resolution procedures
information technology and administrative systems
loss
loss recovery
policies and procedures in relation to risks.
Investigative activities include:
consultation
credit and character checks
desktop and other research
financial
forensic, mechanical, electrical, metallurgical, chemical and other tests
interviews
legal procedures
physical examinations
surveying
surveys
valuations.
Relevant legislation may include:
building or construction
Consumer Credit Code
contracts law
environmental
hazardous materials
industry codes of practice
Insurance Agents and Brokers Act
Insurance Contracts Act
motor vehicle
occupational health and safety (OHS)
Privacy Act
secrecy laws
Trade Practices Act.
Means of preserving evidence may include:
documentation
electronic
forensic, medical, mechanical, chemical and other means
photographic
physical.
Appropriate authorities may include:
fire services
industry and professional associations
local governments
medical and legal professionals
police
statutory authorities
unions and union representatives.
Methods to clarify conflicting evidence or information include:
consultation
credit and character checks
desktop and other research
financial
forensic, mechanical, electrical, metallurgical, chemical and other tests
interviews
legal procedures
physical examinations
surveying
surveys
valuations.
Documentation may include:
interview records
legal, government, professional, other documents
meeting notes
minutes
official, general, other correspondence
reasons for adopting/incorporating certain evidence/information preferred over other evidence/information
records of telephone conversations
reference to all evidence/information considered
reports from others such as loss adjusters/assessors/ insurers/medical providers and others
the basis on which the decision was determined
time sheets.
Specialist assistance may include:
accountants
arborists
architects
building consultants
chemists
consultants
engineers
forensic
hydrologists
jewellers
legal
medical
metallurgists
meteorologists
private and other investigators
quantity and other surveyors
valuers.
EVIDENCE GUIDE
The Evidence Guide provides advice on assessment and must be read in conjunction with the performance criteria, required skills and knowledge, range statement and the Assessment Guidelines for the Training Package.
Overview of assessment
Critical aspects for assessment and evidence required to demonstrate competency in this unit
Evidence of the ability to:
apply loss adjusting principles and practice and investigative practices and guidelines relevant to various types of loss/damage
apply loss prevention principles and practice
use fraud detection, control and prevention principles
apply thorough knowledge of types and categories of insurance policies, industry codes of practice and relevant legislation
roles, responsibilities and jurisdiction of specialists and other authorities.
Context of and specific resources for assessment
Assessment must ensure:
competency is demonstrated in the context of the work environment and conditions specified in the range statement either in a relevant workplace or a closely simulated work environment
access to and the use of a range of common office equipment, technology, software and consumables
access to organisation records
access to organisational policies and procedures.
Method of assessment
A range of assessment methods should be used to assess practical skills and knowledge. The following examples, in combination, are appropriate for this unit:
evaluating an integrated activity, which combines the elements of competency for the unit, or a cluster of related units of competency
observing processes and procedures in workplaces
verbal or written questioning on underpinning knowledge and skills
evaluating samples of work
accessing and validating third party reports
setting and reviewing workplace projects and business simulations or scenarios.
Guidance information for assessment
The Evidence Guide provides advice on assessment and must be read in conjunction with the performance criteria, required skills and knowledge, range statement and the Assessment Guidelines for the Training Package.
Overview of assessment
Critical aspects for assessment and evidence required to demonstrate competency in this unit
Evidence of the ability to:
apply loss adjusting principles and practice and investigative practices and guidelines relevant to various types of loss/damage
apply loss prevention principles and practice
use fraud detection, control and prevention principles
apply thorough knowledge of types and categories of insurance policies, industry codes of practice and relevant legislation
roles, responsibilities and jurisdiction of specialists and other authorities.
Context of and specific resources for assessment
Assessment must ensure:
competency is demonstrated in the context of the work environment and conditions specified in the range statement either in a relevant workplace or a closely simulated work environment
access to and the use of a range of common office equipment, technology, software and consumables
access to organisation records
access to organisational policies and procedures.
Method of assessment
A range of assessment methods should be used to assess practical skills and knowledge. The following examples, in combination, are appropriate for this unit:
evaluating an integrated activity, which combines the elements of competency for the unit, or a cluster of related units of competency
observing processes and procedures in workplaces
verbal or written questioning on underpinning knowledge and skills
evaluating samples of work
accessing and validating third party reports
setting and reviewing workplace projects and business simulations or scenarios.
Guidance information for assessment
Replaced By
| State Code | National Code | Title | Type |
|---|---|---|---|
| AUS06 | FNSILA501 | Plan and implement loss investigation | Unit of competency |
| State Code | National Code | Title | Type |
|---|---|---|---|
| D714 | FNS41611 | Certificate IV in Loss Adjusting | Qualification |
| S730 | FNS51410 | Diploma of Loss Adjusting | Qualification |