Unit of competency Outline

Date retreived
22/07/2026 9:48 PM AWST

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Review claims settlement policies and procedures

Review claims settlement policies and procedures

Unit of competency
National Code
FNSISV537
State Code
OCZ20
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
55
Description
This unit describes the skills and knowledge required to review the effectiveness of claims settlement policy and procedures, including monitoring trends in claims settlement and formulating changes to minimise losses. The unit applies to those involved in developing and monitoring policies and procedures associated with organisational claims risk within the insurance sector.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. Collect data on claims trends
  • 1.1 Design and implement data gathering processes
  • 1.2 Research and obtain data on industry claims settlement trends for benchmarking purposes
  • 1.3 Compare organisational data to industry benchmark data, and against industry codes of practice and regulatory requirements
  • 1.4 Document findings according to organisational and regulatory requirements
2. Analyse and report on recommendations
  • 2.1 Analyse data and identify claims settlement areas requiring review of policies and procedures
  • 2.2 Conduct further analyses as required
  • 2.3 Formulate recommendations report for improvements to claims settlement policies and procedures according to organisational policies and procedures
3. Finalise review
  • 3.1 Obtain feedback on draft recommendations report from required stakeholders
  • 3.2 Update recommendations report as required
  • 3.3 Submit finalised recommendations report to required stakeholders
  • 3.4 Instigate changes to policies and procedures as required
No information
No information
Replaces
State Code National Code Title Type
AUS30 FNSISV517 Review claims settlement policies and procedures Unit of competency
State Code National Code Title Type
BHU8 FNS51822 Diploma of Financial Services Qualification
BFE8 FNS51820 Diploma of Financial Services Qualification
AWB9 FNS51315 Diploma of Life Insurance Qualification