Unit of competency Outline
Date retreived
23/07/2026 5:51 AM AWST
23/07/2026 5:51 AM 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.
Evaluate and report on status of insurance claims portfolios
Evaluate and report on status of insurance claims portfolios
Unit of competency
National Code
FNSISV525
FNSISV525
State Code
OCI51
OCI51
TGA Status
Current
Current
DTWD Status
Approved
Approved
State Implementation and Classification
Approved Date
11/03/2021
Field of Education
081103 - Insurance And Actuarial Studies
Original Release Date
11/03/2021
Nominal Hours
50
Description
This unit describes the skills and knowledge required to review, analyse and evaluate an insurance claims portfolio or line of business, including preparing reports on portfolio profitability status and recommending changes to minimise losses. It involves analysing claims data and risk, reviewing claims reserves, making assumptions and recommendations about the risks, preparing reports, and monitoring trends in claims activity. It requires the use of information systems, mathematics, financial theories and statistics, risk management methodologies, and financial modelling specific to the line of business.The unit applies to those who work in claims management and underwriting job roles involving specialist knowledge and functions in a range of insurance sectors in organisations of various sizes and across a range of client bases. 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. Evaluate data on an insurance claims portfolio or a line of business claim
- 1.1 Source portfolio or line of business claims data using organisational collection processes in preparation for analysis
- 1.2 Identify any additional claims data sources, external influences and improvement to policies and procedures
- 1.3 Identify organisation’s expectations for claims portfolio performance
- 1.4 Analyse data and undertake risk analysis to determine profitability, loss ratio, claims reserves and future trends according to organisational policies and procedures
- 1.5 Research industry to determine benchmarks for claims portfolio
2. Interpret findings to report on assumptions and recommendations
- 2.1 Identify findings and formulate assumptions and recommendations to identify trends, future profitability, claims reserves and loss ratio for the line of business
- 2.2 Review and suggest amendments to policies and procedures to improve line of business financial outcomes
- 2.3 Prepare a report documenting findings, identified issues and assumptions
3. Communicate and review report
- 3.1 Communicate findings and recommendations to required stakeholders within required timeframe and according to organisational policies and procedures
- 3.2 Collate feedback and identified issues, and amend report accordingly
4. Finalise report findings and confirm approval
- 4.1 Submit final report for approval according to organisational lines of approval and delegation of authority
- 4.2 Document final report and communicate to relevant stakeholders for implementation according to organisational procedures
No information
No information
Replaces
| State Code | National Code | Title | Type |
|---|---|---|---|
| AUS15 | FNSISV515 | Evaluate and report on status of claims portfolio | Unit of competency |
| State Code | National Code | Title | Type |
|---|---|---|---|
| BFX4 | FNS51120 | Diploma of General Insurance | Qualification |
| AWB9 | FNS51315 | Diploma of Life Insurance | Qualification |