Unit of competency Outline
Date retreived
22/07/2026 10:16 PM AWST
22/07/2026 10:16 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.
Review claims settlement policies and procedures
Review claims settlement policies and procedures
Unit of competency
National Code
FNSISV517A
FNSISV517A
State Code
WC249
WC249
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
60
Description
This unit describes the skills needed to review the effectiveness of claims settlement policies and procedures including monitoring trends in claims settlement and formulating changes to minimise losses.
Notes
Elements and Performance Criteria
1. Collect data on claims trends
- 1.1 Data gathering processes are designed and implemented
- 1.2 New data requirements and sources of information are identified and process for collecting the data established
2. Monitor and report on claims trends
- 2.1 Data collected is analysed to identify trends
- 2.2 Accurate and timely claims reports are prepared to document trends where appropriate
3. Identify required changes to portfolio, claims settlement policy or procedures
- 3.1 Information which impacts on the various portfolios is communicated promptly to management according to company procedures
- 3.2 Changes to policy and procedures are instigated to minimise future losses
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.
Sources of information may include:
reports on claims
declinature claims
inter-disciplinary rehabilitation (IDR) referrals
claim statistic reports
previous policies and historical documents
premium income
claims settlement costs
loss ratios
claims frequency
surveys.
Claims reports may include:
loss ratios
claims settlement costs
claims frequencies.
Sources of information may include:
reports on claims
declinature claims
inter-disciplinary rehabilitation (IDR) referrals
claim statistic reports
previous policies and historical documents
premium income
claims settlement costs
loss ratios
claims frequency
surveys.
Claims reports may include:
loss ratios
claims settlement costs
claims frequencies.
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:
collect and interpret data from a wide range of sources
analyse the causes of trends and the effects on claims settlement policies and procedures.
Context of and specific resources for assessment
Assessment must ensure:
competency is demonstrated in the context of the financial services 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 financial services product information
access to information about workplace policy and procedures.
Method of assessment
A range of assessment methods should be used to assess practical skills and knowledge. The following examples 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
simulated tasks involving preparation of reports from supplied data
verbal or written questioning on underpinning knowledge and skills
evaluating samples of work.
Guidance information for assessment
Overview of assessment
Critical aspects for assessment and evidence required to demonstrate competency in this unit
Evidence of the ability to:
collect and interpret data from a wide range of sources
analyse the causes of trends and the effects on claims settlement policies and procedures.
Context of and specific resources for assessment
Assessment must ensure:
competency is demonstrated in the context of the financial services 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 financial services product information
access to information about workplace policy and procedures.
Method of assessment
A range of assessment methods should be used to assess practical skills and knowledge. The following examples 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
simulated tasks involving preparation of reports from supplied data
verbal or written questioning on underpinning knowledge and skills
evaluating samples of work.
Guidance information for assessment
Replaced By
| State Code | National Code | Title | Type |
|---|---|---|---|
| AUS30 | FNSISV517 | Review claims settlement policies and procedures | Unit of competency |
| State Code | National Code | Title | Type |
|---|---|---|---|
| D776 | FNS51312 | Diploma of Life Insurance | Qualification |