Unit of competency Outline
Date retreived
22/07/2026 8:39 AM AWST
22/07/2026 8:39 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.
Analyse financial, medical and psychological claims assessments
Analyse financial, medical and psychological claims assessments
Unit of competency
National Code
FNSISV509A
FNSISV509A
State Code
D4247
D4247
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 performance outcomes, skills and knowledge required to arrange financial, medical or psychological assessments to support the claims assessment process and to analyse and report on the results.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. Establish the need to appoint a specialist to undertake the assessment
- 1.1. Facts, evidence and information, including fraud indicators, relevant to the circumstances of loss/damage/injury, are reviewed thoroughly, systematically and accurately
- 1.2. The need to appoint specialist assistance to undertake a financial, medical, or psychological assessment is identified and determined promptly and accurately and conveyed to the client and other relevant parties
2. Organise financial, medical or psychological assessments
- 2.1. Appointed specialists are engaged as required and thoroughly briefed
- 2.2. Assessment activity progress is monitored and reported to relevant parties, as appropriate, and adherence to timelines ensured
3. Analyse data for claims assessments
- 3.1. Financial, medical or psychological assessment data is analysed and assessed for thoroughness and consistency
- 3.2. Analysis tools to assess financial, medical and/or psychological assessments are used to calculate loss damages
- 3.3. Validity of loss situation and/or claims is assessed fairly and impartially against the assessment data and analysed against reported circumstances, available evidence, facts and information
- 3.4. Insurance cover/policy conditions are reviewed to ensure loss falls within policy coverage
4. Report results
- 4.1. Assessment actions, procedures and outcomes are documented and recorded promptly and accurately
- 4.2. Reporting includes recommendations on the validity of the claim and recovery amounts in relation to the assessment and other relevant data
- 4.3. Stakeholders are provided with accurate and timely advice regarding the financial, medical or psychological assessment for claim proceedings
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.
Specialist assistance may include:
accountants
chemists
consultants
legal
medical personnel
psychologist/psychiatrist
valuers.
Assessment activities may include:
consultation
credit and character checks
desktop and other research
financial checks
interviews
medical/physical examinations
psychological testing
surveys
valuations.
Documentation may include:
reasons for adopting/incorporating certain data/information preferred over other data/information
records of assessment documents/findings/reports
records of telephone conversations
reference to all assessment data/information considered
specialist/other correspondence related to the assessment process
the basis on which recommendations on the assessment outcome in relation to the claim were determined.
Stakeholders may include:
claimants
claims managers/specialists
insurance broker
underwriters
other relevant parties.
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.
Specialist assistance may include:
accountants
chemists
consultants
legal
medical personnel
psychologist/psychiatrist
valuers.
Assessment activities may include:
consultation
credit and character checks
desktop and other research
financial checks
interviews
medical/physical examinations
psychological testing
surveys
valuations.
Documentation may include:
reasons for adopting/incorporating certain data/information preferred over other data/information
records of assessment documents/findings/reports
records of telephone conversations
reference to all assessment data/information considered
specialist/other correspondence related to the assessment process
the basis on which recommendations on the assessment outcome in relation to the claim were determined.
Stakeholders may include:
claimants
claims managers/specialists
insurance broker
underwriters
other relevant parties.
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:
interpret and adapt to circumstances in which specialist assistance should be sought in resolution of a claim
analyse claims information to determine the need for specialist assistance and application of skills to monitor the specialist assistance and interpret and report on the outcomes of the specialist advice in relation to the claim context.
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 organisation 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:
interpret and adapt to circumstances in which specialist assistance should be sought in resolution of a claim
analyse claims information to determine the need for specialist assistance and application of skills to monitor the specialist assistance and interpret and report on the outcomes of the specialist advice in relation to the claim context.
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 organisation 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 |
|---|---|---|---|
| AUS34 | FNSISV509 | Analyse financial, medical and psychological claims assessments | Unit of competency |
| State Code | National Code | Title | Type |
|---|---|---|---|
| D776 | FNS51312 | Diploma of Life Insurance | Qualification |
| S717 | FNS50110 | Diploma of Personal Injury Management | Qualification |