Assessor Resource

FNSILF406A
Collect and manage information to facilitate claims assessment

Assessment tool

Version 1.0
Issue Date: May 2024


Not applicable.

This unit applies to those engaged in collecting, collating and managing information in relation to Life Insurance policy claims.

You may want to include more information here about the target group and the purpose of the assessments (eg formative, summative, recognition)

Prerequisites

Not applicable.

Employability Skills

This unit contains employability skills.



Evidence Required

List the assessment methods to be used and the context and resources required for assessment. Copy and paste the relevant sections from the evidence guide below and then re-write these in plain English.

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 analytical and administrative skills in the assessment of claims

maintain and apply a thorough and up-to-date understanding of life insurance terms and conditions and claims processing

maintain and apply a thorough and up-to-date understanding of life insurance administrative requirements

perform tasks in accordance with relevant procedures and regulatory requirements.

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 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 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

Submission Requirements

List each assessment task's title, type (eg project, observation/demonstration, essay, assingnment, checklist) and due date here

Assessment task 1: [title]      Due date:

(add new lines for each of the assessment tasks)

Assessment Tasks

Copy and paste from the following data to produce each assessment task. Write these in plain English and spell out how, when and where the task is to be carried out, under what conditions, and what resources are needed. Include guidelines about how well the candidate has to perform a task for it to be judged satisfactory.

This section describes the skills and knowledge required for this unit.

Required skills

communication skills to:

liaise and share information with others

gather and check information

communicate appropriately with people from diverse backgrounds

IT skills to:

use computer applications (word processing, spreadsheet, database, specific purpose computer systems)

access and update records electronically

access web-based information services

numeracy skills to interpret numeric data and relevant statistics and perform calculations related to policy payments

organisational skills to efficiently plan and sequence work

problem solving skills to address errors in life insurance documentation

reading skills to:

read and understand relevant procedures

read and understand life insurance policies

read and interpret life insurance claims and supporting documentation

research and analysis skills to:

identify and interpret relevant information

analyse information and data

maintain currency of products and services knowledge

writing skills to:

accurately record information

prepare professional letters and emails.

Required knowledge

the ability to apply and explain as relevant to the evaluation of life insurance claims:

life insurance administrative requirements

life insurance policy payment criteria

life insurance policy terms and conditions

organisational procedures

organisational systems for data entry and filing

product information

relevant regulatory requirements.

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.

Life insurance policy may include:

annuities (immediate or deferred)

disability income

endowment

insurance bonds (investment only policies)

term life (including terminal illness and Total and Permanent Disablement (TPD))

trauma

whole of life.

Payment criteria may include:

for ordinary policies:

cancellation

commutation (for annuities and other income streams)

death (including terminal illness)

invalidity (permanent or temporary disability)

maturity

rollover

surrender

trauma

for superannuation policies:

death (including terminal illness)

invalidity (permanent or temporary disability)

retirement

rollover.

satisfying another condition of release.

Additional information may include:

medical evidence

financial evidence

interviews

surveillance

employment details

specialist advice.

Evidence may include:

proof of age

proof of morbidity/disability

proof of survival

proof of title.

Appropriate sources may include:

interviewing the claimant

requesting reports and records

speaking with professionals

specialist advice

surveillance.

Procedures may include:

organisational complaints handling processes

organisational customer service charter

organisational guidelines

organisational policy

organisational privacy and confidentiality guidelines

organisational procedures.

Investigations may include:

financial investigations

interviews

medical investigations

surveillance.

Ethical and regulatory requirements may include:

Australian Securities and Investments Commission (ASIC) regulatory guides

corporations legislation

privacy legislation

relevant professional Codes of Practice.

Copy and paste from the following performance criteria to create an observation checklist for each task. When you have finished writing your assessment tool every one of these must have been addressed, preferably several times in a variety of contexts. To ensure this occurs download the assessment matrix for the unit; enter each assessment task as a column header and place check marks against each performance criteria that task addresses.

Observation Checklist

Tasks to be observed according to workplace/college/TAFE policy and procedures, relevant legislation and Codes of Practice Yes No Comments/feedback
Review claim files and life insurance policy to identify payment criteria 
Identify additional information needed as evidence for claims assessment 
Identify appropriate sources of required proofs 
Select and enact an appropriate information collection method 
Collect additional information from appropriate sources in accordance with procedures 
Manage investigations in accordance with ethical and regulatory requirements 
Organise information for clarity and accessibility in accordance with procedures 

Forms

Assessment Cover Sheet

FNSILF406A - Collect and manage information to facilitate claims assessment
Assessment task 1: [title]

Student name:

Student ID:

I declare that the assessment tasks submitted for this unit are my own work.

Student signature:

Result: Competent Not yet competent

Feedback to student

 

 

 

 

 

 

 

 

Assessor name:

Signature:

Date:

Assessment Record Sheet

FNSILF406A - Collect and manage information to facilitate claims assessment

Student name:

Student ID:

Assessment task 1: [title] Result: Competent Not yet competent

(add lines for each task)

Feedback to student:

 

 

 

 

 

 

 

 

Overall assessment result: Competent Not yet competent

Assessor name:

Signature:

Date:

Student signature:

Date: