Assessor Resource

FNSILF502A
Underwrite complex medical risks

Assessment tool

Version 1.0
Issue Date: April 2024


This unit applies to those engaged in the underwriting functions of companies within the life insurance sector.

This unit describes the performance outcomes, skills and knowledge required to apply complex medical risk assessments to the underwriting of a life insurance application.

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 relation to medical risk assessment

maintain and apply a thorough understanding of guidelines and administrative requirements

apply underwriting policies and procedures

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.

Required skills

communication skills to:

gather and check information

liaise and share information with others

communicate appropriately with people from diverse backgrounds

IT skills to:

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

access web-based information services

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 applications 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 underwriting of complex medical risks:

integrated actuarial, underwriting and medical information

life insurance administrative requirements

life insurance policy terms and conditions

life insurance risk management practices

medical treatment and recovery processes relative to insurance underwriting

organisational procedures

product information

relevant medical techniques, diseases, injuries and terminology relative to insurance underwriting

relevant regulatory requirements

types of medical risk and probability of occurrence.

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.

Medical information may include:

advice from a senior underwriter and/or Chief Medical Officer

adviser reports

medical reports

previous insurance history

supplementary questionnaires

medical specialties and the titles of doctors working in specialist fields

illnesses

injuries

diseases

description of the onset and/or nature of condition

medical investigations and procedures

treatments

prognosis.

Medical risk factors may relate to:

blood, spleen and lymphatic system

cardiovascular system

endocrine system

gastro-intestinal system

genitourinary system

inherited disorders and family history

mental disorders

musculoskeletal system

neurological system

physical dimensions

respiratory system

tumours.

Life risk is a potential change to health or wellbeing that would have an adverse effect on the financial sustainability of an individual, a family or a group, and may include:

death

total and permanent disablement

temporary loss of income resulting from accident or sickness

traumatic sickness or injury.

Medical risks rating systems and risk handling techniques may include:

cash extra loadings

class systems

exclusions

numerical systems.

Risk acceptance criteria may include:

exclusions

loadings

other specific terms and conditions

standard cover conditions.

Procedures may include:

organisational complaints handling processes

organisational customer service charter

organisational guidelines

organisational policy

organisational privacy and confidentiality guidelines

organisational procedures.

Regulatory requirements may include:

insurance contracts legislation

life insurance legislation

corporations legislation

privacy legislation

Australian Securities and Investments Commission (ASIC) regulatory guides

Industry 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 applications and associated documentation to identify relevant medical information 
Interpret medical information to identify medical risk factors 
Recognise the need for additional medical information and collect as appropriate 
Identify potential life risk implications of supplied medical information 
Recognise interrelationships between medical conditions and the implications for medical risk factors 
Identify long-term risk implications of medical treatment and recovery processes 
Select and apply appropriate medical risks rating systems and risk handling techniques 
Determine risk acceptance criteria to suit type and context of risk in accordance with procedures 
Assess the adequacy of medical information against risk acceptance criteria in accordance with procedures 
Develop terms of acceptance in accordance with market conditions and accepted levels of exposure 
Document the life insurance policy with terms and conditions in accordance with procedures and regulatory requirements 

Forms

Assessment Cover Sheet

FNSILF502A - Underwrite complex medical risks
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

FNSILF502A - Underwrite complex medical risks

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: