This unit describes the skills and knowledge required to review claims history, predict future claims costs and review policies and procedures, including analysing data, preparing reports on claims and monitoring trends in claims settlement to advise on changes to minimise losses.

It applies to individuals working in claims and underwriting job roles involving specialist knowledge and functions in a range of insurance sectors and may be applied within 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. Refer to the FNS Implementation Guide Companion Volume or the relevant regulator for specific guidance on requirements.

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

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.

ELEMENT	PERFORMANCE CRITERIA
Elements describe the essential outcomes.	Performance criteria describe the performance needed to demonstrate achievement of the element.
1. Collect and analyse data on claims trends	1.1 Design and implement data gathering processes 1.2 Identify new data requirements and sources, and establish process for collecting data 1.3 Analyse data collected to identify trends in claims and related documents
2. Monitor claims trends	2.1 Prepare accurate and timely claims reports to document trends and identify issues, where appropriate 2.2 Communicate to management promptly relevant information which impacts on clients according to organisational procedures
3. Identify opportunities to improve client outcomes	3.1 Assist clients to identify changes to policies and procedures that will improve health and safety and return to work practices, and minimise claims costs in similar circumstances 3.2 Communicate advice to clients effectively and promote positive action 3.3 Provide sources of advice to clients where required

Evidence of the ability to:

collect and interpret data from a wide range of sources

effectively monitor and analyse:

claims trends and their causes

effects on claims history

settlement policy and procedures

review policies and procedures and make recommendations for change

accurately prepare advice and recommendations for management and clients to undertake suitable actions.

Note: If a specific volume or frequency is not stated, then evidence must be provided at least once.

To complete the unit requirements safely and effectively, the individual must:

outline organisational policy, procedures, claims guidelines and levels of authority

explain and employ analysis techniques in evaluating data

outline broad industry trends in claims handling

explain the different type of claims events and possible remediation strategies

outline the types of data and documents to be analysed to monitor claim trends.

Assessment must be conducted in a safe environment where evidence gathered demonstrates consistent performance of typical activities experienced in the insurance services field of work and include access to:

organisational records

organisational policy, procedures, legislation and regulations as they relate to contracts of insurance

a range of common technology and software.

Assessors must satisfy NVR/AQTF assessor 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)

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.

ELEMENT	PERFORMANCE CRITERIA
Elements describe the essential outcomes.	Performance criteria describe the performance needed to demonstrate achievement of the element.
1. Collect and analyse data on claims trends	1.1 Design and implement data gathering processes 1.2 Identify new data requirements and sources, and establish process for collecting data 1.3 Analyse data collected to identify trends in claims and related documents
2. Monitor claims trends	2.1 Prepare accurate and timely claims reports to document trends and identify issues, where appropriate 2.2 Communicate to management promptly relevant information which impacts on clients according to organisational procedures
3. Identify opportunities to improve client outcomes	3.1 Assist clients to identify changes to policies and procedures that will improve health and safety and return to work practices, and minimise claims costs in similar circumstances 3.2 Communicate advice to clients effectively and promote positive action 3.3 Provide sources of advice to clients where required

Evidence of the ability to:

collect and interpret data from a wide range of sources

effectively monitor and analyse:

claims trends and their causes

effects on claims history

settlement policy and procedures

review policies and procedures and make recommendations for change

accurately prepare advice and recommendations for management and clients to undertake suitable actions.

Note: If a specific volume or frequency is not stated, then evidence must be provided at least once.

To complete the unit requirements safely and effectively, the individual must:

outline organisational policy, procedures, claims guidelines and levels of authority

explain and employ analysis techniques in evaluating data

outline broad industry trends in claims handling

explain the different type of claims events and possible remediation strategies

outline the types of data and documents to be analysed to monitor claim trends.

Assessment must be conducted in a safe environment where evidence gathered demonstrates consistent performance of typical activities experienced in the insurance services field of work and include access to:

organisational records

organisational policy, procedures, legislation and regulations as they relate to contracts of insurance

a range of common technology and software.

Assessors must satisfy NVR/AQTF assessor requirements.

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
Design and implement data gathering processes
Identify new data requirements and sources, and establish process for collecting data
Analyse data collected to identify trends in claims and related documents
Prepare accurate and timely claims reports to document trends and identify issues, where appropriate
Communicate to management promptly relevant information which impacts on clients according to organisational procedures
Assist clients to identify changes to policies and procedures that will improve health and safety and return to work practices, and minimise claims costs in similar circumstances
Communicate advice to clients effectively and promote positive action
Provide sources of advice to clients where required

Assessment Cover Sheet

FNSISV508 - Review and advise on claims costs, policies and procedures

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

FNSISV508 - Review and advise on claims costs, policies and procedures

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: