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. Review claims reserves and monitor funds | 1.1 Review claims reserves regularly to ensure they accurately reflect expectations 1.2 Monitor funds to ensure adequate reserves exist to pay claims as they fall due for payment 1.3 Provide accurate data to assist underwriters to identify and charge appropriate policy premiums |
2. Support claims staff in claims reserve activities | 2.1 Ensure claims coordination staff are supported, as required, to identify accurate initial claims reserves 2.2 Ensure claims coordination staff are supported, as required, in allocation of claims to appropriate claims specialists |
3. Authorise payments, settlements and changes to reserves | 3.1 Authorise payments, settlements and reserves changes that are requested or required by claims specialists but outside their delegated authority |
4. Identify required changes to portfolio, claims reserves policy or procedures | 4.1 Communicate identified information promptly to decision-makers in the management structure according to organisational procedures 4.2 Instigate changes to policy and procedures to minimise claims losses in similar circumstances |
Evidence of the ability to:
undertake high level data collection, financial analysis and monitoring of funds for managing claims reserves
apply effective communication and management skills related to the review, update and reporting in an insurance claims portfolio
accurately interpret and comply with relevant legislation, and claims and reserves trends.
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:
explain data analysis techniques relating to claims reserves
outline industry trends in claims reserving policy and procedures
outline relevant information technology and communications systems required for determining claims reserves
outline key features of insurance guidelines, levels of authority and organisational policy, procedures and obligations in reserving
identify and describe key features of relevant legislation, regulatory guidelines and industry sector codes of practice
explain the importance of wording of insurance policies in keeping with the organisation or industry sector
explain the reinsurance processes and implications on claims reserves
explain risk prevention and loss minimisation methods and application to claims reserves
explain types and categories of insurance policies
outline processes for authorising payments, settlements and reserves changes.
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.