Assessor Resource

FNSISV515
Evaluate and report on status of claims portfolio

Assessment tool

Version 1.0
Issue Date: May 2024


This unit describes the skills and knowledge required to evaluate a claims portfolio, including preparing reports on portfolio status and recommending changes to minimise losses.

It applies to individuals working in claims management 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)


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.

ELEMENT

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Evaluate status of claims portfolio

1.1 Identify organisation’s expectations for claims portfolio performance

1.2 Analyse and evaluate claims portfolio data and information to identify trends and determine status of portfolio

1.3 Research industry to determine benchmarks for claims portfolios

2. Recommend changes to claims portfolio, policy and/or procedures, as required

2.1 Identify changes to portfolio, policy and procedures to improve portfolio performance and minimise claims losses

2.2 Document all changes and update records in compliance with organisational policy and procedures

3. Prepare status report

3.1 Prepare accurate and timely claims portfolio reports to document status and trends, where appropriate

3.2 Make recommendations on improvements to claims portfolio

4. Communicate findings to key stakeholders

4.1 Communicate promptly information which impacts on various portfolios to stakeholders according to organisational procedures

5. Review status report findings

5.1 Use feedback from stakeholders to review key findings and recommendations

5.2 Document all feedback and subsequent amendments to status report and record according to organisational policy and procedures

Evidence of the ability to:

effectively apply planning, data collection, analysis, communication and report writing skills to the interpretation and evaluation of the status of a claims portfolio

accurately interpret charts, graphs and statistical information

research industry trends in portfolio management to reduce losses

prepare claims portfolio reports to document status and trends of the portfolio.

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 and apply data analysis techniques relevant to claims portfolios

explain and apply evaluation methodologies

describe industry trends in insurance portfolio management

outline organisational policy, procedures, underwriting guidelines and levels of authority relating to claims portfolios

outline key features of relevant legislation, regulatory guidelines and industry sector codes of practice relating to claims management and reporting

explain risk prevention and loss minimisation methods and application in the development of claims portfolios

define types and categories of insurance policies.

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.

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.

ELEMENT

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Evaluate status of claims portfolio

1.1 Identify organisation’s expectations for claims portfolio performance

1.2 Analyse and evaluate claims portfolio data and information to identify trends and determine status of portfolio

1.3 Research industry to determine benchmarks for claims portfolios

2. Recommend changes to claims portfolio, policy and/or procedures, as required

2.1 Identify changes to portfolio, policy and procedures to improve portfolio performance and minimise claims losses

2.2 Document all changes and update records in compliance with organisational policy and procedures

3. Prepare status report

3.1 Prepare accurate and timely claims portfolio reports to document status and trends, where appropriate

3.2 Make recommendations on improvements to claims portfolio

4. Communicate findings to key stakeholders

4.1 Communicate promptly information which impacts on various portfolios to stakeholders according to organisational procedures

5. Review status report findings

5.1 Use feedback from stakeholders to review key findings and recommendations

5.2 Document all feedback and subsequent amendments to status report and record according to organisational policy and procedures

Evidence of the ability to:

effectively apply planning, data collection, analysis, communication and report writing skills to the interpretation and evaluation of the status of a claims portfolio

accurately interpret charts, graphs and statistical information

research industry trends in portfolio management to reduce losses

prepare claims portfolio reports to document status and trends of the portfolio.

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 and apply data analysis techniques relevant to claims portfolios

explain and apply evaluation methodologies

describe industry trends in insurance portfolio management

outline organisational policy, procedures, underwriting guidelines and levels of authority relating to claims portfolios

outline key features of relevant legislation, regulatory guidelines and industry sector codes of practice relating to claims management and reporting

explain risk prevention and loss minimisation methods and application in the development of claims portfolios

define types and categories of insurance policies.

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
Identify organisation’s expectations for claims portfolio performance 
Analyse and evaluate claims portfolio data and information to identify trends and determine status of portfolio 
Research industry to determine benchmarks for claims portfolios 
Identify changes to portfolio, policy and procedures to improve portfolio performance and minimise claims losses 
Document all changes and update records in compliance with organisational policy and procedures 
Prepare accurate and timely claims portfolio reports to document status and trends, where appropriate 
Make recommendations on improvements to claims portfolio 
Communicate promptly information which impacts on various portfolios to stakeholders according to organisational procedures 
Use feedback from stakeholders to review key findings and recommendations 
Document all feedback and subsequent amendments to status report and record according to organisational policy and procedures 

Forms

Assessment Cover Sheet

FNSISV515 - Evaluate and report on status of claims portfolio
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:

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Date:

Assessment Record Sheet

FNSISV515 - Evaluate and report on status of claims portfolio

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:

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