Assessor Resource

FNSSUP502
Supervise insurer liaison

Assessment tool

Version 1.0
Issue Date: May 2024


This unit describes the skills and knowledge required to implement and supervise liaison with insurance bodies. It encompasses establishing insurer liaison, supervising the claim procedures, managing complex claims and managing risk.

It applies to individuals who use analytical skills and systematic approaches to liaise with insurance bodies and oversee specific organisational processes.

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. Establish insurer liaison

1.1 Identify organisational procedures for insurance arrangements

1.2 Determine insurance performance measures

1.3 Establish contact with insurer and maintain regular liaison

1.4 Determine insurance premiums payment details

1.5 Establish procedures for processing claims

1.6 Obtain paperwork required to undertake activities

1.7 Provide insurer with information to maintain accurate member records

2. Manage risk

2.1 Assess risk of member profile with insurer

2.2 Undertake procedures to reduce risk in line with organisational procedures

2.3 Assess claims documentation and generate reports for trustee

2.4 Implement trustee decisions on claims and risk management procedures

3. Supervise claim procedures

3.1 Monitor performance requirements for insurer

3.2 Provide insurer with information as required to process claim

3.3 Refer disputed claims to complaints procedure

4. Manage complex claims

4.1 Gather documentation for complex claims and prepare for insurer

4.2 Check claim applications against conditions identified in trust deed

4.3 Incorporate claim beneficiaries into claims processing procedure

4.4 Compile claim correspondence in accordance with conditions identified in trust deed, relevant legislation and organisational procedures

4.5 Forward claim correspondence to insurer

Evidence of the ability to:

use risk profiling techniques

implement trustee instructions

develop and maintain documentation systems for insurance claims

identify, source and interpret required information to process benefits for lump sum payments, death claims and disablement claims.

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:

describe the key features of organisational policy, objectives and guidelines relating to insurance arrangements and performance measures

describe procedures for:

calculating and processing benefits

assessing insurance claims, and calculating and processing benefit payments

outline documentation requirements for processing death and disability payments

explain how regulations and legislation apply to payments

describe the key steps in the internal, Superannuation Complaints Tribunal (SCT) and other external complaints processes

identify compliance responsibilities for claims processing

outline the key steps in tendering processes

describe the organisation’s risk management strategies.

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

common office equipment, technology, software and consumables

organisational financial records

organisational policy and procedures.

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. Establish insurer liaison

1.1 Identify organisational procedures for insurance arrangements

1.2 Determine insurance performance measures

1.3 Establish contact with insurer and maintain regular liaison

1.4 Determine insurance premiums payment details

1.5 Establish procedures for processing claims

1.6 Obtain paperwork required to undertake activities

1.7 Provide insurer with information to maintain accurate member records

2. Manage risk

2.1 Assess risk of member profile with insurer

2.2 Undertake procedures to reduce risk in line with organisational procedures

2.3 Assess claims documentation and generate reports for trustee

2.4 Implement trustee decisions on claims and risk management procedures

3. Supervise claim procedures

3.1 Monitor performance requirements for insurer

3.2 Provide insurer with information as required to process claim

3.3 Refer disputed claims to complaints procedure

4. Manage complex claims

4.1 Gather documentation for complex claims and prepare for insurer

4.2 Check claim applications against conditions identified in trust deed

4.3 Incorporate claim beneficiaries into claims processing procedure

4.4 Compile claim correspondence in accordance with conditions identified in trust deed, relevant legislation and organisational procedures

4.5 Forward claim correspondence to insurer

Evidence of the ability to:

use risk profiling techniques

implement trustee instructions

develop and maintain documentation systems for insurance claims

identify, source and interpret required information to process benefits for lump sum payments, death claims and disablement claims.

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:

describe the key features of organisational policy, objectives and guidelines relating to insurance arrangements and performance measures

describe procedures for:

calculating and processing benefits

assessing insurance claims, and calculating and processing benefit payments

outline documentation requirements for processing death and disability payments

explain how regulations and legislation apply to payments

describe the key steps in the internal, Superannuation Complaints Tribunal (SCT) and other external complaints processes

identify compliance responsibilities for claims processing

outline the key steps in tendering processes

describe the organisation’s risk management strategies.

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

common office equipment, technology, software and consumables

organisational financial records

organisational policy and procedures.

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 organisational procedures for insurance arrangements 
Determine insurance performance measures 
Establish contact with insurer and maintain regular liaison 
Determine insurance premiums payment details 
Establish procedures for processing claims 
Obtain paperwork required to undertake activities 
Provide insurer with information to maintain accurate member records 
Assess risk of member profile with insurer 
Undertake procedures to reduce risk in line with organisational procedures 
Assess claims documentation and generate reports for trustee 
Implement trustee decisions on claims and risk management procedures 
Monitor performance requirements for insurer 
Provide insurer with information as required to process claim 
Refer disputed claims to complaints procedure 
Gather documentation for complex claims and prepare for insurer 
Check claim applications against conditions identified in trust deed 
Incorporate claim beneficiaries into claims processing procedure 
Compile claim correspondence in accordance with conditions identified in trust deed, relevant legislation and organisational procedures 
Forward claim correspondence to insurer 

Forms

Assessment Cover Sheet

FNSSUP502 - Supervise insurer liaison
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

FNSSUP502 - Supervise insurer liaison

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: