Elements and Performance Criteria
- Investigate circumstances of claim
- Facts and information are collected
- Validity of the claim against reported circumstances is assessed
- Fraud indicators are identified
- Policy conditions are reviewed to ensure loss falls within policy coverage
- Data and information collated is recorded progressively
- Investigation procedures are carried out according to industry regulations/guidelines, occupational health and safety (OHS) legislation, statutory legislation and enterprise procedures/policies
- Assess extent of loss
- Determine suitable action
- Prepare report on investigation and assessment