Google Links

Follow the links below to find material targeted to the unit's elements, performance criteria, required skills and knowledge

Elements and Performance Criteria

1. Advise insurers and complete required documentation
   • Verify appointment of loss adjuster on receipt of claim
   • Obtain formal acknowledgment of receipt of claim from insurers
   • Make formal claim reports according to organisational procedures and within brokerage time requirements
   • Provide assistance to client, when required to complete claim documentation according to codes of practice
   • Ensure full and accurate information is available to insurers in assessing claim
2. Advise client of rights and obligations
   • Formally request insurer to reinstate sum insured where required and inform client where reinstatement occurs
   • Review terms and conditions of insurance policy with client to ensure maximum claim recovery is sought
   • Advise client on administration of claims to ensure no breach of contract occurs and claims are managed efficiently
   • Advise client of legislative requirements to protect client interests
3. Liaise with service providers
   • Identify need for independent service providers with suitable expertise for claim, where settlement authority exists
   • Engage suitable service provider based on client instructions where settlement authority exists and according to organisational policies and procedures
   • Brief service provider thoroughly to ensure investigation is comprehensive where settlement authority exists
   • Review and assess service provider’s report within agreed timeframes where settlement authority exists
   • Maintain contact with insurer’s service provider to ensure reports and issues are dealt with within required timeframe
4. Notify terms of settlement to client and update files and records
   • Prepare details of insurer’s settlement offer without delay, with recommendations for client to review
   • Obtain and act on client’s response to settlement offer without delay and according to organisational procedures
   • Remit settlement funds to client according to legislative requirements and organisational policies and procedures
   • Update business records promptly according to organisational policies and procedures

Performance Evidence

The candidate must demonstrate the ability to complete the tasks outlined in the elements, performance criteria and foundation skills of this unit, including evidence of the ability to:

provide a claims service to at least two different insurance broking clients.

---

Knowledge Evidence

The candidate must be able to demonstrate knowledge to complete the tasks outlined in the elements, performance criteria and foundation skills of this unit, including knowledge of:

legislative compliance requirements and codes of practice relating to adviser dealing with client claims

organisational policies and procedures, including for:

establishing client insurance requirements and covers

notifying insurer of claims-related information

assisting client in completing required documentation and declarations

using brokerage claims systems and procedures

finalising client documentation and declarations

engaging external service providers

remitting funds

responsibilities of adviser in claims process

processes for analysing insurance contract terms and conditions in relation to claims process and administering claims

key components of broking claim systems and claim documentation

common terms and conditions in brokerage insurance policies.

---