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

Elements and Performance Criteria

1. Establish content of claim
   • Review terms and conditions of insurance policy with client to ensure maximum claims recovery is sought
   • Provide client with advice relating to potential claim recovery
   • Identify non-insured items
2. Negotiate terms and conditions of settlement
   • Identify type of claim and level of variation to standard claims settlement to establish type of negotiation required
   • Represent client interests to ensure full legal entitlement is forthcoming
   • Prepare grounds for negotiation to ensure logical, persuasive and technically correct representations can be made
   • Obtain negotiated agreement with insurer that in most cases meets client requirements and approval
3. Notify terms of settlement to client
   • Prepare and document details of insurer’s settlement offer with recommendations without delay for client review and acceptance
   • Obtain client’s response to settlement offer and act on it without delay
   • Remit settlement funds to client within terms of legislative requirements, and brokerage policy and operating procedures
4. Update relevant files and records
   • Update business records without delay and according to company operating procedures

Performance Evidence

Evidence of the ability to:

review and analyse the insurance cover to determine insured and non-insured items

prepare advice and recommendations for clients based on analysis of the insurance cover and claims made

negotiate with the insurer to obtain the optimum outcome for the client

document the insurer’s settlement offer, including recommendations for client review and acceptance, and obtain client response.

Note: If a specific volume or frequency is not stated, then evidence must be provided at least once.

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Knowledge Evidence

To complete the unit requirements safely and effectively, the individual must:

provide a detailed analysis of the roles and responsibility of the broker in the process of negotiating a complex claim

outline a plan to manage the claim’s process on behalf of the client through application of the insurance broking systems and procedures, and a thorough understanding of the underwriter’s claims process

explain how the key features of insurance contract terms and conditions are evaluated to enable the claim’s negotiation to be planned effectively

explain the application of communication strategies to advise clients throughout the negotiation process, including explaining the roles of underwriters and loss adjusters in the claims process

explain the application of relevant legislation and industry compliance requirements that impact on the client’s rights and obligations.

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