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. Establish content of complex claim
   • Review terms and conditions of insurance policy with client
   • Advise client on potential claim recovery
   • Identify non-insured items and potential issues
2. Negotiate matters relating to complex claim
   • Identify type of claim and establish applicable type of negotiation based on variation to standard claims settlement
   • Prepare grounds for negotiation according to legislative and organisational requirements
   • Negotiate terms and conditions of settlement with insurer, representing client interests
   • Obtain and review negotiated agreement with insurer
3. Finalise complex claim settlement
   • Prepare and document details of insurer’s settlement offer with recommendations for client review and acceptance
   • Obtain client’s response to settlement offer according to organisational procedures
   • Update business records according to organisational 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:

negotiate complex claims settlements for 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 and industry compliance requirements that impact client rights and obligations when negotiating complex claims

organisational policies and procedures relating to negotiating complex claims settlement for insurance broking clients, including for managing the claims process on behalf of clients and:

obtaining client responses to settlement offers

using insurance broking systems and procedures

features of insurance contract terms and conditions

roles and responsibilities of broker in negotiating complex claims

key aspects of underwriter’s claims dispute resolution process

techniques to interpret and analyse client’s needs, including key trends of client’s business environment

processes for preparing grounds for negotiation and for negotiating complex insurance claims

communication strategies to advise clients throughout negotiation process

insurance fundamentals and methods to interpret, comprehend and apply policy wording.

---