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Elements and Performance Criteria

  1. Receive instructions from client
  2. Establish relevant facts
  3. Plan and implement loss investigation
  4. Preserve evidence
  5. Liaise with authorities
  6. Verify and document information
  7. Appoint specialists

Required Skills

Required skills

welldeveloped communication skills to

negotiate and interview clients and others

determine and confirm information using questioning and active listening as required

liaise with others share information listen and understand

use language and concepts appropriate to cultural differences

numeracy and IT skills to

calculate and estimate loss

apply data analysis techniques and procedures

use computer applications word processing spreadsheet database specific purpose computer systems to assist in achieving required outcomes

access and update records electronically

access webbased information services

literacy skills to read and interpret documentation from a variety of sources and record and consolidate relevant related information and maintain currency of industry products and services knowledge

research and analysis for accessing and interpreting relevant information

organisational skills including the ability to plan and sequence work

investigative analytical evaluative and deductive reasoning skills

Required knowledge

business mathematics and statistics

claims management

data analysis techniques and procedures

fraud detection control and prevention principles

insurable interest

investigative practices and guidelines

loss adjusting principles and practice

policy coverage and requirements

principles of cost estimating

relevant contract and commercial law principles

insurance law

relevant legislation and industry codes of practice

roles responsibilities and jurisdiction of specialists and other authorities

rules of evidence and information gathering and documenting principles

subrogation

types and categories of insurance policies

Evidence Required

The Evidence Guide provides advice on assessment and must be read in conjunction with the performance criteria required skills and knowledge range statement and the Assessment Guidelines for the Training Package

Overview of assessment

Critical aspects for assessment and evidence required to demonstrate competency in this unit

Evidence of the ability to

apply loss adjusting principles and practice and investigative practices and guidelines relevant to various types of lossdamage

apply loss prevention principles and practice

use fraud detection control and prevention principles

apply thorough knowledge of types and categories of insurance policies industry codes of practice and relevant legislation

roles responsibilities and jurisdiction of specialists and other authorities

Context of and specific resources for assessment

Assessment must ensure

competency is demonstrated in the context of the work environment and conditions specified in the range statement either in a relevant workplace or a closely simulated work environment

access to and the use of a range of common office equipment technology software and consumables

access to organisation records

access to organisational policies and procedures

Method of assessment

A range of assessment methods should be used to assess practical skills and knowledge The following examples in combination are appropriate for this unit

evaluating an integrated activity which combines the elements of competency for the unit or a cluster of related units of competency

observing processes and procedures in workplaces

verbal or written questioning on underpinning knowledge and skills

evaluating samples of work

accessing and validating third party reports

setting and reviewing workplace projects and business simulations or scenarios

Guidance information for assessment


Range Statement

The range statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised wording, if used in the performance criteria, is detailed below. Essential operating conditions that may be present with training and assessment (depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts) may also be included.

Terms of reference or instructions may include:

date and location of loss (local or remote)

estimate of loss

instructions for investigating loss/damage/injury

insurer's reference

name of insured and initial contact

negotiating settlements date of receipt of instructions

other parties involved

period of insurance

policy cover

policy number

type.

Terms of reference or instructions may be:

electronic

verbal

written.

Relevant parties may include:

broker or agent

client

consultants

government or statutory authorities

insured

insurer

legal or other practitioners

manufacturers

medical

mortgagee

principal

subcontractor

suppliers

third party

trustee.

Client or organisation policy and legislative guidelines may include:

Australasian Institute of Chartered Loss Adjusters (AICLA) Charter of Objects and Professional Conduct

claims

clerical

codes of practice

complaints and dispute resolution procedures

information technology and administrative systems

loss

loss recovery

policies and procedures in relation to risks.

Investigative activities include:

consultation

credit and character checks

desktop and other research

financial

forensic, mechanical, electrical, metallurgical, chemical and other tests

interviews

legal procedures

physical examinations

surveying

surveys

valuations.

Relevant legislation may include:

building or construction

Consumer Credit Code

contracts law

environmental

hazardous materials

industry codes of practice

Insurance Agents and Brokers Act

Insurance Contracts Act

motor vehicle

occupational health and safety (OHS)

Privacy Act

secrecy laws

Trade Practices Act.

Means of preserving evidence may include:

documentation

electronic

forensic, medical, mechanical, chemical and other means

photographic

physical.

Appropriate authorities may include:

fire services

industry and professional associations

local governments

medical and legal professionals

police

statutory authorities

unions and union representatives.

Methods to clarify conflicting evidence or information include:

consultation

credit and character checks

desktop and other research

financial

forensic, mechanical, electrical, metallurgical, chemical and other tests

interviews

legal procedures

physical examinations

surveying

surveys

valuations.

Documentation may include:

interview records

legal, government, professional, other documents

meeting notes

minutes

official, general, other correspondence

reasons for adopting/incorporating certain evidence/information preferred over other evidence/information

records of telephone conversations

reference to all evidence/information considered

reports from others such as loss adjusters/assessors/ insurers/medical providers and others

the basis on which the decision was determined

time sheets.

Specialist assistance may include:

accountants

arborists

architects

building consultants

chemists

consultants

engineers

forensic

hydrologists

jewellers

legal

medical

metallurgists

meteorologists

private and other investigators

quantity and other surveyors

valuers.