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Elements and Performance Criteria

Identify medical risks
Identify the underwriting significance
Determine risk acceptance criteria
- Determine risk acceptance criteria to suit type and context of risk in accordance with procedures
- Assess the adequacy of medical information against risk acceptance criteria in accordance with procedures
Prepare life insurance policy
- Develop terms of acceptance in accordance with market conditions and accepted levels of exposure
- Document the life insurance policy with terms and conditions in accordance with procedures and regulatory requirements

Required Skills

Required skills

communication skills to

gather and check information

liaise and share information with others

communicate appropriately with people from diverse backgrounds

use computer applications word processing spreadsheet database specific purpose computer systems

access webbased information services

organisational skills to efficiently plan and sequence work

problem solving skills to address errors in life insurance documentation

reading skills to

read and understand relevant procedures

read and understand life insurance policies

read and interpret life insurance applications and supporting documentation

research and analysis skills to

identify and interpret relevant information

analyse information and data

maintain currency of products and services knowledge

writing skills to

accurately record information

prepare professional letters and emails

Required knowledge

the ability to apply and explain as relevant to the underwriting of complex medical risks

integrated actuarial underwriting and medical information

life insurance administrative requirements

life insurance policy terms and conditions

life insurance risk management practices

medical treatment and recovery processes relative to insurance underwriting

organisational procedures

product information

relevant medical techniques diseases injuries and terminology relative to insurance underwriting

relevant regulatory requirements

types of medical risk and probability of occurrence

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 analytical and administrative skills in relation to medical risk assessment

maintain and apply a thorough understanding of guidelines and administrative requirements

apply underwriting policies and procedures

perform tasks in accordance with relevant procedures and regulatory requirements

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 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 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.

Medical information may include:	advice from a senior underwriter and/or Chief Medical Officer adviser reports medical reports previous insurance history supplementary questionnaires medical specialties and the titles of doctors working in specialist fields illnesses injuries diseases description of the onset and/or nature of condition medical investigations and procedures treatments prognosis.
Medical risk factors may relate to:	blood, spleen and lymphatic system cardiovascular system endocrine system gastro-intestinal system genitourinary system inherited disorders and family history mental disorders musculoskeletal system neurological system physical dimensions respiratory system tumours.
Life risk is a potential change to health or wellbeing that would have an adverse effect on the financial sustainability of an individual, a family or a group, and may include:	death total and permanent disablement temporary loss of income resulting from accident or sickness traumatic sickness or injury.
Medical risks rating systems and risk handling techniques may include:	cash extra loadings class systems exclusions numerical systems.
Risk acceptance criteria may include:	exclusions loadings other specific terms and conditions standard cover conditions.
Procedures may include:	organisational complaints handling processes organisational customer service charter organisational guidelines organisational policy organisational privacy and confidentiality guidelines organisational procedures.
Regulatory requirements may include:	insurance contracts legislation life insurance legislation corporations legislation privacy legislation Australian Securities and Investments Commission (ASIC) regulatory guides Industry Codes of Practice.