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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. Evaluate data on an insurance claims portfolio or a line of business claim
   • Source portfolio or line of business claims data using organisational collection processes in preparation for analysis
   • Identify any additional claims data sources, external influences and improvement to policies and procedures
   • Identify organisation’s expectations for claims portfolio performance
   • Analyse data and undertake risk analysis to determine profitability, loss ratio, claims reserves and future trends according to organisational policies and procedures
   • Research industry to determine benchmarks for claims portfolio
2. Interpret findings to report on assumptions and recommendations
   • Identify findings and formulate assumptions and recommendations to identify trends, future profitability, claims reserves and loss ratio for the line of business
   • Review and suggest amendments to policies and procedures to improve line of business financial outcomes
   • Prepare a report documenting findings, identified issues and assumptions
3. Communicate and review report
   • Communicate findings and recommendations to required stakeholders within required timeframe and according to organisational policies and procedures
   • Collate feedback and identified issues, and amend report accordingly
4. Finalise report findings and confirm approval
   • Submit final report for approval according to organisational lines of approval and delegation of authority
   • Document final report and communicate to relevant stakeholders for implementation 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:

evaluate and report on status of at least one insurance claims portfolio or line of business.

In the course of the above, the candidate must:

research industry trends in portfolio management to reduce losses

make assumptions and recommendations based on findings

engage with required colleagues, communicate findings, and apply feedback.

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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 requirements, regulatory guidelines and industry sector codes of practice relating to claims management and reporting

organisational policies and procedures, underwriting guidelines and levels of authority relating to evaluating and reporting on insurance claims portfolios

data and risk analysis techniques relevant to insurance claims portfolios

key aspects of financial theories and statistics relevant to insurance claims portfolios, including financial modelling and related mathematics

evaluation methodologies relevant to insurance claims portfolios

industry trends in insurance portfolio management

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

risk prevention and loss minimisation methods and their application in the development of claims portfolios

reporting techniques to communicate assumptions used and recommendations developed

types and categories of insurance policies.

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