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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 insurer liaison
   • Identify organisational procedures for insurance arrangements
   • Determine insurance performance measures
   • Establish contact with insurer and maintain regular liaison
   • Determine insurance premiums payment details
   • Establish procedures for processing claims
   • Obtain paperwork required to undertake activities
   • Provide insurer with information to maintain accurate member records
2. Manage risk
   • Assess risk of member profile with insurer
   • Undertake procedures to reduce risk in line with organisational procedures
   • Assess claims documentation and generate reports for trustee
   • Implement trustee decisions on claims and risk management procedures
3. Supervise claim procedures
   • Monitor performance requirements for insurer
   • Provide insurer with information as required to process claim
   • Refer disputed claims to complaints procedure
4. Manage complex claims
   • Gather documentation for complex claims and prepare for insurer
   • Check claim applications against conditions identified in trust deed
   • Incorporate claim beneficiaries into claims processing procedure
   • Compile claim correspondence in accordance with conditions identified in trust deed, relevant legislation and organisational procedures
   • Forward claim correspondence to insurer

Performance Evidence

Evidence of the ability to:

use risk profiling techniques

implement trustee instructions

develop and maintain documentation systems for insurance claims

identify, source and interpret required information to process benefits for lump sum payments, death claims and disablement claims.

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:

describe the key features of organisational policy, objectives and guidelines relating to insurance arrangements and performance measures

describe procedures for:

calculating and processing benefits

assessing insurance claims, and calculating and processing benefit payments

outline documentation requirements for processing death and disability payments

explain how regulations and legislation apply to payments

describe the key steps in the internal, Superannuation Complaints Tribunal (SCT) and other external complaints processes

identify compliance responsibilities for claims processing

outline the key steps in tendering processes

describe the organisation’s risk management strategies.

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