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

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:

manage insurer liaison on at least three occasions.

In the course of the above, the candidate must:

maintain documentation systems for insurance claims

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

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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:

organisational policies, procedures, objectives and guidelines relating to insurance arrangements and performance measures, including for:

calculating and processing benefits

assessing insurance claims, and calculating and processing benefit payments

documentation requirements for processing death and disability payments

applying regulations and legislation to payments

key steps in internal and external complaints processes in superannuation

compliance responsibilities for claims processing

tendering processes

organisation’s risk management strategies.

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