Unit of Competency Mapping – Information for Teachers/Assessors – Information for Learners

FNSIBK414 Mapping and Delivery Guide
Provide a claims service to insurance broking clients

Version 1.0
Issue Date: May 2024


Qualification -
Unit of Competency FNSIBK414 - Provide a claims service to insurance broking clients
Description
Employability Skills
Learning Outcomes and Application This unit describes the skills and knowledge required to provide an insurance claims service to clients in an insurance broking context.The unit applies to those who use well-developed communication and interpersonal skills in insurance broking organisations of various sizes and across a range of customer bases.Work functions in the occupational areas where this unit may be used are subject to regulatory requirements. Users are advised to check with the relevant state and territory regulatory authorities to confirm those requirements.
Duration and Setting X weeks, nominally xx hours, delivered in a classroom/online/blended learning setting.

Skills in this unit must be demonstrated in a workplace or simulated environment where the conditions are typical of those in a working environment in this industry.

This includes access to:

organisational equipment, technology, software and consumables

organisational records

organisational policies and procedures.

Assessors of this unit must satisfy the requirements for assessors in applicable vocational education and training legislation, frameworks and/or standards.

Prerequisites/co-requisites
Competency Field
Development and validation strategy and guide for assessors and learners Student Learning Resources Handouts
Activities
Slides
PPT
Assessment 1 Assessment 2 Assessment 3 Assessment 4
Elements of Competency Performance Criteria              
Element: Advise insurers and complete required documentation
  • Verify appointment of loss adjuster on receipt of claim
  • Obtain formal acknowledgment of receipt of claim from insurers
  • Make formal claim reports according to organisational procedures and within brokerage time requirements
  • Provide assistance to client, when required to complete claim documentation according to codes of practice
  • Ensure full and accurate information is available to insurers in assessing claim
       
Element: Advise client of rights and obligations
  • Formally request insurer to reinstate sum insured where required and inform client where reinstatement occurs
  • Review terms and conditions of insurance policy with client to ensure maximum claim recovery is sought
  • Advise client on administration of claims to ensure no breach of contract occurs and claims are managed efficiently
  • Advise client of legislative requirements to protect client interests
       
Element: Liaise with service providers
  • Identify need for independent service providers with suitable expertise for claim, where settlement authority exists
  • Engage suitable service provider based on client instructions where settlement authority exists and according to organisational policies and procedures
  • Brief service provider thoroughly to ensure investigation is comprehensive where settlement authority exists
  • Review and assess service provider’s report within agreed timeframes where settlement authority exists
  • Maintain contact with insurer’s service provider to ensure reports and issues are dealt with within required timeframe
       
Element: Notify terms of settlement to client and update files and records
  • Prepare details of insurer’s settlement offer without delay, with recommendations for client to review
  • Obtain and act on client’s response to settlement offer without delay and according to organisational procedures
  • Remit settlement funds to client according to legislative requirements and organisational policies and procedures
  • Update business records promptly according to organisational policies and procedures
       


Evidence Required

List the assessment methods to be used and the context and resources required for assessment. Copy and paste the relevant sections from the evidence guide below and then re-write these in plain English.

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:

provide a claims service to at least two different insurance broking clients.

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 compliance requirements and codes of practice relating to adviser dealing with client claims

organisational policies and procedures, including for:

establishing client insurance requirements and covers

notifying insurer of claims-related information

assisting client in completing required documentation and declarations

using brokerage claims systems and procedures

finalising client documentation and declarations

engaging external service providers

remitting funds

responsibilities of adviser in claims process

processes for analysing insurance contract terms and conditions in relation to claims process and administering claims

key components of broking claim systems and claim documentation

common terms and conditions in brokerage insurance policies.


Submission Requirements

List each assessment task's title, type (eg project, observation/demonstration, essay, assignment, checklist) and due date here

Assessment task 1: [title]      Due date:

(add new lines for each of the assessment tasks)


Assessment Tasks

Copy and paste from the following data to produce each assessment task. Write these in plain English and spell out how, when and where the task is to be carried out, under what conditions, and what resources are needed. Include guidelines about how well the candidate has to perform a task for it to be judged satisfactory.
Copy and paste from the following performance criteria to create an observation checklist for each task. When you have finished writing your assessment tool every one of these must have been addressed, preferably several times in a variety of contexts. To ensure this occurs download the assessment matrix for the unit; enter each assessment task as a column header and place check marks against each performance criteria that task addresses.

Observation Checklist

Tasks to be observed according to workplace/college/TAFE policy and procedures, relevant legislation and Codes of Practice Yes No Comments/feedback
Verify appointment of loss adjuster on receipt of claim 
Obtain formal acknowledgment of receipt of claim from insurers 
Make formal claim reports according to organisational procedures and within brokerage time requirements 
Provide assistance to client, when required to complete claim documentation according to codes of practice 
Ensure full and accurate information is available to insurers in assessing claim 
Formally request insurer to reinstate sum insured where required and inform client where reinstatement occurs 
Review terms and conditions of insurance policy with client to ensure maximum claim recovery is sought 
Advise client on administration of claims to ensure no breach of contract occurs and claims are managed efficiently 
Advise client of legislative requirements to protect client interests 
Identify need for independent service providers with suitable expertise for claim, where settlement authority exists 
Engage suitable service provider based on client instructions where settlement authority exists and according to organisational policies and procedures 
Brief service provider thoroughly to ensure investigation is comprehensive where settlement authority exists 
Review and assess service provider’s report within agreed timeframes where settlement authority exists 
Maintain contact with insurer’s service provider to ensure reports and issues are dealt with within required timeframe 
Prepare details of insurer’s settlement offer without delay, with recommendations for client to review 
Obtain and act on client’s response to settlement offer without delay and according to organisational procedures 
Remit settlement funds to client according to legislative requirements and organisational policies and procedures 
Update business records promptly according to organisational policies and procedures 

Forms

Assessment Cover Sheet

FNSIBK414 - Provide a claims service to insurance broking clients
Assessment task 1: [title]

Student name:

Student ID:

I declare that the assessment tasks submitted for this unit are my own work.

Student signature:

Result: Competent Not yet competent

Feedback to student

 

 

 

 

 

 

 

 

Assessor name:

Signature:

Date:


Assessment Record Sheet

FNSIBK414 - Provide a claims service to insurance broking clients

Student name:

Student ID:

Assessment task 1: [title] Result: Competent Not yet competent

(add lines for each task)

Feedback to student:

 

 

 

 

 

 

 

 

Overall assessment result: Competent Not yet competent

Assessor name:

Signature:

Date:

Student signature:

Date: