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

FNSISV310 Mapping and Delivery Guide
Process insurance claims payments

Version 1.0
Issue Date: May 2024


Qualification -
Unit of Competency FNSISV310 - Process insurance claims payments
Description
Employability Skills
Learning Outcomes and Application This unit describes the skills and knowledge required to generate and process claim related payments and required documentation in a timely manner.It applies to individuals in a range of insurance sectors and may be applied within 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. Refer to the FNS Implementation Guide Companion Volume or the relevant regulator for specific guidance on requirements.
Duration and Setting X weeks, nominally xx hours, delivered in a classroom/online/blended learning setting.

Assessment must be conducted in a safe environment where evidence gathered demonstrates consistent performance of typical activities experienced in the insurance services field of work and include access to:

organisational records

organisational policy, procedures, legislation and regulations as they relate to contracts of insurance

a range of common technology and software.

Assessors must satisfy NVR/AQTF assessor requirements.
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: Process payments
  • Identify, check and accurately record payment information
  • Authorise all payments according to organisational operating procedures
  • Generate payments within timeframes with reference to legislation, organisational policy and operating procedures, and codes of practice if applicable
  • Complete payment documents and identify relevant details
  • Observe payment limits for amounts requiring personal signing
       
Element: Notify reinsurer, if appropriate
  • Check reinsurance information related to claims payment
  • Notify reinsurers of claim payment amount and details under relevant reinsurance arrangements, where appropriate
       
Element: Finalise claims payment information to facilitate payment
  • Finalise payment information and enter on system for prompt payment, where required
  • Despatch claims payment data or payments within required timeframe
  • Copy and file documents for auditing purposes according to organisational operating procedures
  • Advise interested parties according to operating procedures where liability is not accepted
       


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.

ELEMENT

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Process payments

1.1 Identify, check and accurately record payment information

1.2 Authorise all payments according to organisational operating procedures

1.3 Generate payments within timeframes with reference to legislation, organisational policy and operating procedures, and codes of practice if applicable

1.4 Complete payment documents and identify relevant details

1.5 Observe payment limits for amounts requiring personal signing

2. Notify reinsurer, if appropriate

2.1 Check reinsurance information related to claims payment

2.2 Notify reinsurers of claim payment amount and details under relevant reinsurance arrangements, where appropriate

3. Finalise claims payment information to facilitate payment

3.1 Finalise payment information and enter on system for prompt payment, where required

3.2 Despatch claims payment data or payments within required timeframe

3.3 Copy and file documents for auditing purposes according to organisational operating procedures

3.4 Advise interested parties according to operating procedures where liability is not accepted

Evidence of the ability to:

identify, collate and organise information to document payments

authorise payments within required parameters and timeframes

accurately maintain and file documentation

follow relevant legislation and organisational policies to ensure accuracy.

Note: If a specific volume or frequency is not stated, then evidence must be provided at least once.

To complete the unit requirements safely and effectively, the individual must:

describe the key principles and practices relevant to making claims payments

outline key features of relevant legislation, regulations, organisational operating procedures and codes of practice relating to processing claims

outline key features of taxation laws relevant to processing insurance claims

outline the conditions when reinsurers need to be informed in the claims process.

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.

ELEMENT

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Process payments

1.1 Identify, check and accurately record payment information

1.2 Authorise all payments according to organisational operating procedures

1.3 Generate payments within timeframes with reference to legislation, organisational policy and operating procedures, and codes of practice if applicable

1.4 Complete payment documents and identify relevant details

1.5 Observe payment limits for amounts requiring personal signing

2. Notify reinsurer, if appropriate

2.1 Check reinsurance information related to claims payment

2.2 Notify reinsurers of claim payment amount and details under relevant reinsurance arrangements, where appropriate

3. Finalise claims payment information to facilitate payment

3.1 Finalise payment information and enter on system for prompt payment, where required

3.2 Despatch claims payment data or payments within required timeframe

3.3 Copy and file documents for auditing purposes according to organisational operating procedures

3.4 Advise interested parties according to operating procedures where liability is not accepted

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
Identify, check and accurately record payment information 
Authorise all payments according to organisational operating procedures 
Generate payments within timeframes with reference to legislation, organisational policy and operating procedures, and codes of practice if applicable 
Complete payment documents and identify relevant details 
Observe payment limits for amounts requiring personal signing 
Check reinsurance information related to claims payment 
Notify reinsurers of claim payment amount and details under relevant reinsurance arrangements, where appropriate 
Finalise payment information and enter on system for prompt payment, where required 
Despatch claims payment data or payments within required timeframe 
Copy and file documents for auditing purposes according to organisational operating procedures 
Advise interested parties according to operating procedures where liability is not accepted 

Forms

Assessment Cover Sheet

FNSISV310 - Process insurance claims payments
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

FNSISV310 - Process insurance claims payments

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: