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

FNSISV508A Mapping and Delivery Guide
Review and advise on claims costs, policies and procedures

Version 1.0
Issue Date: May 2024


Qualification -
Unit of Competency FNSISV508A - Review and advise on claims costs, policies and procedures
Description This unit describes the performance outcomes, skills and knowledge required to review claims history, predict future claims costs and policies and procedures including analysing data, prepare reports on claims and monitor trends in claims settlement to advise on changes to minimise losses.This unit is applicable to individuals working within enterprises and job roles subject to licensing, legislative, regulatory or certification requirements including legislation administered by the Australian Securities and Investments Commission (ASIC).
Employability Skills This unit contains employability skills.
Learning Outcomes and Application This unit applies to claims and underwriting job roles involving specialist knowledge and functions in a range of insurance sectors and may be applied within organisations of various sizes and across a range of customer bases.
Duration and Setting X weeks, nominally xx hours, delivered in a classroom/online/blended learning setting.
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: Collect and analyse data on claims trends
  • Data gathering processes are designed and implemented
  • New data requirements and sources are identified and process for collecting the data established
  • Data collected is analysed to identify trends and trends are documented
       
Element: Monitor claims trends
  • Accurate and timely claims reports are prepared to document trends and identify issues where appropriate
  • Relevant information which impacts on a client portfolio is communicated promptly to management according to organisation procedures
       
Element: Identify opportunities to improve client outcomes
  • Assist clients identify changes to policies and procedures to improve occupational health and safety and return to work practices and minimise claims costs in similar circumstances
  • Advice to clients is communicated effectively promoting positive action
  • Sources of advice are provided to client where required
       


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 Evidence Guide provides advice on assessment and must be read in conjunction with the performance criteria, required skills and knowledge, range statement and the Assessment Guidelines for the Training Package.

Overview of assessment

Critical aspects for assessment and evidence required to demonstrate competency in this unit

Evidence of the ability to:

collect and interpret data from a wide range of sources and analyse the causes of trends and the effects on claims history, settlement policies and procedures

prepare advice and recommendations for suitable actions.

Context of and specific resources for assessment

Assessment must ensure:

competency is demonstrated in the context of the work environment and conditions specified in the range statement either in a relevant workplace or a closely simulated work environment

access to and the use of a range of common office equipment, technology, software and consumables

access to organisation records

access to organisation policies and procedures.

Method of assessment

A range of assessment methods should be used to assess practical skills and knowledge. The following examples, in combination, are appropriate for this unit:

evaluating an integrated activity, which combines the elements of competency for the unit, or a cluster of related units of competency

observing processes and procedures in workplaces

verbal or written questioning on underpinning knowledge and skills

evaluating samples of work

accessing and validating third party reports

setting and reviewing workplace projects and business simulations or scenarios.

Guidance information for assessment

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.

Required skills

highly developed communication skills to:

determine and confirm information, using questioning and active listening as required

relate effectively to customers

liaise with others, share information, listen and understand

use language and concepts appropriate to cultural differences

well-developed numeracy and IT skills to:

perform calculations related to achieving required outcomes

use computer applications (word processing, spreadsheet, database, specific purpose computer systems) to undertake analysis and generate reports

access and update records electronically

access web-based information services

well-developed literacy skills to read and interpret documentation from a variety of sources and record and consolidate relevant related information

learning skills to maintain knowledge of changes to compliance legislation and requirements

problem solving skills to identify any issues that have the potential to impact on work outcomes and to develop options to resolve these issues when they arise

self-management skills for complying with ethical, legal and procedural requirements research and analysis skills for accessing and interpreting relevant information

organisational skills, including the ability to plan and sequence work

Required knowledge

claims policies and procedures

data analysis techniques

industry trends in claims handling

type of claims events and possible remediation strategies

The range statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised wording, if used in the performance criteria, is detailed below. Essential operating conditions that may be present with training and assessment (depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts) may also be included.

Data may include:

claim statistic reports

claims history

claims reports

costs

declinature claims

frequency of events

inter-disciplinary rehabilitation (IDR) referrals

occupational health and safety reports

surveys

type of events.

Sources of information may include:

occupational health and safety (OHS) reports

previous policies and historical documents

reports on claims

surveys.

Documentation may include:

claims frequency

claims settlement costs

loss ratios

premium calculations/income

premium income

reports on claims

surveys.

Relevant information may include:

changes to type of business conducted

claims impact on client policy premiums

client operating conditions

client organisation or organisational structure or financial arrangements

industry trends, regulations

internal or external factors impacting premiums

legislative, industry or economic changes.

Changes may include:

OHS and environmental practices

organisation processes and procedures

relevant return to work, health strategies.

Sources of advice may include:

industry consultants

industry specialists

OHS and Return to Work specialists

specialist brokers.

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
Data gathering processes are designed and implemented 
New data requirements and sources are identified and process for collecting the data established 
Data collected is analysed to identify trends and trends are documented 
Accurate and timely claims reports are prepared to document trends and identify issues where appropriate 
Relevant information which impacts on a client portfolio is communicated promptly to management according to organisation procedures 
Assist clients identify changes to policies and procedures to improve occupational health and safety and return to work practices and minimise claims costs in similar circumstances 
Advice to clients is communicated effectively promoting positive action 
Sources of advice are provided to client where required 

Forms

Assessment Cover Sheet

FNSISV508A - Review and advise on claims costs, policies and procedures
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

FNSISV508A - Review and advise on claims costs, policies and procedures

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: