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

FNSISV513 Mapping and Delivery Guide
Provide decisions on legal liability and indemnity of a claim

Version 1.0
Issue Date: May 2024


Qualification -
Unit of Competency FNSISV513 - Provide decisions on legal liability and indemnity of a claim
Description
Employability Skills
Learning Outcomes and Application This unit describes the skills and knowledge required to convey decisions to ensure stakeholders receive accurate, timely advice regarding the legal liability and indemnity of a claim.It applies to individuals working in roles that require high level communication, analysis and decision-making skills to provide advice on the legal liability and indemnity of a claim to key stakeholders.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: Monitor claims to support decision-making process
  • Establish monitoring procedures to ensure that validity of claim is assessed against organisational and policy acceptance criteria for relevant type and category of policy
  • Monitor claims practices to ensure that information used to determine claim validity is accurate, comprehensive and authentic
       
Element: Decide on legal liability and indemnity of claim
  • Review relevant information and data to determine legal liability and indemnity of claim
  • Make decisions that comply with relevant legislation, organisational procedures and underwriting guidelines
  • Review decisions to ensure accuracy and that compliance requirements are fully met
       
Element: Provide stakeholders with accurate, timely advice regarding legal liability and indemnity of claim
  • Provide stakeholders with consistent, accurate and timely advice regarding claim
  • Provide technical and non-technical claims advice to claims specialists, including review of outgoing correspondence and negotiation and settlement strategies, as appropriate
  • Provide stakeholders with accurate and timely advice regarding legal liability and indemnity of claim
  • Convey decisions within timeframes to ensure performance targets are achieved
       
Element: Review decisions and identify any required policy or procedural changes
  • Evaluate and review decisions against requirements and outcomes on regular basis
  • Ensure review process identifies extent to which decisions support process of accepting and managing claim
  • Ensure review process identifies extent to which decisions support setting of accurate claim portfolio reserves
  • Document circumstances of claims and decisions concerning legal liability and indemnity of claim for consideration in portfolio review
  • Instigate changes to policy and procedures to minimise further loss in similar circumstances, if appropriate
       
Element: Update records
  • Document actions, procedures and outcomes, and record promptly and accurately
  • Maintain finalised documentation according to organisational policy and legislative requirements and codes of practice, as applicable
       


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. Monitor claims to support decision-making process

1.1 Establish monitoring procedures to ensure that validity of claim is assessed against organisational and policy acceptance criteria for relevant type and category of policy

1.2 Monitor claims practices to ensure that information used to determine claim validity is accurate, comprehensive and authentic

2. Decide on legal liability and indemnity of claim

2.1 Review relevant information and data to determine legal liability and indemnity of claim

2.2 Make decisions that comply with relevant legislation, organisational procedures and underwriting guidelines

2.3 Review decisions to ensure accuracy and that compliance requirements are fully met

3. Provide stakeholders with accurate, timely advice regarding legal liability and indemnity of claim

3.1 Provide stakeholders with consistent, accurate and timely advice regarding claim

3.2 Provide technical and non-technical claims advice to claims specialists, including review of outgoing correspondence and negotiation and settlement strategies, as appropriate

3.3 Provide stakeholders with accurate and timely advice regarding legal liability and indemnity of claim

3.4 Convey decisions within timeframes to ensure performance targets are achieved

4. Review decisions and identify any required policy or procedural changes

4.1 Evaluate and review decisions against requirements and outcomes on regular basis

4.2 Ensure review process identifies extent to which decisions support process of accepting and managing claim

4.3 Ensure review process identifies extent to which decisions support setting of accurate claim portfolio reserves

4.4 Document circumstances of claims and decisions concerning legal liability and indemnity of claim for consideration in portfolio review

4.5 Instigate changes to policy and procedures to minimise further loss in similar circumstances, if appropriate

5. Update records

5.1 Document actions, procedures and outcomes, and record promptly and accurately

5.2 Maintain finalised documentation according to organisational policy and legislative requirements and codes of practice, as applicable

Evidence of the ability to:

effectively establish and implement monitoring processes

make decisions on legal liability and indemnity within given parameters

advise clients of decisions in a timely manner

initiate changes to policies and procedures to better support organisational goals

document all aspects of the process

apply organisational policy and procedures, and comply with legislation, regulations and industry codes of practice in the determination and provision of legal and indemnity advice associated with a claim.

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:

explain the claims management process

outline data analysis techniques and procedures

identify and outline key features of relevant legislation, regulatory guidelines and industry sector codes of practice as they apply to legal liability and indemnity in insurance claims

outline information technology and communications systems

explain the principles and practice of loss adjustment

outline key features of organisational policy, procedures, insurance guidelines and levels of authority

outline and explain the importance of wording of insurance policies in keeping with the organisation or industry sector

explain risk prevention and loss minimisation methods and application

identify types and categories of 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.

ELEMENT

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

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

1. Monitor claims to support decision-making process

1.1 Establish monitoring procedures to ensure that validity of claim is assessed against organisational and policy acceptance criteria for relevant type and category of policy

1.2 Monitor claims practices to ensure that information used to determine claim validity is accurate, comprehensive and authentic

2. Decide on legal liability and indemnity of claim

2.1 Review relevant information and data to determine legal liability and indemnity of claim

2.2 Make decisions that comply with relevant legislation, organisational procedures and underwriting guidelines

2.3 Review decisions to ensure accuracy and that compliance requirements are fully met

3. Provide stakeholders with accurate, timely advice regarding legal liability and indemnity of claim

3.1 Provide stakeholders with consistent, accurate and timely advice regarding claim

3.2 Provide technical and non-technical claims advice to claims specialists, including review of outgoing correspondence and negotiation and settlement strategies, as appropriate

3.3 Provide stakeholders with accurate and timely advice regarding legal liability and indemnity of claim

3.4 Convey decisions within timeframes to ensure performance targets are achieved

4. Review decisions and identify any required policy or procedural changes

4.1 Evaluate and review decisions against requirements and outcomes on regular basis

4.2 Ensure review process identifies extent to which decisions support process of accepting and managing claim

4.3 Ensure review process identifies extent to which decisions support setting of accurate claim portfolio reserves

4.4 Document circumstances of claims and decisions concerning legal liability and indemnity of claim for consideration in portfolio review

4.5 Instigate changes to policy and procedures to minimise further loss in similar circumstances, if appropriate

5. Update records

5.1 Document actions, procedures and outcomes, and record promptly and accurately

5.2 Maintain finalised documentation according to organisational policy and legislative requirements and codes of practice, as applicable

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
Establish monitoring procedures to ensure that validity of claim is assessed against organisational and policy acceptance criteria for relevant type and category of policy 
Monitor claims practices to ensure that information used to determine claim validity is accurate, comprehensive and authentic 
Review relevant information and data to determine legal liability and indemnity of claim 
Make decisions that comply with relevant legislation, organisational procedures and underwriting guidelines 
Review decisions to ensure accuracy and that compliance requirements are fully met 
Provide stakeholders with consistent, accurate and timely advice regarding claim 
Provide technical and non-technical claims advice to claims specialists, including review of outgoing correspondence and negotiation and settlement strategies, as appropriate 
Provide stakeholders with accurate and timely advice regarding legal liability and indemnity of claim 
Convey decisions within timeframes to ensure performance targets are achieved 
Evaluate and review decisions against requirements and outcomes on regular basis 
Ensure review process identifies extent to which decisions support process of accepting and managing claim 
Ensure review process identifies extent to which decisions support setting of accurate claim portfolio reserves 
Document circumstances of claims and decisions concerning legal liability and indemnity of claim for consideration in portfolio review 
Instigate changes to policy and procedures to minimise further loss in similar circumstances, if appropriate 
Document actions, procedures and outcomes, and record promptly and accurately 
Maintain finalised documentation according to organisational policy and legislative requirements and codes of practice, as applicable 

Forms

Assessment Cover Sheet

FNSISV513 - Provide decisions on legal liability and indemnity of a claim
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

FNSISV513 - Provide decisions on legal liability and indemnity of a claim

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: