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

FNSISV527 Mapping and Delivery Guide
Implement insurance claim recovery procedures

Version 1.0
Issue Date: May 2024


Qualification -
Unit of Competency FNSISV527 - Implement insurance claim recovery procedures
Description
Employability Skills
Learning Outcomes and Application This unit describes the skills and knowledge required to recover money relating to an insurance claim. It encompasses the complete process, from initiating the recovery to finalisation of the claim.The unit applies to those who work in job roles such as underwriting. It involves specialist knowledge and functions in a range of insurance sectors, and may be applied in organisations of various sizes and across a range of client 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 records

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

common technology and software required to implement insurance claim recovery.

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: Establish viability of recovery
  • Identify sources and rights of recovery
  • Calculate achievable recovery amount
  • Evaluate extent of recovery success
       
Element: Evaluate recovery methods
  • Determine recovery method based on assessing benefit to organisation and according to organisational operating procedures
  • Confirm that selected recovery method is appropriate to circumstances of loss and compliant with legislative and organisational requirements
       
Element: Implement and monitor recovery progress and negotiate recovery
  • Issue demand to responsible party and appoint agents to undertake loss recovery, as required
  • Confirm knock for knock, as required
  • Make referral to solicitor and other relevant service provider, as required
  • Implement and follow up recovery within required timeframes and according to organisational procedures
  • Negotiate recovery settlement within required timeframes and according to organisational procedures
       
Element: Process monies and record outcomes
  • Confirm receipt of recovery amounts
  • Prepare payment information and facilitation of claim payment, as required
  • Make recommendation to relevant team on payment of client’s share of recovery money, as required
  • Finalise claims according to legislation, regulations, organisational operating procedures and codes of practice, as required
  • Update required records and advise underwriter of any special circumstances, as 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 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:

implement claim recovery procedures for at least three different insurance claims.

In the course of the above, the candidate must:

collate information and determine viability of the recovery

review options and determine a suitable claim recovery method

engage in negotiations to secure settlement conditions

calculate achievable recovery amounts

oversee financial transactions of payments

maintain accurate records.

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 requirements, regulatory guidelines and industry sector compliance requirements as they apply to:

insurance contracts

consumer protection

privacy

collection of monies

Corporations Act

General Insurance Code of Practice

organisational policies, procedures, insurance guidelines and key stakeholders in claim recovery processes

legal aspects of insurance agents and brokers that apply when implementing claim recovery procedures

key aspects of claim recovery methods and their application

techniques for negotiating recovery settlements

insurance fundamentals and methods to interpret and apply policy wording, including rights of subrogation

key aspects of procedures of claims recovery from reinsurance

legal precedents and previous organisational results for insurance claims recovery.


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
Identify sources and rights of recovery 
Calculate achievable recovery amount 
Evaluate extent of recovery success 
Determine recovery method based on assessing benefit to organisation and according to organisational operating procedures 
Confirm that selected recovery method is appropriate to circumstances of loss and compliant with legislative and organisational requirements 
Issue demand to responsible party and appoint agents to undertake loss recovery, as required 
Confirm knock for knock, as required 
Make referral to solicitor and other relevant service provider, as required 
Implement and follow up recovery within required timeframes and according to organisational procedures 
Negotiate recovery settlement within required timeframes and according to organisational procedures 
Confirm receipt of recovery amounts 
Prepare payment information and facilitation of claim payment, as required 
Make recommendation to relevant team on payment of client’s share of recovery money, as required 
Finalise claims according to legislation, regulations, organisational operating procedures and codes of practice, as required 
Update required records and advise underwriter of any special circumstances, as required 

Forms

Assessment Cover Sheet

FNSISV527 - Implement insurance claim recovery 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

FNSISV527 - Implement insurance claim recovery 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: