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

FNSPIM402A Mapping and Delivery Guide
Represent personal injury management agent or insurer at conciliation and review hearings

Version 1.0
Issue Date: May 2024


Qualification -
Unit of Competency FNSPIM402A - Represent personal injury management agent or insurer at conciliation and review hearings
Description This unit describes the performance outcomes, skills and knowledge required to represent personal injury management agents or insurers at formal or informal conciliation and review hearings. It encompasses application of relevant State or Territory legislative requirements in relation to personal injury management, knowledge of organisation policies and procedures, and external conciliation processes.This unit may apply to job roles subject to licensing, legislative, regulatory or certification requirements so Commonwealth, State or Territory requirements should be confirmed with the relevant body.
Employability Skills This unit contains employability skills.
Learning Outcomes and Application This unit may be relevant for case managers and technical managers and applied within the claims handling area of the personal injury management sector.
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: Prepare for hearings of disputes
  • Review of decision is made by contacting the person, relevant parties and the treating doctor where relevant, and considering any new/additional information provided
  • Additional information is obtained from relevant parties as required and provided to stakeholders
  • All parties affected by the decision are clearly and promptly advised of their review rights in accordance with legislative requirements
       
Element: Present cases at conciliation conferences
  • Appropriate forms are completed in accordance with conciliation office requirements and referred to the conciliation office
  • Conciliation conference is arranged to bring the parties to agreement and reach conciliation
  • Formal notification documenting the outcome of conciliation, including any disputes is provided to all relevant parties
       
Element: Present case in court/tribunal/review hearings
  • Courts are provided with all relevant documentation prior to pre-hearing conference
  • Insurers manage matter before the court or tribunal in a matter that achieves the best and most expeditious resolution at minimum cost
       


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:

interpret and comply with industry and organisation obligations and objectives

negotiate effectively on behalf of the organisation and build client relationships

understand conciliation and review hearing procedures and requirements

effectively prepare for and represent the agent's or insurer's interests at review hearings.

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.

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

Well-developed communication skills to:

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

liaise with others, share information, listen and understand

negotiate and advocate for clients

make effective and clear presentations

write business reports

use language and concepts appropriate to cultural differences

numeracy and IT skills to:

perform calculations related to achieving required outcomes

use computer applications (word processing, spreadsheet, database, specific purpose computer systems) to assist in achieving required outcomes

access and update records electronically

use internet information

well-developed literacy skills to:

read and interpret documentation from a variety of sources and record and consolidate relevant related information

interpret and apply policy

research and analysis skills for accessing and interpreting relevant information

effective interpersonal skills

organisation skills, including the ability to plan and sequence work

research skills

risk assessment skills

Required knowledge

common law, legal systems and procedures, relevant acts

organisation policy, procedures, underwriting guidelines and authorities

industry and organisation policy wording

industry compliance requirements

relevant information technology and communications systems

risk prevention methods and application

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.

Relevant parties may include:

employer and industry associations

family members

medical and like providers

workers compensation, personal injury authority

self insurer

the authorised insurer

the community

the employer

unions and union representatives.

Conciliation conferences may include:

formal legal proceedings

informal meetings between the disputing parties.

Disputes may involve:

insurer's procedures including failure to meet response time limits set for both informal and formal disputes resolution made direct to the insurer by any of the parties involved in the claim

liability

medical and like providers/panels.

Documentation may include:

assessor's reports and reports from medical and like providers

medical panels

rehabilitation providers

the employer.

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
Review of decision is made by contacting the person, relevant parties and the treating doctor where relevant, and considering any new/additional information provided 
Additional information is obtained from relevant parties as required and provided to stakeholders 
All parties affected by the decision are clearly and promptly advised of their review rights in accordance with legislative requirements 
Appropriate forms are completed in accordance with conciliation office requirements and referred to the conciliation office 
Conciliation conference is arranged to bring the parties to agreement and reach conciliation 
Formal notification documenting the outcome of conciliation, including any disputes is provided to all relevant parties 
Courts are provided with all relevant documentation prior to pre-hearing conference 
Insurers manage matter before the court or tribunal in a matter that achieves the best and most expeditious resolution at minimum cost 

Forms

Assessment Cover Sheet

FNSPIM402A - Represent personal injury management agent or insurer at conciliation and review hearings
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

FNSPIM402A - Represent personal injury management agent or insurer at conciliation and review hearings

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: