Application
This unit describes the performance outcomes required to identify and report fraud indicators associated with a vehicle insurance claim.
The unit applies to those who identify signs of fraudulent activity on inspection of vehicles; collecting and evaluating information, and providing a written assessment report. Work may relate to light vehicles, commercial vehicles, heavy vehicles, agricultural and plant equipment, recreational vehicles and motorcycles.
Licensing, legislative, regulatory or certification requirements may apply to this unit in some jurisdictions. Users are advised to check with the relevant regulatory authority.
Elements and Performance Criteria
ELEMENTS | PERFORMANCE CRITERIA |
Elements describe the essential outcomes | Performance criteria describe the performance needed to demonstrate achievement of the element. Where bold italicised text is used, further information is detailed in the range of conditions section |
1. Prepare for vehicle assessment | 1.1 Assessment information is gathered 1.2 Assessment information is reviewed and interpreted 1.3 Safety requirements relating to vehicle claim fraud indicators are identified |
2. Inspect the vehicle for fraud | 2.1 Fraud indicators are identified and recorded 2.2 Workplace policies and procedures, industry guidelines and legal requirements are read and interpreted 2.3 Vehicle is assessed in line with compliance requirements |
3. Determine suitable action | 3.3 Possible actions to deal with fraud indicators are determined 3.2 Action consistent with nature of claim, assessment made, and workplace and legal restraints is decided |
4. Prepare assessment report | 4.1 Comprehensive report is prepared specifying full results of identified fraud and vehicle assessment 4.2 Recommendations are documented, including actions and justifications 4.3 Report is submitted and filed according to workplace procedures |
Foundation Skills
This section describes those language, literacy, numeracy and employment skills that are essential to performance and are not explicit in the performance criteria.
Skills | Description |
Reading skills to: | interpret information relating to automotive insurance claims and assessment information. |
Writing skills to: | write a comprehensive assessment report integrating information from a range of sources and using appropriate support material, such as photographs and measurements. |
Oral communication skills to: | gather and interpret information from customers and others relating to a fraudulent vehicle insurance claim. |
Numeracy skills to: | use calculations of actual damage when reviewing vehicle claims to identify and report vehicle claim fraud indicators. |
Problem-solving skills to: | establish diagnostic processes relating to identifying and reporting vehicle claim fraud indicators. |
Teamwork skills to: | work effectively with customers, repairers and supervisors. |
Range Statement
This section specifies work environments and conditions that may affect performance. Essential operating conditions that may be present (depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts) are included. Bold italicised wording, if used in the performance criteria, is detailed below.
Assessment information must include: | assessment notification detailing: claims handler insurance policy details where applicable vehicle owner details vehicle details driver details incident details vehicle inspection details, including assess without prejudice or assess and authorise digital images quote for repairs or total loss determination. |
Safety requirements | first aid equipment personal protective equipment and clothing safety equipment. |
Fraud indicators must include two of the following: | claim report inconsistent with vehicle damage manufactured damage staged accidents. |
Workplace policies and procedures must include: | recording and reporting procedures safe work procedures. |
Industry guidelines must include: | instructions issued by authorised organisation or external persons industry codes of practice verbal, written and graphical instructions. |
Legal requirements are to be in accordance with applicable commonwealth, state or territory legislation, regulations, certification requirements and codes of practice, and must include: | commercial-in-confidence practices Competition and Consumer Act confidentiality and privacy Motor Vehicle Insurance and Repair Industry Code of Conduct personal legal liability relevant industry codes of practice Written-Off Vehicles Register (WOVR) managed by each State and Territory. |
Sectors
Regulatory and Legal
Competency Field
Vehicle Body