Application
This unit describes the skills and knowledge required to identify all available options for settlement and to assist in the settlement process relating to loss situations, damage or injury including dispute resolution in the case of contention within the settlement process.
It applies to individuals in the loss adjusting sector who use specialised knowledge, well-developed organisational skills and strong communication skills to effectively negotiate with a range of personnel. It may be applied within organisations of various sizes and across a range of customer bases.
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.
Elements and Performance Criteria
ELEMENT | PERFORMANCE CRITERIA |
Elements describe the essential outcomes. | Performance criteria describe the performance needed to demonstrate achievement of the element. |
1. Prepare for negotiation | 1.1 Accurately identify all relevant issues and options for settlement in advance 1.2 Obtain additional information to support identified options from relevant sources and parties 1.3 Carry out cost–benefit analysis on various options identified 1.4 Document and accurately prepare settlement options in professional format prior to negotiations, and in accordance with client or organisational policy and guidelines and with relevant legislation or codes of practice |
2. Attend meetings with involved parties | 2.1 Document and accurately prepare all information and data needed for settlement meetings in professional format prior to meetings 2.2 Arrange and conduct meetings of involved parties in orderly, courteous and professional manner to ensure resolution of issues and settlement 2.3 Accurately document and promptly convey outcomes of meetings between involved parties to clients and all other parties 2.4 Promptly make available, where appropriate, all documents and information processed as part of loss adjustment activities to other involved parties |
3. Represent clients in cases where disputation arises | 3.1 Represent clients or organisational interests satisfactorily and provide all relevant documents and information to other involved parties 3.2 Manage disputations courteously and professionally to ensure best and most expeditious outcome for clients or organisations at minimum monetary and other costs |
Evidence of Performance
Evidence of the ability to:
undertake a cost–benefit analysis of a loss situation and recommend appropriate action
apply security practices and principles
use risk management and minimisation practices
develop a settlement document with options for consideration
maintain and apply up-to-date knowledge of the types and categories of insurance policies relevant to loss adjusting.
Note: If a specific volume or frequency is not stated, then evidence must be provided at least once.
Evidence of Knowledge
explain the key features of:
claims management processes and procedures
recovery processes
relevant policy coverage and requirements
salvage and disposal methods
subrogation
types and categories of insurance policies
identify and describe the key features of:
insurance and contract law principles
loss adjusting principles and practice
relevant legislation and industry codes of practice
risk management and minimisation principles and techniques.
Assessment Conditions
Assessment must be conducted in a safe environment where evidence gathered demonstrates consistent performance of typical activities experienced in the insurance loss adjusting field of work and include access to:
organisational records
organisational policy, procedures, legislation and regulations as they relate to contracts of insurance
common office equipment, technology, software and consumables.
Assessors must satisfy NVR/AQTF assessor requirements.
Foundation Skills
This section describes language, literacy, numeracy and employment skills incorporated in the performance criteria that are required for competent performance.
Skill | Performance Criteria | Description |
Reading | 1.1, 1.2 | Critically analyses complex documentation from a variety of sources and consolidates information relating to specific criteria to determine requirements |
Writing | 1.4, 2.1, 2.3 | Accurately records and completes organisational documents and correspondence using clear language and correct spelling, grammar and terminology Writes, edits and proofreads reports to ensure clarity of meaning, and accuracy and consistency of information |
Oral Communication | 1.2, 2.2, 2.3, 3.2 | Participates in verbal exchanges, clearly presenting a case using language, tone and pace appropriate to the audience and environment Uses listening and questioning techniques to elicit the views and opinions of others and to confirm understanding |
Numeracy | 1.3, 1.4, 2.1 | Performs calculations and uses mathematical problem-solving techniques to analyse numerical and financial data |
Navigate the world of work | 1.4, 3.1 | Takes full responsibility for following policies, procedures and legislative requirements and identifies the organisational implications of new legislation or regulation |
Interact with others | 1.2, 2.2-2.4, 3.1, 3.2 | Implements strategies for a diverse range of colleagues and clients to build rapport, foster strong relationships and negotiate positive outcomes Manages conflict through the recognition of contributing factors and by implementing strategies to resolve it |
Get the work done | 1.4, 2.1-2.4, 3.1, 3.2 | Accepts responsibility for planning and sequencing complex tasks and workload, negotiating key aspects with others and taking into account capabilities, efficiencies and effectiveness Responds intuitively to problems requiring immediate resolution, drawing on past experiences to focus on the cause of a problem Applies systematic and analytical decision-making processes for complex and non-routine situations Uses the main features and functions of digital tools to complete work tasks and access information |
Sectors
Insurance loss adjusting