Not applicable.
Not applicable.
1. Identify information needs | 1.1 Review claim files and life insurance policy to identify payment criteria 1.2 Identify additional information needed as evidence for claims assessment |
2. Plan information collection | 2.1 Identify appropriate sources of required proofs 2.2 Select and enact an appropriate information collection method |
3. Collect and manage information | 3.1 Collect additional information from appropriate sources in accordance with procedures 3.2 Manage investigations in accordance with ethical and regulatory requirements 3.3 Organise information for clarity and accessibility in accordance with procedures |
This section describes the skills and knowledge required for this unit.
Required skills
communication skills to:
liaise and share information with others
gather and check information
communicate appropriately with people from diverse backgrounds
IT skills to:
use computer applications (word processing, spreadsheet, database, specific purpose computer systems)
access and update records electronically
access web-based information services
numeracy skills to interpret numeric data and relevant statistics and perform calculations related to policy payments
organisational skills to efficiently plan and sequence work
problem solving skills to address errors in life insurance documentation
reading skills to:
read and understand relevant procedures
read and understand life insurance policies
read and interpret life insurance claims and supporting documentation
research and analysis skills to:
identify and interpret relevant information
analyse information and data
maintain currency of products and services knowledge
writing skills to:
accurately record information
prepare professional letters and emails.
Required knowledge
the ability to apply and explain as relevant to the evaluation of life insurance claims:
life insurance administrative requirements
life insurance policy payment criteria
life insurance policy terms and conditions
organisational procedures
organisational systems for data entry and filing
product information
relevant regulatory requirements.
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: apply analytical and administrative skills in the assessment of claims maintain and apply a thorough and up-to-date understanding of life insurance terms and conditions and claims processing maintain and apply a thorough and up-to-date understanding of life insurance administrative requirements perform tasks in accordance with relevant procedures and regulatory requirements. |
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 records access to organisational policies and procedures. |
Method of assessment | A range of assessment methods should be used to assess practical skills and knowledge. The following examples 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 setting and reviewing workplace projects and business simulations or scenarios |
Guidance information for assessment |
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.
Life insurance policy may include: | annuities (immediate or deferred) disability income endowment insurance bonds (investment only policies) term life (including terminal illness and Total and Permanent Disablement (TPD)) trauma whole of life. |
Payment criteria may include: | for ordinary policies: cancellation commutation (for annuities and other income streams) death (including terminal illness) invalidity (permanent or temporary disability) maturity rollover surrender trauma for superannuation policies: death (including terminal illness) invalidity (permanent or temporary disability) retirement rollover. satisfying another condition of release. |
Additional information may include: | medical evidence financial evidence interviews surveillance employment details specialist advice. |
Evidence may include: | proof of age proof of morbidity/disability proof of survival proof of title. |
Appropriate sources may include: | interviewing the claimant requesting reports and records speaking with professionals specialist advice surveillance. |
Procedures may include: | organisational complaints handling processes organisational customer service charter organisational guidelines organisational policy organisational privacy and confidentiality guidelines organisational procedures. |
Investigations may include: | financial investigations interviews medical investigations surveillance. |
Ethical and regulatory requirements may include: | Australian Securities and Investments Commission (ASIC) regulatory guides corporations legislation privacy legislation relevant professional Codes of Practice. |
Life insurance
This unit contains employability skills.
Not applicable.