Application
This unit applies to those engaged in the underwriting functions of companies within the life insurance sector.
Prerequisites
Not applicable.
Elements and Performance Criteria
1. Identify medical risks | 1.1 Review applications and associated documentation to identify relevant medical information 1.2 Interpret medical information to identify medical risk factors 1.3 Recognise the need for additional medical information and collect as appropriate |
2. Identify the underwriting significance | 2.1 Identify potential life risk implications of supplied medical information 2.2 Recognise interrelationships between medical conditions and the implications for medical risk factors 2.3 Identify long-term risk implications of medical treatment and recovery processes 2.4 Select and apply appropriate medical risks rating systems and risk handling techniques |
3. Determine risk acceptance criteria | 3.1 Determine risk acceptance criteria to suit type and context of risk in accordance with procedures 3.2 Assess the adequacy of medical information against risk acceptance criteria in accordance with procedures |
4. Prepare life insurance policy | 4.1 Develop terms of acceptance in accordance with market conditions and accepted levels of exposure 4.2 Document the life insurance policy with terms and conditions in accordance with procedures and regulatory requirements |
Required Skills
Required skills
communication skills to:
gather and check information
liaise and share information with others
communicate appropriately with people from diverse backgrounds
IT skills to:
use computer applications (word processing, spreadsheet, database, specific purpose computer systems)
access web-based information services
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 applications 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 underwriting of complex medical risks:
integrated actuarial, underwriting and medical information
life insurance administrative requirements
life insurance policy terms and conditions
life insurance risk management practices
medical treatment and recovery processes relative to insurance underwriting
organisational procedures
product information
relevant medical techniques, diseases, injuries and terminology relative to insurance underwriting
relevant regulatory requirements
types of medical risk and probability of occurrence.
Evidence Required
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 relation to medical risk assessment maintain and apply a thorough understanding of guidelines and administrative requirements apply underwriting policies and procedures 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 |
Range Statement
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.
Medical information may include: | advice from a senior underwriter and/or Chief Medical Officer adviser reports medical reports previous insurance history supplementary questionnaires medical specialties and the titles of doctors working in specialist fields illnesses injuries diseases description of the onset and/or nature of condition medical investigations and procedures treatments prognosis. |
Medical risk factors may relate to: | blood, spleen and lymphatic system cardiovascular system endocrine system gastro-intestinal system genitourinary system inherited disorders and family history mental disorders musculoskeletal system neurological system physical dimensions respiratory system tumours. |
Life risk is a potential change to health or wellbeing that would have an adverse effect on the financial sustainability of an individual, a family or a group, and may include: | death total and permanent disablement temporary loss of income resulting from accident or sickness traumatic sickness or injury. |
Medical risks rating systems and risk handling techniques may include: | cash extra loadings class systems exclusions numerical systems. |
Risk acceptance criteria may include: | exclusions loadings other specific terms and conditions standard cover conditions. |
Procedures may include: | organisational complaints handling processes organisational customer service charter organisational guidelines organisational policy organisational privacy and confidentiality guidelines organisational procedures. |
Regulatory requirements may include: | insurance contracts legislation life insurance legislation corporations legislation privacy legislation Australian Securities and Investments Commission (ASIC) regulatory guides Industry Codes of Practice. |
Sectors
Life insurance
Employability Skills
This unit contains employability skills.
Licensing Information
No licensing, legislative, regulatory or certification requirements apply to this unit at the time of publication.