NTISthis.com

Evidence Guide: FNSIBK404 - Provide a claims service to an insurance broking client

Student: __________________________________________________

Signature: _________________________________________________

Tips for gathering evidence to demonstrate your skills

The important thing to remember when gathering evidence is that the more evidence the better - that is, the more evidence you gather to demonstrate your skills, the more confident an assessor can be that you have learned the skills not just at one point in time, but are continuing to apply and develop those skills (as opposed to just learning for the test!). Furthermore, one piece of evidence that you collect will not usualy demonstrate all the required criteria for a unit of competency, whereas multiple overlapping pieces of evidence will usually do the trick!

From the Wiki University

 

FNSIBK404 - Provide a claims service to an insurance broking client

What evidence can you provide to prove your understanding of each of the following citeria?

Register claim

  1. Use internal broking claims system to register and process client’s claim in comprehensive and detailed manner
  2. Update claims recording system regularly and accurately to minimise processing time
Use internal broking claims system to register and process client’s claim in comprehensive and detailed manner

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Update claims recording system regularly and accurately to minimise processing time

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Advise insurers and complete necessary documentation

  1. Verify appointment of loss adjuster immediately on receiving claim
  2. Seek formal acknowledgment of receipt of claim immediately from insurers
  3. Make formal claims reports within brokerage time requirements
  4. Provide assistance to client to complete claims documentation, when required
  5. Ensure full and accurate information is available to insurers in assessing claim
Verify appointment of loss adjuster immediately on receiving claim

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Seek formal acknowledgment of receipt of claim immediately from insurers

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Make formal claims reports within brokerage time requirements

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Provide assistance to client to complete claims documentation, when required

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Ensure full and accurate information is available to insurers in assessing claim

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Advise client of rights and obligations

  1. Formally request insurer to reinstate sum insured where required and inform client where reinstatement occurs
  2. Review terms and conditions of insurance policy with client to ensure maximum claims recovery is sought
  3. Advise client on administration of claims to ensure no breach of contract occurs and claims are managed efficiently
  4. Advise client of appropriate legislative requirements to protect client’s interests
Formally request insurer to reinstate sum insured where required and inform client where reinstatement occurs

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Review terms and conditions of insurance policy with client to ensure maximum claims recovery is sought

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Advise client on administration of claims to ensure no breach of contract occurs and claims are managed efficiently

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Advise client of appropriate legislative requirements to protect client’s interests

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Liaise with service providers

  1. Identify need for independent service providers with suitable expertise for claim, where settlement authority exists
  2. Engage suitable service provider based on client’s instructions where settlement authority exists
  3. Brief service provider thoroughly to ensure any investigation is comprehensive where settlement authority exists
Identify need for independent service providers with suitable expertise for claim, where settlement authority exists

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Engage suitable service provider based on client’s instructions where settlement authority exists

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Brief service provider thoroughly to ensure any investigation is comprehensive where settlement authority exists

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Review and assess service provider’s report within agreed timeframes where settlement authority exists

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Maintain contact with insurer’s service provider to ensure reports and issues are dealt with promptly

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Notify terms of settlement to client and update files and records

  1. 5.1 Prepare details of insurer's settlement offer without delay, with recommendations for client to review
  2. Obtain and act on client’s response to settlement offer without delay
  3. Remit settlement funds to client in accordance with legislative requirements and business policy and procedures
  4. Update business records promptly according to brokerage policy and guidelines
5.1 Prepare details of insurer's settlement offer without delay, with recommendations for client to review

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Obtain and act on client’s response to settlement offer without delay

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Remit settlement funds to client in accordance with legislative requirements and business policy and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Update business records promptly according to brokerage policy and guidelines

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assessed

Teacher: ___________________________________ Date: _________

Signature: ________________________________________________

Comments:

 

 

 

 

 

 

 

 

Instructions to Assessors

Evidence Guide

ELEMENT

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Register claim

1.1 Use internal broking claims system to register and process client’s claim in comprehensive and detailed manner

1.2 Update claims recording system regularly and accurately to minimise processing time

2. Advise insurers and complete necessary documentation

2.1 Verify appointment of loss adjuster immediately on receiving claim

2.2 Seek formal acknowledgment of receipt of claim immediately from insurers

2.3 Make formal claims reports within brokerage time requirements

2.4 Provide assistance to client to complete claims documentation, when required

2.5 Ensure full and accurate information is available to insurers in assessing claim

3. Advise client of rights and obligations

3.1 Formally request insurer to reinstate sum insured where required and inform client where reinstatement occurs

3.2 Review terms and conditions of insurance policy with client to ensure maximum claims recovery is sought

3.3 Advise client on administration of claims to ensure no breach of contract occurs and claims are managed efficiently

3.4 Advise client of appropriate legislative requirements to protect client’s interests

4. Liaise with service providers

4.1 Identify need for independent service providers with suitable expertise for claim, where settlement authority exists

4.2 Engage suitable service provider based on client’s instructions where settlement authority exists

4.3 Brief service provider thoroughly to ensure any investigation is comprehensive where settlement authority exists

Review and assess service provider’s report within agreed timeframes where settlement authority exists

Maintain contact with insurer’s service provider to ensure reports and issues are dealt with promptly

5. Notify terms of settlement to client and update files and records

5.1 Prepare details of insurer's settlement offer without delay, with recommendations for client to review

5.2 Obtain and act on client’s response to settlement offer without delay

5.3 Remit settlement funds to client in accordance with legislative requirements and business policy and procedures

5.4 Update business records promptly according to brokerage policy and guidelines

Required Skills and Knowledge

ELEMENT

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Register claim

1.1 Use internal broking claims system to register and process client’s claim in comprehensive and detailed manner

1.2 Update claims recording system regularly and accurately to minimise processing time

2. Advise insurers and complete necessary documentation

2.1 Verify appointment of loss adjuster immediately on receiving claim

2.2 Seek formal acknowledgment of receipt of claim immediately from insurers

2.3 Make formal claims reports within brokerage time requirements

2.4 Provide assistance to client to complete claims documentation, when required

2.5 Ensure full and accurate information is available to insurers in assessing claim

3. Advise client of rights and obligations

3.1 Formally request insurer to reinstate sum insured where required and inform client where reinstatement occurs

3.2 Review terms and conditions of insurance policy with client to ensure maximum claims recovery is sought

3.3 Advise client on administration of claims to ensure no breach of contract occurs and claims are managed efficiently

3.4 Advise client of appropriate legislative requirements to protect client’s interests

4. Liaise with service providers

4.1 Identify need for independent service providers with suitable expertise for claim, where settlement authority exists

4.2 Engage suitable service provider based on client’s instructions where settlement authority exists

4.3 Brief service provider thoroughly to ensure any investigation is comprehensive where settlement authority exists

Review and assess service provider’s report within agreed timeframes where settlement authority exists

Maintain contact with insurer’s service provider to ensure reports and issues are dealt with promptly

5. Notify terms of settlement to client and update files and records

5.1 Prepare details of insurer's settlement offer without delay, with recommendations for client to review

5.2 Obtain and act on client’s response to settlement offer without delay

5.3 Remit settlement funds to client in accordance with legislative requirements and business policy and procedures

5.4 Update business records promptly according to brokerage policy and guidelines

Evidence of the ability to:

follow organisational procedures to complete a claims register accurately and process client claims

provide the client with accurate and easily understood advice regarding contract terms and conditions and insurance procedures

prepare a report on the settlement offer for client review

research appropriate service providers for provision of claims services.

Note: If a specific volume or frequency is not stated, then evidence must be provided at least once.

To complete the unit requirements safely and effectively, the individual must:

explain the application of the brokerage claims systems and procedures

explain the responsibility of the adviser in the claims process

outline the process for analysing insurance contract terms and conditions in relation to the claims process

explain the relevant legislation and code of practice requirements that are to be met by the adviser dealing with client claims.