Settle non-routine and complex claims

Formats and tools

Unit Description
Reconstruct the unit from the xml and display it as an HTML page.
Assessment Tool
an assessor resource that builds a framework for writing an assessment tool
Assessment Template
generate a spreadsheet for marking this unit in a classroom environment. Put student names in the top row and check them off as they demonstrate competenece for each of the unit's elements and performance criteria.
Assessment Matrix
a slightly different format than the assessment template. A spreadsheet with unit names, elements and performance criteria in separate columns. Put assessment names in column headings to track which performance criteria each one covers. Good for ensuring that you've covered every one of the performance criteria with your assessment instrument (all assessement tools together).
Wiki Markup
mark up the unit in a wiki markup codes, ready to copy and paste into a wiki page. The output will work in most wikis but is designed to work particularly well as a Wikiversity learning project.
Evidence Guide
create an evidence guide for workplace assessment and RPL applicants
Competency Mapping Template
Unit of Competency Mapping – Information for Teachers/Assessors – Information for Learners. A template for developing assessments for a unit, which will help you to create valid, fair and reliable assessments for the unit, ready to give to trainers and students
Observation Checklist
create an observation checklist for workplace assessment and RPL applicants. This is similar to the evidence guide above, but a little shorter and friendlier on your printer. You will also need to create a seperate Assessor Marking Guide for guidelines on gathering evidence and a list of key points for each activity observed using the unit's range statement, required skills and evidence required (see the unit's html page for details)

Self Assessment Survey
A form for students to assess thier current skill levels against each of the unit's performance criteria. Cut and paste into a web document or print and distribute in hard copy.
Moodle Outcomes
Create a csv file of the unit's performance criteria to import into a moodle course as outcomes, ready to associate with each of your assignments. Here's a quick 'how to' for importing these into moodle 2.x
Registered Training Organisations
Trying to find someone to train or assess you? This link lists all the RTOs that are currently registered to deliver FNSISV511A, 'Settle non-routine and complex claims'.
Google Links
links to google searches, with filtering in place to maximise the usefulness of the returned results
Books
Reference books for 'Settle non-routine and complex claims' on fishpond.com.au. This online store has a huge range of books, pretty reasonable prices, free delivery in Australia *and* they give a small commission to ntisthis.com for every purchase, so go nuts :)


Elements and Performance Criteria

ELEMENT

PERFORMANCE CRITERIA

1. Determine terms and conditions of settlement

1.1. Non-routine aspects of the claim are determined and evaluated in light of the policy wording and the general policy of the organisation

1.2. Organisation claims procedures for non-routine/complex claims are followed where required

1.3. Settlement terms are determined according to policy wording, legislation, organisation operating procedures and codes of practice, taking into account the non-routine aspects of the claim

1.4. Type and level of variation to standard claims settlement is identified in order to establish type of negotiation or mediation that may be required and to ensure logical, persuasive and technically correct claims interpretations can be applied

2. Negotiate and communicate settlement terms

2.1. Terms and conditions of settlement offer are promptly advised to client and/or relevant party, according to claims procedures

2.2. Response by client and/or relevant party to terms of settlement offer is considered to assess whether adjustment is required

2.3. Settlement terms are negotiated where required to reach mutual agreement, to meet obligations and to minimise unnecessary loss to the organisation

2.4. Negotiated settlements are supported with suitable documentation that clearly states agreements reached

2.5. Terms of settlement offer are modified as necessary and client and/or relevant party advised promptly

3. Document liability decisions

3.1. Decisions are clearly communicated to the relevant parties in a manner required by the legislation, operating procedures and codes of practice

3.2. Decisions are documented in such a way as to determine the basis on which the decision was reached and all the evidence/information that was considered

3.3. Any aspects of the claim relevant to policy wording and general organisation policy are communicated to relevant personnel

4. Finalise settlement

4.1. Once settlement is reached, final payments are made in the required timeframe

4.2. Settlement release is obtained from client and/or third party, as applicable

4.3. Discharge is obtained to ensure any potential for further liability is eliminated

5. Identify any required changes to policy or procedures

5.1. Circumstances of claim are documented for consideration in portfolio review

5.2. Changes to policy and procedures are instigated to minimise further loss in similar circumstances, if appropriate

6. Report findings and update records

6.1. Actions, procedures and outcomes are documented and recorded promptly and accurately

6.2. Stakeholders are provided with accurate and timely advice regarding the claim settlement

6.3. Finalised claims files are stored and maintained according to organisation policy and legislative requirements and codes of practice, as applicable


Qualifications and Skillsets

FNSISV511A appears in the following qualifications:

  • FNS51110 - Diploma of General Insurance