Work with legal teams to resolve 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 FNSISV512, 'Work with legal teams to resolve complex claims'.
Google Links
links to google searches, with filtering in place to maximise the usefulness of the returned results
Books
Reference books for 'Work with legal teams to resolve 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

Elements describe the essential outcomes.

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

1. Establish requirements of legal proceedings for insurance claim

1.1 Establish comprehensive terms of reference or instructions relevant to legal proceedings for non-routine and complex claim

1.2 Check terms of reference to ensure they are within organisational and legislative guidelines, codes of practice and personal authorities, and are clearly documented

1.3 Negotiate, confirm and document roles and responsibilities of all parties involved in legal proceedings for claim

1.4 Clarify requirements and procedures of legal systems involved in claim proceedings, including domestic and/or other relevant countries

2. Provide relevant claims information to legal team

2.1 Identify legal team representatives and confirm information requirements

2.2 Discuss options for obtaining legal data and information, and identify sources of legal data and information

2.3 Collect facts, evidence and information relevant to claims proceedings thoroughly, systematically and accurately

2.4 Research historical data, as required

2.5 Analyse legal data and information for relevance

2.6 Identify information deficiencies and seek additional information from appropriate sources

2.7 Provide legal data and information to legal team in compliance with organisational policy and procedures, compliance, ethical and legal requirements and within required timeframes and authorities

3. Support legal process from claims perspective

3.1 Ensure instructions for and receipt of legal advice pertaining to claim occurs as required

3.2 Liaise with legal team, doctors or other relevant parties as required to expedite insurance claim resolution

3.3 Ensure documents passed as part of legal proceedings comply with organisational, regulatory and legislative considerations

3.4 Negotiate timelines for provision of relevant documents to legal team and ensure they are adhered to

3.5 Ensure insurers manage matters before court in a manner that achieves best and most expeditious resolution and at minimum cost

3.6 Employ all appropriate methods within organisational, legislative, codes of practice or other guidelines to clarify conflicting evidence or information

3.7 Document all actions, procedures and outcomes in supporting legal team and record promptly

4. Participate in settlement arrangements

4.1 Participate in mediation and negotiation activities as required

4.2 Arrange meeting with instructing legal practitioner to discuss settlement meeting and review settlement documents

4.3 Attend settlement meeting at prescribed venue

4.4 Check documentation to ensure it is correct

4.5 Exchange documentation with appropriate parties

4.6 Draft letter of confirmation of settlement, forward to instructing legal practitioner for review and despatch to relevant parties

4.7 Register, lodge and record relevant documents as appropriate

4.8 Inform stakeholders of outcome

5. Report outcomes and update records

5.1 Document and record actions, procedures and outcomes promptly and accurately according to organisational policy, legislative requirements and codes of practice, as applicable

5.2 Provide stakeholders with accurate and timely advice regarding the claim settlement


Qualifications and Skillsets

FNSISV512 appears in the following qualifications:

  • FNS51110 - Diploma of General Insurance
  • FNS51312 - Diploma of Life Insurance
  • FNS51315 - Diploma of Life Insurance
  • FNS51115 - Diploma of General Insurance
  • FNS51915 - Diploma of Personal Injury and Disability Insurance Management
  • FNS42115 - Certificate IV in Personal Injury Management