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 FNSISV512A, '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

1. Establish the requirements of legal proceedings for an insurance claim

1.1. Comprehensive terms of reference or instructions relevant to the legal proceedings for the non-routine and complex claim are established

1.2. Terms of reference are checked to ensure they are within organisation and legislative guidelines, codes of practice and personal authorities and are clearly documented

1.3. Roles and responsibilities of all parties involved in the legal proceedings for the claim are negotiated, confirmed and documented

1.4. Requirements and procedures of legal systems involved in the claim proceedings, including domestic and/or other relevant countries, are clarified

2. Provide relevant claims information to the legal team

2.1. Legal team representatives are identified and information requirements confirmed

2.2. Options for obtaining the legal data/information are discussed and sources of legal data/information are identified

2.3. Facts, evidence and information relevant to claims proceedings, is collected thoroughly, systematically and accurately

2.4. Historical data is researched, as required

2.5. Legal data/information is analysed for relevance

2.6. Information deficiencies are identified and additional information is sought from appropriate sources

2.7. Legal data and information is provided to legal team in compliance with organisation policies and procedures, compliance, ethical and legal requirements and within required timeframes and authorities

3. Support the legal process from a claims/underwriting perspective

3.1. Instructions for and receipt of legal advice pertaining to the claim occurs as required

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

3.3. Documents passed as part of the legal proceedings comply with organisation, regulatory and legislative considerations

3.4. Timelines are negotiated for provision of relevant documents to the legal team and adhered to

3.5. Insurers manage matter before the court in a matter that achieves the best and most expeditious resolution at minimum cost

3.6. All appropriate methods within organisation, legislative, codes of practice or other guidelines are employed to clarify conflicting evidence or information

3.7. All actions, procedures and outcomes in supporting the legal team are documented and recorded promptly

4. Participate in settlement arrangements

4.1. Participation in mediation and negotiation activities occurs, as required

4.2. Meeting is arranged with instructing legal practitioner to discuss settlement meeting and to review settlement documents

4.3. Settlement meeting is attended at prescribed venue

4.4. Documentation is checked to ensure it is correct

4.5. Documentation is exchanged with the appropriate parties

4.6. Letter of confirmation of settlement is drafted, forwarded to instructing legal practitioner for review and despatched to relevant parties

4.7. Relevant documents are registered/lodged/recorded as appropriate

4.8. Stakeholders are informed of outcome

5. Report outcomes and update records

5.1. Actions, procedures and outcomes are documented and recorded promptly and accurately according to organisation policy and legislative requirements and codes of practice, as applicable

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


Qualifications and Skillsets

FNSISV512A appears in the following qualifications: