Unit of competency
Modification History
Release |
Comments |
Release 1 |
This version first released with FNS Financial Services Training Package Version 5.0. |
Application
This unit describes the skills and knowledge required to provide an insurance claims service to clients in an insurance broking context.
The unit applies to those who use well-developed communication and interpersonal skills in insurance broking organisations of various sizes and across a range of customer bases.
Work functions in the occupational areas where this unit may be used are subject to regulatory requirements. Users are advised to check with the relevant state and territory regulatory authorities to confirm those requirements.
Unit Sector
Insurance broking
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. Register claim |
1.1 Use internal broking claims system to register and process client claims 1.2 Update claims recording system in a manner that minimises processing time and according to organisational policies and procedures |
2. Advise insurers and complete required documentation |
2.1 Verify appointment of loss adjuster on receipt of claim 2.2 Obtain formal acknowledgment of receipt of claim from insurers 2.3 Make formal claim reports according to organisational procedures and within brokerage time requirements 2.4 Provide assistance to client, when required to complete claim documentation according to codes of practice 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 claim 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 legislative requirements to protect client 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 instructions where settlement authority exists and according to organisational policies and procedures 4.3 Brief service provider thoroughly to ensure investigation is comprehensive where settlement authority exists 4.4 Review and assess service provider’s report within agreed timeframes where settlement authority exists 4.5 Maintain contact with insurer’s service provider to ensure reports and issues are dealt with within required timeframe |
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 and according to organisational procedures 5.3 Remit settlement funds to client according to legislative requirements and organisational policies and procedures 5.4 Update business records promptly according to organisational policies and procedures |
Foundation Skills
This section describes those language, literacy, numeracy and employment skills that are essential to performance but not explicit in the performance criteria.
S KILL |
DESCRIPTION |
Numeracy |
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Oral communication |
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Reading |
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Writing |
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Planning and organising |
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Self-management |
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Teamwork |
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Technology |
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Unit Mapping Information
Supersedes and is equivalent to FNSIBK404 Provide a claims service to an insurance broking client.
Links
Companion Volume Implementation Guide is found on VETNet - https://vetnet.gov.au/Pages/TrainingDocs.aspx?q=c7200cc8-0566-4f04-b76f-e89fd6f102fe