Release 

Comments 

Release 1

This version first released with FNS Financial Services Training Package Version 1.0.

ELEMENT 

PERFORMANCE CRITERIA 

Elements describe the essential outcomes.

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

1. Receive claim form

1.1 Receive claim form and compile necessary documentation

1.2 Review policy details to ensure valid cover is in force

1.3 Establish that claimant is authorised to deal with policy

1.4 Check that documentation is correct and complete

1.5 Determine authority level required to evaluate claim and refer application to appropriate authority as necessary

2. Evaluate claim information

2.1 Identify and review evidence against payment criteria

2.2 Check and confirm whether terms and conditions of policy have been met

2.3 Identify whether policy exclusions apply

2.4 Seek additional specialist advice as appropriate

2.5 Recognise where information suggests unresolved complexity and seek further information as appropriate

3. Establish liability for payment

3.1 Determine whether claim can be admitted in accordance with procedures and within authority limits

3.2 Make payment recommendation in accordance with procedures

3.3 Communicate outcomes to all relevant parties in accordance with procedures

3.4 Update records and file documentation in accordance with procedures and regulatory requirements

Skill 

Performance Criteria 

Description 

Reading

1.1-1.5, 2.1-2.3, 2.5, 3.1

• Gathers, analyses and interprets simple to complex information from a range of sources and identifies relevant information and actions

Writing

2.4, 3.3, 3.4

• Produces texts of varying complexity using appropriate language, grammar and logical sequence to convey and record information accurately and effectively

Oral Communication

2.4, 3.3

• Uses clear, specific language and correct terminology to convey information and achieve required outcomes

Numeracy

2.1, 3.2

• Uses mathematical equations to perform calculations

Navigate the world of work

1.5, 3.1-3.4

• Recognises and follows legislative requirements, explicit and implicit protocols, policies and procedures, and meets expectations associated with own role

Interact with others

2.4, 2.5, 3.3

• Selects and uses appropriate communication conventions and protocols to liaise with others
• Adjusts personal communication style in response to the values, beliefs and cultural expectations of others

Get the work done

1.1-1.5, 2.1-2.3, 3.1-3.4

• Takes responsibility for planning, sequencing and prioritising tasks and own workload for efficiency and effectiveness
• Makes decisions regarding claim validity based on implementation of standard procedures and/or evaluation against set criteria
• Uses the main features and functions of digital tools to complete work tasks

Code and title 

current version 

Code and title 

previous version 

Comments 

Equivalence status 

FNSILF405 Evaluate life insurance claims

FNSILF405A Evaluate life insurance claims

Updated to meet Standards for Training Packages

Equivalent unit

Release 

Comments 

Release 1

This version first released with FNS Financial Services Training Package Version 1.0.