Unit of competency
Modification History
Release |
Comments |
Release 1 |
This version first released with FNS Financial Services Training Package Version 1.0. |
Application
This unit describes the skills and knowledge required to review and update insurance claims reserves in a portfolio to minimise losses. It encompasses identifying and analysing claims, reserves trends data, legislation and regulations, reports and related documents, monitoring funds, interpreting the results and reporting on the findings to minimise losses.
It applies to individuals working in claims management job roles involving specialist knowledge and functions in a range of insurance sectors and may be applied within organisations of various sizes and across a range of client bases.
Work functions in the occupational areas where this unit may be used are subject to regulatory requirements. Refer to the FNS Implementation Guide Companion Volume or the relevant regulator for specific guidance on requirements.
Unit Sector
Insurance services
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. Review claims reserves and monitor funds |
1.1 Review claims reserves regularly to ensure they accurately reflect expectations 1.2 Monitor funds to ensure adequate reserves exist to pay claims as they fall due for payment 1.3 Provide accurate data to assist underwriters to identify and charge appropriate policy premiums |
2. Support claims staff in claims reserve activities |
2.1 Ensure claims coordination staff are supported, as required, to identify accurate initial claims reserves 2.2 Ensure claims coordination staff are supported, as required, in allocation of claims to appropriate claims specialists |
3. Authorise payments, settlements and changes to reserves |
3.1 Authorise payments, settlements and reserves changes that are requested or required by claims specialists but outside their delegated authority |
4. Identify required changes to portfolio, claims reserves policy or procedures |
4.1 Communicate identified information promptly to decision-makers in the management structure according to organisational procedures 4.2 Instigate changes to policy and procedures to minimise claims losses in similar circumstances |
Foundation Skills
This section describes language, literacy, numeracy and employment skills incorporated in the performance criteria that are required for competent performance.
Skill |
Performance Criteria |
Description |
Reading |
1.1, 1.2, 4.2 |
|
Writing |
1.3, 2.1, 2.2, 3.1, 4.1 |
|
Oral Communication |
1.3, 4.1 |
|
Numeracy |
1.1, 1.2, 1-3, 2.1, 3.1 |
|
Navigate the world of work |
3.1, 4.2 |
|
Interact with others |
2.1, 2.2, 4.1 |
|
Get the work done |
2.1, 2.2, 3.1, 4.1, 4.2 |
|
Unit Mapping Information
Code and title current version |
Code and title previous version |
Comments |
Equivalence status |
FNSISV514 Review and update claim reserves in portfolio |
FNSISV514A Review and update claim reserves in portfolio |
Updated to meet Standards for Training Packages. Rewording and reordering of performance criteria to clarify intent. |
Equivalent unit |
Links
Companion Volume implementation guides are found in VETNet - https://vetnet.gov.au/Pages/TrainingDocs.aspx?q=c7200cc8-0566-4f04-b76f-e89fd6f102fe