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Unit of competency details

FNSPIM434 - Manage personal injury claims (Release 1)

Summary

Usage recommendation:
Current
Mapping:
MappingNotesDate
Supersedes and is equivalent to FNSPIM414 - Manage personal injury claims 01/Feb/2021

Release Status:
Current
Releases:
ReleaseRelease date
1 1 (this release) 02/Feb/2021


Classifications

SchemeCodeClassification value
ASCED Module/Unit of Competency Field of Education Identifier 081103 Insurance And Actuarial Studies  

Classification history

SchemeCodeClassification valueStart dateEnd date
ASCED Module/Unit of Competency Field of Education Identifier 081103 Insurance And Actuarial Studies  02/Feb/2021 
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Unit of competency

Modification History

Release 

Comments 

Release 1

This version first released with FNS Financial Services Training Package Version 6.0.

Application

This unit describes the skills and knowledge required to manage personal injury claims. It involves conducting initial assessments, developing case plans, reviewing case progress and conducting completion procedures on case closure.

The unit applies to those who have developed skills and a broad knowledge base of the personal injury management sector and who work independently or across multidisciplinary teams. They make judgements within their level of responsibility to achieve organisational objectives and standards.

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

Personal injury management

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. Conduct initial assessment

1.1 Contact stakeholders to gather information on personal injury case according to organisational policies and procedures, and legislative and regulatory requirements

1.2 Conduct initial client interview and assessment according to organisational policies and procedures, and legislative and regulatory requirements

1.3 Determine need for further assessment and referral services according to legislative and regulatory requirements and provide referrals for these according to organisational policies and procedures

1.4 Collate and provide information to required stakeholders to support the referral process according to organisational policies and procedures, and legislative and regulatory requirements

2. Develop and obtain approval of personal injury case plan

2.1 Negotiate and agree on goals and develop case plan in consultation with client, treating medical practitioner, employer and other key stakeholders

2.2 Obtain approvals from treating medical practitioner and stakeholders prior to commencement of a return to life and health program according to organisational policies and procedures

3. Monitor and review case progress

3.1 Conduct case review meetings with multidisciplinary team and key stakeholders according to organisational policies and procedures

3.2 Monitor progress and effectiveness of client’s case against goals using organisational policies and procedures and modify case plan as required

3.3 Conduct follow up review meetings with client according to case plan and organisational policies and procedures

3.4 Conduct closure interviews on completion of case management plan according to organisational policies and procedures, and legislative and regulatory requirements

3.5 Complete and distribute case management reports according to organisational policies and procedures, and legislative and regulatory requirements

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

  • Performs calculations, and records, sequences and schedules information to achieve required outcomes

Oral communication

  • Uses active listening and questioning techniques to clarify information
  • Uses appropriate language, concepts, pace and tone to convey information appropriate to audience and purpose

Reading

  • Analyses and interprets complex information, including legislative and regulatory requirements and policies, from a range of sources synthesising specific aspects of information to meet requirements

Writing

  • Records information and completes documentation following organisational procedures and protocols
  • Uses language and terminology appropriate to audience to convey and clarify explicit information and requirements

Planning and organising

  • Identifies and responds to legislative requirements, policies and procedures and meets expectations associated with own role
  • Builds on protocols to establish more effective workplace systems
  • Develops skills and knowledge through reading and practice

Problem solving

  • Implements strategies aimed at fostering cooperation and positive relationships with a diverse range of clients

Self-management

  • Plans, sequences and implements tasks and appropriate resources to meet requirements

Teamwork

  • Selects and uses appropriate conventions and protocols when collaborating, negotiating or consulting with clients and other stakeholders in a range of work contexts

Technology

  • Uses the main features and functions of digital tools to complete work tasks

Unit Mapping Information

Supersedes and is equivalent to FNSPIM414 Manage personal injury claims.

Links

Companion Volume Implementation Guide is found on VETNet - https://vetnet.gov.au/Pages/TrainingDocs.aspx?q=c7200cc8-0566-4f04-b76f-e89fd6f102fe

 

Assessment requirements

Modification History

Release 

Comments 

Release 1

This version first released with FNS Financial Services Training Package Version 6.0.

Performance Evidence

The candidate must demonstrate the ability to complete the tasks outlined in the elements, performance criteria and foundation skills of this unit, including evidence of the ability to:

  • manage at least three different personal injury claims.

Knowledge Evidence

The candidate must be able to demonstrate knowledge to complete the tasks outlined in the elements, performance criteria and foundation skills of this unit, including knowledge of:

  • key features of organisational policies and procedures, industry codes of practice and legislative and regulatory requirements relating to personal injury case management, including:
  • processes used to assess, plan, monitor, review and close a case
  • documentation requirements for personal injury case plan
  • internal and external case referral processes
  • decision-making processes
  • information required to support referral processes
  • rehabilitation evaluation methods
  • sources of information required for the rehabilitation planning process
  • reporting requirements
  • different goals and related case management methods related to:
  • recovery and rehabilitation
  • returning to work
  • returning to health
  • returning to community
  • negotiation techniques for goal setting
  • key stakeholders and sources of information to assist with managing and developing a case
  • strategies for dealing with issues and problems relating to case management
  • indicators and triggers for modification to the case plan
  • long-term client relationship management techniques.

Assessment Conditions

Skills in this unit must be demonstrated in a workplace or simulated environment where the conditions are typical of those in a working environment in this industry.

This includes access to:

  • clients
  • office equipment, technology and software
  • organisational records, policies and procedures.

Assessors of this unit must satisfy the requirements for assessors in applicable vocational education and training legislation, frameworks and/or standards.

Links

Companion Volume Implementation Guide is found on VETNet - https://vetnet.gov.au/Pages/TrainingDocs.aspx?q=c7200cc8-0566-4f04-b76f-e89fd6f102fe