Assessor Resource

FNSISV308
Process facultative and treaty reinsurance claims

Assessment tool

Version 1.0
Issue Date: June 2024


This unit describes the skills and knowledge required to process facultative and treaty reinsurance claims in accordance with organisational guidelines and procedures.

It applies to individuals employed in a range of insurance sectors within organisations of various sizes and across a range of customer bases who apply systematic approaches to processing non-routine claims.

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.

You may want to include more information here about the target group and the purpose of the assessments (eg formative, summative, recognition)


Evidence Required

List the assessment methods to be used and the context and resources required for assessment. Copy and paste the relevant sections from the evidence guide below and then re-write these in plain English.

ELEMENT

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

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

1. Receive reinsurance claim

1.1 Receive and check information relating to facultative or treaty reinsurance claim

1.2 Check completeness of information

1.3 Confirm coverage of a claim, or series of claims, under specific customer, policy or treaty

2. Calculate recovery, including reinstatements

2.1 Calculate payment amount or amount outstanding according to organisational policy and procedures, and treaty and facultative obligations

2.2 Notify reinsurers of claim amount and details under relevant reinsurance arrangements

2.3 Request payment from reinsurer

2.4 Pass payment information on to appropriate staff, where required

2.5 Accurately record or enter on the system all claim information

Evidence of the ability to:

accurately process facultative and treaty reinsurance claims across a representative range of products, customers and conditions by:

receiving, recording and clarifying the reinsurance claim information

notifying the customer of claim and payment outcomes

documenting and communicating outcomes to the reinsurer

calculate payments within facultative and reinsurance arrangements.

Note: If a specific volume or frequency is not stated, then evidence must be provided at least once.

To complete the unit requirements safely and effectively, the individual must:

describe the difference between facultative and treaty reinsurance

outline key features of relevant legislation, regulations and organisational policy and procedures for processing facultative and treaty reinsurance claims

interpret key wording used in policies relating to facultative and treaty reinsurance

explain reinsurance terminology and concepts such as:

any one risk

any one event

reinstatement premium

outline principles and methods of filing and storing documentation

outline terms and conditions of reinsurance arrangements between insurers and reinsurers.

Assessment must be conducted in a safe environment where evidence gathered demonstrates consistent performance of typical activities experienced in the insurance services field of work and include access to:

organisational records

organisational policy, procedures, legislation and regulations as they relate to contracts of insurance

a range of common technology and software

Assessors must satisfy NVR/AQTF assessor requirements.

Submission Requirements

List each assessment task's title, type (eg project, observation/demonstration, essay, assingnment, checklist) and due date here

Assessment task 1: [title]      Due date:

(add new lines for each of the assessment tasks)

Assessment Tasks

Copy and paste from the following data to produce each assessment task. Write these in plain English and spell out how, when and where the task is to be carried out, under what conditions, and what resources are needed. Include guidelines about how well the candidate has to perform a task for it to be judged satisfactory.

ELEMENT

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

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

1. Receive reinsurance claim

1.1 Receive and check information relating to facultative or treaty reinsurance claim

1.2 Check completeness of information

1.3 Confirm coverage of a claim, or series of claims, under specific customer, policy or treaty

2. Calculate recovery, including reinstatements

2.1 Calculate payment amount or amount outstanding according to organisational policy and procedures, and treaty and facultative obligations

2.2 Notify reinsurers of claim amount and details under relevant reinsurance arrangements

2.3 Request payment from reinsurer

2.4 Pass payment information on to appropriate staff, where required

2.5 Accurately record or enter on the system all claim information

Evidence of the ability to:

accurately process facultative and treaty reinsurance claims across a representative range of products, customers and conditions by:

receiving, recording and clarifying the reinsurance claim information

notifying the customer of claim and payment outcomes

documenting and communicating outcomes to the reinsurer

calculate payments within facultative and reinsurance arrangements.

Note: If a specific volume or frequency is not stated, then evidence must be provided at least once.

To complete the unit requirements safely and effectively, the individual must:

describe the difference between facultative and treaty reinsurance

outline key features of relevant legislation, regulations and organisational policy and procedures for processing facultative and treaty reinsurance claims

interpret key wording used in policies relating to facultative and treaty reinsurance

explain reinsurance terminology and concepts such as:

any one risk

any one event

reinstatement premium

outline principles and methods of filing and storing documentation

outline terms and conditions of reinsurance arrangements between insurers and reinsurers.

Assessment must be conducted in a safe environment where evidence gathered demonstrates consistent performance of typical activities experienced in the insurance services field of work and include access to:

organisational records

organisational policy, procedures, legislation and regulations as they relate to contracts of insurance

a range of common technology and software

Assessors must satisfy NVR/AQTF assessor requirements.
Copy and paste from the following performance criteria to create an observation checklist for each task. When you have finished writing your assessment tool every one of these must have been addressed, preferably several times in a variety of contexts. To ensure this occurs download the assessment matrix for the unit; enter each assessment task as a column header and place check marks against each performance criteria that task addresses.

Observation Checklist

Tasks to be observed according to workplace/college/TAFE policy and procedures, relevant legislation and Codes of Practice Yes No Comments/feedback
Receive and check information relating to facultative or treaty reinsurance claim 
Check completeness of information 
Confirm coverage of a claim, or series of claims, under specific customer, policy or treaty 
Calculate payment amount or amount outstanding according to organisational policy and procedures, and treaty and facultative obligations 
Notify reinsurers of claim amount and details under relevant reinsurance arrangements 
Request payment from reinsurer 
Pass payment information on to appropriate staff, where required 
Accurately record or enter on the system all claim information 

Forms

Assessment Cover Sheet

FNSISV308 - Process facultative and treaty reinsurance claims
Assessment task 1: [title]

Student name:

Student ID:

I declare that the assessment tasks submitted for this unit are my own work.

Student signature:

Result: Competent Not yet competent

Feedback to student

 

 

 

 

 

 

 

 

Assessor name:

Signature:

Date:

Assessment Record Sheet

FNSISV308 - Process facultative and treaty reinsurance claims

Student name:

Student ID:

Assessment task 1: [title] Result: Competent Not yet competent

(add lines for each task)

Feedback to student:

 

 

 

 

 

 

 

 

Overall assessment result: Competent Not yet competent

Assessor name:

Signature:

Date:

Student signature:

Date: