Elements and Performance Criteria
- Register claim
- Advise insurers
- Complete necessary documentation
- When required claim forms and other required documentation are requested without delay
- Assistance is supplied to client to complete claims documentation, when required, to ensure full and accurate information is available to insurers in assessment of the claim
- Claims documentation is checked for errors and omissions to ensure accuracy
- Reinstate sum insured
- Advise client of rights and obligations
- Terms and conditions of the insurance policy are reviewed with the client to ensure the maximum claims recovery is sought
- Client is provided with advice on administration of the claims to ensure no breach of contract occurs and claims are managed efficiently
- Client is advised of appropriate legislative requirements to protect the client's interests
- Liaise with service providers
- Need for independent service providers with the range of expertise required for the claim is identified where settlement authority exists
- Suitable service provider is selected based on client's instructions where settlement authority exists
- Service provider is thoroughly briefed to ensure any investigation is comprehensive where settlement authority exists
- Report of the independent service provider is obtained, reviewed and assessed within agreed timeframes where settlement authority exists
- Contact with insurer's service provider is maintained to ensure reports and issues are dealt with promptly
- Notify terms of settlement to client
- Details of insurer's settlement offer are prepared with recommendations for client review and acceptance without delay
- Client response to settlement offer is obtained and acted on without delay
- Settlement funds are remitted to client within terms of legislative requirements and business policy and procedures
- Update relevant files and records