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Follow the links below to find material targeted to the unit's elements, performance criteria, required skills and knowledge

Elements and Performance Criteria

1. Review claim settlement advice
   • Receive settlement advice for claim against risk based life insurance policy
   • Check that documentation is correct and complete in accordance with procedures
   • Resolve any discrepancies identified between claim and settlement advice
   • Confirm that organisational authority levels have been observed
2. Calculate benefits
   • Identify extent of liability on basis of collected evidence, and terms and conditions of life insurance policy
   • Calculate and check benefits payable in accordance with procedures
3. Finalise claim settlement
   • Advise client of consequences of proceeding with payment in accordance with procedures
   • Obtain policy discharge as appropriate
   • Confirm method of payment with claimant
   • Enter and confirm payment information on appropriate systems to make payment
   • Communicate settlement details to appropriate stakeholders in accordance with procedures and regulatory requirements
   • Update records and file documentation in accordance with procedures and regulatory requirements

Performance Evidence

Evidence of the ability to:

perform claims settlement tasks in accordance with relevant procedures and regulatory requirements including:

checking claims settlement advice against claims to identify and resolve variations

calculating benefits

communicating settlement details

updating documentation.

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

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Knowledge Evidence

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

outline life insurance administrative requirements relating to life insurance claims settlement

explain life insurance policy payment criteria

outline key features of life insurance policy terms and conditions, and claims settlement

outline organisational procedures relating to life insurance claims processing and settlement

explain organisational systems for data entry and filing

outline the various types of life insurance policies

outline relevant regulatory requirements relating to life insurance claims settlement

outline the various stakeholders in the life insurance claims process.

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