Unit of Competency Mapping – Information for Teachers/Assessors – Information for Learners

FNSILF407 Mapping and Delivery Guide
Settle life insurance claims

Version 1.0
Issue Date: May 2024


Qualification -
Unit of Competency FNSILF407 - Settle life insurance claims
Description
Employability Skills
Learning Outcomes and Application This unit describes the skills and knowledge required to calculate benefits and settle claims made under risk based life insurance policies.It applies to individuals who use specialised knowledge and systematic approaches to process and settle life insurance claims.No licensing, legislative or certification requirements apply to this unit at the time of publication.
Duration and Setting X weeks, nominally xx hours, delivered in a classroom/online/blended learning setting.

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

office equipment, technology, software and consumables

organisational records, policy and procedures.

Assessors must satisfy NVR/AQTF assessor requirements.
Prerequisites/co-requisites
Competency Field
Development and validation strategy and guide for assessors and learners Student Learning Resources Handouts
Activities 		Slides
PPT 		Assessment 1 Assessment 2 Assessment 3 Assessment 4
Elements of Competency Performance Criteria              
Element: 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
       
Element: 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
       
Element: 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
       


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. Review claim settlement advice

1.1 Receive settlement advice for claim against risk based life insurance policy

1.2 Check that documentation is correct and complete in accordance with procedures

1.3 Resolve any discrepancies identified between claim and settlement advice

1.4 Confirm that organisational authority levels have been observed

2. Calculate benefits

2.1 Identify extent of liability on basis of collected evidence, and terms and conditions of life insurance policy

2.2 Calculate and check benefits payable in accordance with procedures

3. Finalise claim settlement

3.1 Advise client of consequences of proceeding with payment in accordance with procedures

3.2 Obtain policy discharge as appropriate

3.3 Confirm method of payment with claimant

3.4 Enter and confirm payment information on appropriate systems to make payment

3.5 Communicate settlement details to appropriate stakeholders in accordance with procedures and regulatory requirements

3.6 Update records and file documentation in accordance with procedures and regulatory requirements

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.

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.

Submission Requirements

List each assessment task's title, type (eg project, observation/demonstration, essay, assignment, 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. Review claim settlement advice

1.1 Receive settlement advice for claim against risk based life insurance policy

1.2 Check that documentation is correct and complete in accordance with procedures

1.3 Resolve any discrepancies identified between claim and settlement advice

1.4 Confirm that organisational authority levels have been observed

2. Calculate benefits

2.1 Identify extent of liability on basis of collected evidence, and terms and conditions of life insurance policy

2.2 Calculate and check benefits payable in accordance with procedures

3. Finalise claim settlement

3.1 Advise client of consequences of proceeding with payment in accordance with procedures

3.2 Obtain policy discharge as appropriate

3.3 Confirm method of payment with claimant

3.4 Enter and confirm payment information on appropriate systems to make payment

3.5 Communicate settlement details to appropriate stakeholders in accordance with procedures and regulatory requirements

3.6 Update records and file documentation in accordance with procedures and regulatory 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 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 
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 
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 

Forms

Assessment Cover Sheet

FNSILF407 - Settle life insurance 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

FNSILF407 - Settle life insurance 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: