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Evidence Guide: FNSISV517 - Review claims settlement policies and procedures

Student: __________________________________________________

Signature: _________________________________________________

Tips for gathering evidence to demonstrate your skills

The important thing to remember when gathering evidence is that the more evidence the better - that is, the more evidence you gather to demonstrate your skills, the more confident an assessor can be that you have learned the skills not just at one point in time, but are continuing to apply and develop those skills (as opposed to just learning for the test!). Furthermore, one piece of evidence that you collect will not usualy demonstrate all the required criteria for a unit of competency, whereas multiple overlapping pieces of evidence will usually do the trick!

From the Wiki University

 

FNSISV517 - Review claims settlement policies and procedures

What evidence can you provide to prove your understanding of each of the following citeria?

Collect data on claims trends

  1. Design and implement data gathering processes
  2. Identify new data requirements and sources of information, and establish process for collecting data
  3. Research industry claims settlement trends to benchmark against
Design and implement data gathering processes

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify new data requirements and sources of information, and establish process for collecting data

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Research industry claims settlement trends to benchmark against

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Monitor and report on claims trends

  1. Analyse data collected to identify trends
  2. Prepare accurate and timely claims reports to document trends, where appropriate
  3. Recommend appropriate improvements to claims settlement policy and procedures
Analyse data collected to identify trends

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Prepare accurate and timely claims reports to document trends, where appropriate

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Recommend appropriate improvements to claims settlement policy and procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify required changes to portfolio, claims settlement policy or procedures

  1. Communicate promptly information which impacts on various portfolios to management, according to company procedures
  2. Instigate changes to policy and procedures to minimise future losses
Communicate promptly information which impacts on various portfolios to management, according to company procedures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Instigate changes to policy and procedures to minimise future losses

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assessed

Teacher: ___________________________________ Date: _________

Signature: ________________________________________________

Comments:

 

 

 

 

 

 

 

 

Instructions to Assessors

Evidence Guide

ELEMENT

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

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

1. Collect data on claims trends

1.1 Design and implement data gathering processes

1.2 Identify new data requirements and sources of information, and establish process for collecting data

1.3 Research industry claims settlement trends to benchmark against

2. Monitor and report on claims trends

2.1 Analyse data collected to identify trends

2.2 Prepare accurate and timely claims reports to document trends, where appropriate

2.3 Recommend appropriate improvements to claims settlement policy and procedures

3. Identify required changes to portfolio, claims settlement policy or procedures

3.1 Communicate promptly information which impacts on various portfolios to management, according to company procedures

3.2 Instigate changes to policy and procedures to minimise future losses

Required Skills and Knowledge

ELEMENT

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

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

1. Collect data on claims trends

1.1 Design and implement data gathering processes

1.2 Identify new data requirements and sources of information, and establish process for collecting data

1.3 Research industry claims settlement trends to benchmark against

2. Monitor and report on claims trends

2.1 Analyse data collected to identify trends

2.2 Prepare accurate and timely claims reports to document trends, where appropriate

2.3 Recommend appropriate improvements to claims settlement policy and procedures

3. Identify required changes to portfolio, claims settlement policy or procedures

3.1 Communicate promptly information which impacts on various portfolios to management, according to company procedures

3.2 Instigate changes to policy and procedures to minimise future losses

Evidence of the ability to:

effectively collect and interpret claims settlement data from a wide range of sources

thoroughly analyse the trends and the effects on claims settlement policies and procedures

document and communicate changes required in claims settlement policies and procedures.

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 organisational policy, procedures and guidelines for claims settlement

outline data collection design and practice

outline data analysis techniques relating to claims settlement

describe industry trends in insurance prudential risk management

explain portfolio management techniques in insurance prudential risk management

analyse reasons for losses as a result of poor claims settlement policy and procedures, and recommend improvements to avoid recurrence.