Unit of competency Outline
Date retreived
23/07/2026 2:31 AM AWST
23/07/2026 2:31 AM AWST
Whilst all efforts are made to provide accurate and timely information from the relevant source/documentation, please be aware that the information supplied may not be the most current version. The accuracy of the detail has not been confirmed by the Department and therefore should not be relied upon without first confirming the contents.
Settle claims
Settle claims
Unit of competency
National Code
FNSISV309A
FNSISV309A
State Code
D4231
D4231
TGA Status
Replaced
Replaced
DTWD Status
Replaced
Replaced
State Implementation and Classification
Approved Date
21/02/2012
Field of Education
081103 - Insurance And Actuarial Studies
Original Release Date
21/02/2012
Nominal Hours
40
Description
This unit describes the performance outcomes, skills and knowledge required to settle claims including the negotiation of terms, recording of detail, finalisation of payments and filing of documents.This unit is applicable to individuals working within enterprises and job roles subject to licensing, legislative, regulatory or certification requirements including legislation administered by the Australian Securities and Investments Commission (ASIC).
Notes
Elements and Performance Criteria
1. Calculate claim entitlement
- 1.1. Information is gathered and evaluated to determine the amount of loss suffered by the customer
- 1.2. Settlement terms are determined according to policy wording, legislation and codes of practice
2. Negotiate and communicate settlement terms
- 2.1. Terms and conditions of settlement offer are promptly advised to client and/or third party according to organisation claims procedures, where appropriate
- 2.2. Response by client and/or third party to terms of settlement offer is considered to assess whether adjustment is required to take into account the value of lost or damaged goods
- 2.3. Negotiation is undertaken in an endeavour to reach mutual agreement on valuation
- 2.4. Terms and conditions of settlement offer are modified as necessary and client and/or third party advised promptly
3. Document liability decisions
- 3.1. Claim decisions are clearly communicated to the relevant parties in a manner required by the policy wording, the legislation, organisation operating procedures and codes of practice
- 3.2. Decisions are documented in such a way as to determine the basis on which the decision was reached and all the evidence/information that was considered, where applicable
- 3.3. Claims documentation is sent to reinsurers
4. Finalise settlement
- 4.1. Once settlement is reached, payments are made/instructed within the required timeframe
- 4.2. Settlement release is obtained from client and/or third party, as applicable
- 4.3. Claim referred for recovery action if appropriate, and loss recovery agent appointed if applicable
- 4.4. Recovery action is initiated from reinsurers if applicable
- 4.5. Finalised claims files are stored and maintained according to organisation policy and legislative requirements and codes of practice, as applicable
RANGE STATEMENT
The range statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised wording, if used in the performance criteria, is detailed below. Essential operating conditions that may be present with training and assessment (depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts) may also be included.
Customer may be:
a third party
an agent or a lawyer acting for the client
the client.
Settlement terms may include:
cash settle
ex gratia payments
repair
replace
total loss
vouchers.
Claim decisions may be:
cancellation of claim (excess greater than settlement)
need further details
partial settlement
payment
repair approval
replacement approval.
Recovery action may include:
determining financial status of third party
determining liability of third party
recovery from reinsurers
salvage.
Storage of data may be:
electronic or hard copy (paper).
The range statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised wording, if used in the performance criteria, is detailed below. Essential operating conditions that may be present with training and assessment (depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts) may also be included.
Customer may be:
a third party
an agent or a lawyer acting for the client
the client.
Settlement terms may include:
cash settle
ex gratia payments
repair
replace
total loss
vouchers.
Claim decisions may be:
cancellation of claim (excess greater than settlement)
need further details
partial settlement
payment
repair approval
replacement approval.
Recovery action may include:
determining financial status of third party
determining liability of third party
recovery from reinsurers
salvage.
Storage of data may be:
electronic or hard copy (paper).
EVIDENCE GUIDE
The Evidence Guide provides advice on assessment and must be read in conjunction with the performance criteria, required skills and knowledge, range statement and the Assessment Guidelines for the Training Package.
Overview of assessment
Critical aspects for assessment and evidence required to demonstrate competency in this unit
Evidence of the ability to:
apply organisation policy and procedures and comply with legislation and regulations and industry codes of practice.
Context of and specific resources for assessment
Assessment must ensure:
competency is demonstrated in the context of the work environment and conditions specified in the range statement either in a relevant workplace or a closely simulated work environment
access to and the use of a range of common office equipment, technology, software and consumables
access to organisation records
access to organisation policies and procedures.
Method of assessment
A range of assessment methods should be used to assess practical skills and knowledge. The following examples, in combination, are appropriate for this unit:
evaluating an integrated activity, which combines the elements of competency for the unit, or a cluster of related units of competency
observing processes and procedures in workplaces
verbal or written questioning on underpinning knowledge and skills
evaluating samples of work
accessing and validating third party reports.
Guidance information for assessment
The Evidence Guide provides advice on assessment and must be read in conjunction with the performance criteria, required skills and knowledge, range statement and the Assessment Guidelines for the Training Package.
Overview of assessment
Critical aspects for assessment and evidence required to demonstrate competency in this unit
Evidence of the ability to:
apply organisation policy and procedures and comply with legislation and regulations and industry codes of practice.
Context of and specific resources for assessment
Assessment must ensure:
competency is demonstrated in the context of the work environment and conditions specified in the range statement either in a relevant workplace or a closely simulated work environment
access to and the use of a range of common office equipment, technology, software and consumables
access to organisation records
access to organisation policies and procedures.
Method of assessment
A range of assessment methods should be used to assess practical skills and knowledge. The following examples, in combination, are appropriate for this unit:
evaluating an integrated activity, which combines the elements of competency for the unit, or a cluster of related units of competency
observing processes and procedures in workplaces
verbal or written questioning on underpinning knowledge and skills
evaluating samples of work
accessing and validating third party reports.
Guidance information for assessment
Replaces
| State Code | National Code | Title | Type |
|---|---|---|---|
| C9836 | FNSINSV309B | Settle claims | Unit of competency |
Replaced By
| State Code | National Code | Title | Type |
|---|---|---|---|
| AUR95 | FNSISV309 | Settle insurance claims | Unit of competency |
| State Code | National Code | Title | Type |
|---|---|---|---|
| S697 | FNS30510 | Certificate III in General Insurance | Qualification |
| D704 | FNS30511 | Certificate III in General Insurance | Qualification |