Unit of competency Outline

Date retreived
23/07/2026 1:14 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.

Analyse financial, medical and psychological claims assessments

Analyse financial, medical and psychological claims assessments

Unit of competency
National Code
FNSISV509
State Code
AUS34
TGA Status
Replaced
DTWD Status
Replaced
Current Release Number
1.00
Current Release Date
25/03/2015
View on TGA
State Implementation and Classification
Approved Date
16/09/2015
Field of Education
081103 - Insurance And Actuarial Studies
Original Release Date
16/09/2015
Nominal Hours
60
Description
This unit describes the skills and knowledge required to arrange financial, medical or psychological assessments to support the claims assessment process and to analyse and report on the results.It applies to individuals working in job roles involving specialist knowledge and functions in a range of insurance sectors and may be applied to areas of claims assessment involving personal injury, long-term settlement and/or complex claims.Work functions in the occupational areas where this unit may be used are subject to regulatory requirements. Refer to the FNS Implementation Guide Companion Volume or the relevant regulator for specific guidance on requirements.
Notes
Elements and Performance Criteria
1. Establish need to appoint specialist to undertake assessment
  • 1.1 Review thoroughly, systematically and accurately, the facts, evidence and information, including fraud indicators, relevant to circumstances of loss, damage and injury
  • 1.2 Identify promptly and advise client and other relevant parties of need to appoint specialist assistance to undertake financial, medical or psychological assessment
2. Organise financial, medical or psychological assessments
  • 2.1 Engage appointed specialists, as required, and thoroughly brief them on requirements
  • 2.2 Monitor assessment activity progress and report to relevant parties, as appropriate, within set timelines
3. Analyse data for claims assessments
  • 3.1 Analyse and assess financial, medical or psychological assessment data for thoroughness and consistency
  • 3.2 Use analysis tools to assess financial, medical and/or psychological assessments to calculate loss damages
  • 3.3 Assess fairly and impartially validity of loss situation and/or claims against assessment data, and analyse against reported circumstances, available evidence, facts and information
  • 3.4 Review insurance cover and policy conditions to ensure loss falls within policy coverage
4. Report results
  • 4.1 Document and report assessment actions, procedures and outcomes, and record promptly and accurately
  • 4.2 Ensure reporting includes recommendations on validity of claim and recovery amounts in relation to assessment and other relevant data
  • 4.3 Provide stakeholders with accurate and timely advice regarding financial, medical or psychological assessment for claim proceedings
No information
No information
Replaces
State Code National Code Title Type
D4247 FNSISV509A Analyse financial, medical and psychological claims assessments Unit of competency
Replaced By
State Code National Code Title Type
OCZ55 FNSISV519 Analyse financial, medical and psychological claims assessments Unit of competency