Unit of competency Outline

Date retreived
22/07/2026 11:01 PM AWST

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Investigate insurance claims

Investigate insurance claims

Unit of competency
National Code
FNSISV536
State Code
OCZ40
TGA Status
Current
DTWD Status
Approved
Current Release Number
1.00
Current Release Date
02/02/2021
View on TGA
State Implementation and Classification
Approved Date
22/04/2021
Field of Education
081103 - Insurance And Actuarial Studies
Original Release Date
22/04/2021
Nominal Hours
60
Description
This unit describes the skills and knowledge required to investigate an insurance claim. Investigation covers clarifying the brief, conducting the investigation and reporting on the findings.The unit applies to those working in job roles involving specialist knowledge and functions, in a range of insurance sectors, in organisations of various sizes and across a range of client bases.Work functions in the occupational areas where this unit may be used are subject to regulatory requirements. Users are advised to check with the relevant state and territory regulatory authorities to confirm those requirements.
Notes
Elements and Performance Criteria
1. Confirm investigation instructions
  • 1.1 Clarify brief provided by insurer
  • 1.2 Check subject matter questions to be investigated
2. Conduct claims investigation and document material
  • 2.1 Determine method of investigation
  • 2.2 Collect and organise required information
  • 2.3 Carry out investigations according to legislative and regulatory requirements, organisational operating procedures and codes of practice
  • 2.4 Record all data and information according to organisational procedures
  • 2.5 Store original documents, data and material securely and according to organisational policies and procedures
  • 2.6 Prepare and communicate changes in brief or instructions as required
  • 2.7 Comply with any changes in brief or instructions
3. Report on investigation
  • 3.1 Prepare and transmit reports according to reporting guidelines
  • 3.2 Provide copies of documents and materials to insurer’s nominated representative
  • 3.3 Provide facts and justification for conclusions to insurer’s nominated representative
  • 3.4 Make recommendations for action with appropriate justifications as required
No information
No information
Replaces
State Code National Code Title Type
AUS29 FNSISV506 Investigate insurance claims Unit of competency