The objective of this unit is to develop knowledge and skills for the assessment of life, critical illness and disability claims incorporating medical, legal and financial considerations, and the ability to apply these to claims scenarios.
This course covers life, critical illness and disability claims. The claims assessor will typically be dealing with the claimant following a major life event and sensitivity and tact will be required by the claims assessor in collating the evidence and validating the claim. The claims assessment process requires knowledge of medical, legal, regulatory and financial issues and it is very important that claims assessors learn to refer a case when they have reached the extent of their knowledge.
Some claims will be rejected and claims assessors need to have a firm grasp of how to handle such claims and the regulatory and legal burden placed on them in that situation.
The role of the claims assessor is to: validate the claim made in accordance with the policy or scheme terms and conditions; establish whether the insured event occurred; establish if any restrictions apply preventing acceptance; and determine if the beneficiary of the policy proceeds is clear.
This unit has now been withdrawn
Please note that unit P62 has now been withdrawn. Qualifications and credits achieved via P62 will be valid post unit withdrawal.