GICPIN-20-04
Claims investigation standards and the General Insurance Code of Practice
This learning solution provides an overview of the General Insurance Code of Practice released by the Insurance Council of Australia in 2020 and explains the standards that Investigators must adhere to under the Code. It also outlines the knowledge and skills needed to assist customers who are vulnerable, which is a key focus of the Code.
It is suitable for Investigators and Employees who have been appointed to investigate a claim by a Code subscriber, Employees of Code subscribers who are responsible for appointing external Investigators, and anyone who needs to understand Investigators’ obligations under the Code.
What you'll learn
- Demonstrate the Code’s objectives and principles
- Describe the insurer’s obligations to the customer when the customer is buying insurance, lodging a claim or making a complaint
- Detail the standards of service for Code subscribers, Distributors and Service Suppliers
- Recognise the triggers to hardship
- Identify those in our community who may be more vulnerable
- Refer customers experiencing vulnerability to appropriate specialist support services
- Use a conversation flow structure and the principles of respectful communication to manage your conversations with empathy and confidence
- Understand an Investigator’s general obligations during the investigation process
- Outline what an Investigator is required to do before, during and after conducting a formal interview
- Comply with the standards required when an external Investigator is engaged
- Authorise and conduct surveillance appropriately.
An optional module for team leaders helps them support staff who have been impacted by difficult situations and/or confronting customer interactions.
Topics Covered
- General Insurance Code of Practice
- Introduction
- The long and the short of it
- What the Code means for the customer
- Caring for the customer
- What good service looks like
- The technical stuff
- Vulnerability
- Understanding Vulnerability and Financial Hardship
- Respectful communication
- (Optional) Leader guide for supporting conversations with staff
- Claims investigation standards
Assessment
3 Tests