We are not taking new students for the current version of the Certificate IV in Life Insurance (FNS41515) due to the development of the Life Insurance Professional Standards Framework. The updated qualification will be available from late October 2021. Continuing students who are part way through can enrol by contacting Customer Service at [email protected] or phone 03 9613 7200.
Skills Unit

Claims Management

This module looks at the technical and practical requirements of claims management. It aims to provide participants with the skills required to manage and settle life insurance claims of varying levels of complexity in an efficient and effective manner.

20 CIP Points
Claims Management
AUD $895
Life and Retirement Income
12 weeks

What you'll learn

  • describe the role of a claims assessor in receiving a life insurance claim
  • determine the role of specialists and when the services of external specialists are required
  • describe the multi-disciplinary approach to claims management
  • determine service parameters and expectations to enable performance to be reviewed effectively
  • describe the strategies to review and monitor ongoing service performance
  • identify the information required to assess the eligibility of benefits in a life insurance claim
  • describe the tasks required to admit a life insurance claim
  • identify the reasons why a life insurance claim may be denied
  • describe the importance of accurate record keeping in claims management
  • describe the role of a financial adviser in the claims management process
  • determine when an insurer can avoid a contract of life insurance
  • determine when a life insurer is obliged, by law, to pay interest on a benefit
  • calculate an adjusted sum insured where new information is revealed after a policy has been taken out
  • describe the evidence required to meet basic proof of death requirements with regard to the policyowner
  • for various death claims scenarios, determine proof of entitlement
  • identify the documentation required to effect payment of proceeds from death claims
  • for a given death claim scenario, identify whether an insurer can avoid a life insurance claim
  • list the required considerations when calculating a death benefit for permanent contracts
  • describe three elements that need to be established to validate a morbidity claim at the initial point of contact
  • list the three standard components that define TPD
  • list at least four documents commonly requested as part of the supporting documentation for lump-sum morbidity claims
  • for two given scenarios, determine the validity of a TPD claim
  • for a given scenario, calculate the amount of death cover for an insured who has received a benefit under a trauma cover rider
  • describe at least five sources of information that may assist in the assessment of a lump-sum morbidity claim
  • list at least three standard exclusions that commonly apply to IP policies
  • list at least three reasons why early advice of an IP claim is preferable
  • describe the proof required by an insured to be deemed eligible for a benefit under an IP claim
  • list at least four payments that can result in a reduced benefit under an IP claim
  • identify three different bases for assessing the impact of a condition on an insured’s ability to work
  • describe how a life office assesses proof of title prior to the payment of a maturity benefit
  • list at least five alternatives to surrendering a life policy
  • determine the conditions for paying surrender values under a life policy
  • describe superannuation business and its legislative basis for life insurance business
  • outline the two stages that a benefit payment must pass through to get to the insured member
  • list at least four points of contact that can apply under a group insurance situation
  • identify the different conditions of release which regulate the payment and forwarding of life insurance benefits.


  • FNSILF504 Manage complex life insurance claims
  • FNSILF505 Manage ongoing disability claims
  • FNSILF506 Manage group life insurance claims

Online Assignment

  • Pass Grade: students must be assessed as competent in all assignment questions

Online Exam

  • Pass Grade: 50%
  • Duration: 120min
20 CIP Points
Claims Management
AUD $895
Life and Retirement Income
12 weeks