This module is no longer being offered to new students. Continuing students who are part way through can enrol by contacting Customer Service at [email protected] or phone 03 9613 7200.
Skills Unit
PIM503-15
Personal Injury Claims Management
This module looks at how and why organisations and insurers use claims data and reports to review and measure claims performance. Students will learn about injury notification, claims lodgement and the issues to consider in determining initial liability for personal injury claims. The module also covers personal injury claims investigations and management including the provision of benefits to injured parties, ongoing liability reviews and the role of service providers.
20 CIP Points
Personal Injury Claims Management
AUD $1060
Life and Retirement Income
12 weeks
What you'll learn
- Define common law and the principles of tort
- Distinguish a business outcome from a key performance indicator (KPI)
- Describe the three main areas of business performance in personal injury insurance
- Describe service utilisation data and its use in managing claims and revising work practices
- Identify the potential barriers in implementing proposed work practices and the strategies used to overcome them
- Outline the role of team managers, technical advisers and injury management advisers in identifying and implementing changes to claims management processes
- Describe the importance of early notification of injury
- Describe the purpose of the claims management regulatory obligations
- Identify the different groupings of claims that organisations use to ensure the most effective claims management
- Identify the required time frames to determine initial liability
- Describe different investigations and their ability to influence liability decisions
- Describe different types of medical investigations, including the role of medico-legal reports
- Review and analyse information in order to make a sound decision regarding liability
- Notify stakeholders of the decision, their rights, obligations and the mechanism for review
- Establish a claims strategy
- Maintain appropriate records in accordance with organisational guidelines
- Describe how weekly benefits entitlements and possible lump sum payments are determined
- Determine when the services of external service providers are required
- Describe the multi-disciplinary approach to claims management
- Identify the risks associated with the ineffective monitoring and review of the claim
- Identify potential avenues for recovery and instigate recovery proceedings
- Describe a service provider and list four common external and internal service providers
- Determine service parameters and expectations to enable performance to be reviewed effectively
- Describe your organisation’s data-recording facilities and explain the importance of recording clear, brief claim notes
- Describe the strategies to review and monitor ongoing service performance.
Competencies
FNSCUS503 Review business performance
FNSISV506 Investigate insurance claims
FNSISV508 Review and advise on claims costs, policies and procedures
FNSISV509 Analyse financial, medical and psychological claims assessments
Online Assignment
- Pass Grade: students must be assessed as competent in all assignment questions
Online Exam
- Pass Grade: 50%
- Duration: 90min