FNSILF516 — Manage group life insurance claims

1 Receive and evaluate claim against group life insurance policy

• 1.1Confirm channels of lodgement have been followed according to organisational policies and procedures
• 1.2Identify relevant policy and type of cover
• 1.3Evaluate evidence of identity for member
• 1.4Communicate details of claim with claimant and group policy owner according to organisational policies and procedures, and legislative and regulatory requirements, as required

2 Review group history and eligibility for cover of claimant

• 2.1Identify nature of fund membership and retained cover for claimant
• 2.2Determine whether cover is limited to automatic acceptance and if additional cover was made available
• 2.3Establish whether claimant was at work on commencement date of present insurance and determine impact on nature and extent of coverage
• 2.4Verify currency and accuracy of premium contributions

3 Manage claim and information collection

• 3.1Identify communication channels required for each claim and suited to stakeholder
• 3.2Identify required contact points and intermediaries, and engage in line with their role and responsibilities, as required and according to organisational policies and procedures
• 3.3Manage information collection and communication strategy in line with agreements and obligations and according to organisational policies and procedures, and legislative and regulatory requirements
• 3.4Refer claim to authorised team member where problems or disputes arise, as required, according to organisational policies and procedures

4 Assess claim

• 4.1Review claim submission and establish circumstances of claimed condition of member
• 4.2Identify and interpret policy wordings and request additional information required to progress claims assessment information according to the code of ethics, as required
• 4.3Communicate reasoning to the claimant and Group Policy owner where required
• 4.4Evaluate evidence to determine whether assessment criteria are satisfied
• 4.5Assess claimant compliance to additional disclosure requirements where cover was provided by means other than automatic acceptance
• 4.6Determine benefit payable, and communicate decision to required stakeholders and personnel
• 4.7Inform member and Group Policy owner of end date of benefit payments, and any changes to the terms of the cover

5 Pay group life insurance benefits

• 5.1Determine entitlements according to required policy conditions and within authority levels, and obtain sign-off as required
• 5.2Identify parties authorised to receive benefits paid by insurer
• 5.3Communicate decisions to required parties, according to organisational policies and procedures, and legislative and regulatory requirements
• 5.4Evaluate dependent relationships and beneficiary nominations for death benefits, as required
• 5.5Set in place ongoing assessment processes for salary continuance claims and confirm benefit is taxed prior to payment
• 5.6Request additional evidence for salary continuance claims as required

6 Finalise and close claim

• 6.1File required documentation on claim according to organisational policies and procedures
• 6.2Complete medical, financial and closure fields according to organisational policies and procedures
• 6.3Update policy records in required systems according to organisational policies and procedures
• 6.4Close claim in required systems and communicate closure to policy owner or authorised parties

What does an assessment tool for FNSILF516 need to cover?

To satisfy the Principles of Assessment and Rules of Evidence, an assessment for FNSILF516 needs to address all 47 unit components: 6 elements with 29 performance criteria, 2 performance evidence requirements, 9 knowledge evidence requirements, and the foundation skills. A coverage matrix mapping each question and task to these components is what an auditor looks for.

How does Auditori generate an assessment tool for FNSILF516?

Auditori pulls the current release of FNSILF516 from training.gov.au and generates a complete package: candidate assessment, assessor guide with model answers and observation criteria, and a coverage matrix mapping every component. A suitably qualified person then reviews and approves the draft in a built-in workflow — consistent with ASQA's guidance on AI use in VET — before export as branded PDF and editable Word.

Is the first assessment tool really free?

Yes. Every new account includes one free credit — enough to generate the complete assessment tool for FNSILF516 — with no card and no subscription required. After that it's pay-as-you-go per unit.

Can I check my existing FNSILF516 assessment instead of generating a new one?

Yes — upload your existing assessment or learner guide and Auditori maps it against every element, performance criterion, PE and KE of FNSILF516, showing exactly what's covered and what's missing. Mapping costs a quarter of a credit.