Table of Contents s623

LEARNER’S ASSESSMENT PACK

Demonstrate knowledge and skill in order to assess a fire or accident claim

(14974)

NAME:
ORGANISATION:
COURSE NO.:
OR
RPL:

Unit Standard SAQA 14974 – Demonstrate knowledge and skill in order to assess a fire or accident claim

Contents
Instructions to the learner / 2
SPECIFIC OUTCOME 1
Prepare to conduct an assessment / 5
SPECIFIC OUTCOME 2
Investigate the merits of a claim / 12
SPECIFIC OUTCOME 3
Make a decision to settle a claim / 16
SPECIFIC OUTCOME 4
Conclude a settlement with a client / 19
Declaration of authenticity / 22

Instructions to the learner

Introduction / This assessment guide has been designed as a generic assessment guide for the banking sector.
Banking organisations may customise the guide according to their organisational requirements.
Purpose of the assessment / The purpose of assessment against this unit standard is to do the following:
1.  Award credits on the National Qualifications Framework (NQF) to learners who are capable of
·  preparing to conduct an assessment,
·  investigating the merits of a claim,
·  making a decision to settle a claim, and
·  concluding a settlement with a client.
2. In order for you to comply with the terms and requirements of the Financial Advisory and Intermediary Services (FAIS) Act 37 of 2002, you must achieve a minimum value of credits. This unit standard can assist and enable you to progress towards your credit registration. On qualification, and written approval, to perform financial services in terms of the FAIS Act, you are required to conduct your duties in terms of the Code of Conduct, as detailed in section 16 of this Act. Failure could result in your employer being found guilty of an offence, in terms of this Act, and the key individual being liable to a fine of up to R1 m or up to 10 years imprisonment, or both. It is incumbent upon you that you comply with the terms of the FAIS Act in all your business activities. The assessor must be absolutely sure that you are competent to apply your studies of this unit standard to safeguard the employer from possible future penalties or imprisonment.
Context of the unit standard / This unit standard is registered on the NQF as follows:
Field: / Business, Commerce, and Management Studies
Sub-field: / Finance, Economics, and Accounting
Number: / 14974
Level: / 4
Credit 1s: / 3
Learning assumptions / Learning assumed to be in place:
·  Learners should be competent in Communication, Mathematical Literacy, and Financial Literacy at NQF Level 3.

Assessment / In order to obtain the three credits for Unit Standard 14974, as discussed previously, you must provide evidence of your competence after working through the self-study guide.
Providing evidence of your competence will occur during the assessment process. The laid-down policies, procedures, and related issues regarding assessments will be explained to you before the assessment takes place. You will also be given an overview of, or instructions on how, the assessment will take place, what evidence you must produce, how you must prepare yourself, etc.
A qualified assessor or your line manager will guide and support you throughout this process.
Accreditation / Anyone assessing a learner against this unit standard must be a registered assessor with the relevant ETQA.
Assessment process / Step 1
Planning for the assessments / 1.  You will need to complete an assessment plan together with your assessor or line supervisor.
2.  Your assessor will prepare you for your assessment and complete the assess-ment preparation plan with you.
3.  Ensure that you are familiar with what is expected of you for this assessment and the unit standard.
Step 2
Completing the assessments
/ 1.  These assessments will be by means of exercises detailed below.
2.  Submit these exercises fully completed as per the instructions by the date agreed on the assessment plan.
3.  Your assessor may ask you additional questions.
4.  Your assessor will record the evidence that you have submitted in the assess-ment guide.
5.  Based on this evidence, the assessor will make a judgement of “Competent” or “Not yet competent” or “Not assessed” for each assessment criterion and overall for the total unit standard.
Step 3
After the assessments / 1.  If “Not assessed”, you and the assessor will agree the criteria not assessed and arrange an additional assessment date.
2.  If “Not yet competent”, you and the assessor will identify why this judgement has been made and the action(s) necessary. A reassessment date should also be agreed on.
3.  All decisions will be recorded in the assessment guide, which all parties should sign.
4.  You will only be declared “Competent” if you have provided sufficient and valid evidence against all the assessment criteria and specific outcomes of this unit standard.
5.  After declaration of competence, your assessment is subject to the internal moderation process.
6. Once this has been completed, your results will be entered onto SAQA's National Learner Record Database (NLRD).
Declaration of authenticity / Step 4 / 1.  The declaration of authenticity on p. 15 must be signed by your manager, your assessor, and you to certify that the evidence is authentic and that this has been applied in your workplace.
2.  Your line manager or assessor will give feedback on your assessment to you.

Specific Outcome 1

Prepare to conduct an assessment

Assessment Criterion 1.1 / Information relating to the client is analysed in order to compile a profile.
Project 1 / Produce, for the Banking Sector Education and Training Authority (BANKSETA) assessor (not a claims assessor), an assessment form for both a business and a personal lines possible claim.
The assessment forms must
·  include as much information as is available from the records, and as is accessible by you, contained on your employer’s electronic filing system and in files retained in the insurance claims area and
·  record information for a minimum period of three prior years.
Do not refer to Assessment Criterion 1.2 when completing this project.
Attach the forms to this document.
Assessment Criterion 1.2 / The schedule of cover is analysed to establish the cover in terms of the policy.
Project 2 / Add the policy details from the information supplied in the sample and personal lines schedules below to Project 1.
Multimark III™ sample:
SCHEDULE
The Company : ABC Insurance Company Limited
Policy Number : BANKSETA 123/456
The Insured :
The Business :
Postal Address :
Territorial Limits All premises, as stated in each section, owned, occupied, or used by the Insured for the purposes of the business, and situated in the Republic of South Africa, Namibia, Botswana, Lesotho, Swaziland, Zimbabwe, and Malawi
Period of Insurance a) From 01/08/2003 to 31/07/2004, both dates inclusive
b) Any subsequent period for which the Company agrees to renew this policy or any section thereof
Renewal or Anniversary Date: 01 August

Date…15/08/2003 Signed…………………………….
FIRE SECTION SPECIFICATION
Premises:
Property insured: / Sum insured
Column 1 / Buildings constructed of brick, stone, or concrete and roofed with slate tiles, metal, concrete, or asbestos, unless otherwise stated in this Specification, including landlord’s fixtures and fittings therein and thereon, walls (except dam walls), gates, posts, and fences / R25 000 000
Column 2 / The number of months rent/rental value stated hereunder
Number of months being … / R 1 000 000
Column 3 / Plant, machinery, landlord’s fixtures and fittings for which the Insured is responsible, and all other contents excluding property more specifically insured / R15 000 000
Column 4 / Stock and materials in trade / R10 000 000
Column 5 / Miscellaneous as described hereunder and tenant’s improvements / R0
Total sum insured: / R51 000 000
Clauses/Defined Events Included
Additional claims preparation costs / Yes / R100 000
Earthquake / Yes
Special perils / Yes
Leakage: first loss limit / Yes / R100 000
Subsidence and landslip / No
Riot and strike (other than RSA and Namibia) / No
Premises: / R
Malicious damage / Yes
Stock declaration conditions / No (Monthly/quarterly basis)
Disposal of salvage / No
Escalator clause / No
% Specific percentage
Columns to which it applies
Personal lines sample
SCHEDULE
The Company : XYZ Insurance Company Limited
Policy Number : SETA 987/654
The Insured :
Postal Address :
Territorial Limits All premises as stated in each section, owned, occupied or used by the Insured for the purposes of the business, and situated in the Republic of South Africa, Namibia, Botswana, Lesotho, Swaziland, Zimbabwe, and Malawi
Period of Insurance a) From 01/07/2002 to 30/06/2003, both dates inclusive
b)  Any subsequent period for which the Company agrees to renew this policy or any section thereof

Renewal or Anniversary Date: 01 July

Premium Payment Method: Monthly/annual

Date…20 July 2002 Signed…………………………….
HOUSEHOLDERS
Risk address / Sum insured / Premium
1. 14 2nd Street, Your Suburb / R275 000 / R1 500.00
2.
3.
Total: / R275 000 / R1 500.00
ALL RISKS
Item no. / Description / Sum insured / Premium
1. / Wearing apparel and personal effects / R5 000 / R1 000.00
2. / Sony camera # ab23579 / R3 500 / R 700.00
3.
4.
Total: / R8 500 / R1 700.00
Assessment Criterion 1.3 / A claim’s history is analysed for information relevant to the current claim and risk management requirements.
Case Study 1 / Analyse the following claims history for information relative to the current claim and risk management requirements.
You are required to submit a two-page report, showing your statistics, for both the business and personal lines claims. To assist you in this analysis, we require that you submit your report detailing the following information:
1.  Total number of claims per type of insurance per year
2.  Total gross amount and amount paid per type of insurance per year
3.  Report on the value of the first amount payable per type of insurance per year
4.  Any recommendation you may have on the value of the first amount payable for the next period of insurance
5.  Your findings as to what claims the insured is suffering and any trends
At this stage, we are not looking at the loss reported, nor do you have details as to what actually happened to cause the loss. Your report is to be restricted to analysing the historic claims and identifying any risk management requirements that you recommend be investigated to reduce either the occurrence of a loss or the value of any amount paid.
Personal lines claim
TYPE OF INSURANCE / DATE OF LOSS / DETAILS / GROSS AMOUNT / DATE
PAID / AMOUNT PAID
PERIOD OF INSURANCE 01 OCTOBER TO 30 SEPTEMBER
STORM / 20001112 / STORM DAMAGE / 1 470.00 / 20001205 / 1 470.00
ALL RISKS / 20001119 / CELLPHONE STOLEN FROM CAR / 1 550.00 / 20001126 / 1 050.00
ALL RISKS / 20010505 / DIGITAL CAMERA STOLEN / 5 790.00 / 20010614 / 5 290.00
ELECTRONIC / 20010507 / LAPTOP DROPPED / 14 340.00 / 20010713 / 12 906.00
THEFT / 20010514 / DOOR BROKEN IN ATTEMPTED THEFT / 4 000.00 / 20010514 / 4 000.00
ALL RISKS / 20011104 / CELLPHONE STOLEN IN MUGGING / 3 220.00 / 20011120 / 2 720.00
GLASS / 20020118 / WINDOW GLASS REPLACED / 1 040.00 / 20020120 / 1 040.00
ALL RISKS / 20020215 / CELLPHONE FELL INTO BATH OF WATER / 1 449.00 / 20020302 / 949.00
THEFT / 20020703 / BREAK-IN AT HOUSE / 22 099.00 / 20020916 / 22 099.00
ALL RISKS / 20020824 / PERSONAL EFFECTS STOLEN AT OFFICE / 1 688.00 / 20020915 / 1 688.00
THEFT / 20030628 / TV STOLEN / 3 899.00 / 20030723 / 3 899.00
Business claim
TYPE OF INSURANCE / DATE OF LOSS / DETAILS / GROSS AMOUNT / DATE
PAID / AMOUNT PAID
PERIOD OF INSURANCE 01 OCTOBER TO 30 SEPTEMBER
MONEY / 20001007 / ARMED HOLD-UP / 2 565.00 / 20001123 / 2 565.00
THEFT / 20001012 / RADIO EQUIPMENT STOLEN FROM OFFICE / 30 162.00 / 20001201 / 30 162.00
MONEY / 20001016 / MONEY STOLEN IN MUGGING / 1 250.00 / 20001025 / 1 250.00
ALL RISKS / 20001104 / CELLPHONE STOLEN / 3 450.00 / 20001206 / 3 200.00
STORM / 20001112 / STORM DAMAGE / 76 463.00 / 20010215 / 76 463.00
THEFT / 20001208 / FAX MACHINE STOLEN / 3 603.00 / 20010205 / 3 603.00
ALL RISKS / 20010102 / VIDEO CAMERA STOLEN FROM EMPLOYEE / 3 679.00 / 20010305 / 3 179.00
THEFT / 20010114 / BURGLARY IN WAREHOUSE / 3 483.00 / 20010326 / 3 483.00
FIRE / 20010208 / DEPOT DESTROYED / 22 566.00 / 20010502 / 22 566.00
THEFT / 20010222 / CHARGER STOLEN FROM WORKSHOP / 3 590.00 / 20010304 / 3 590.00
ALL RISKS / 20010306 / CELLPHONE LOST / 2 250.00 / 20010325 / 2 000.00
THEFT / 20010330 / THEFT FROM WORKSHOP / 4 084.00 / 20010426 / 4 084.00
THEFT / 20010403 / BURGLARY IN SHOP / 10 874.00 / 20010614 / 10 874.00
GLASS / 20010409 / DOOR, WINDOW, & FRIDGE GLASS BROKEN / 2 578.00 / 20010422 / 2 578.00
ALL RISKS / 20010425 / MOBILE RADIO STOLEN FROM VEHICLE / 3 186.00 / 20010528 / 2 186.00
THEFT / 20010427 / THEFT OF WELDING EQUIPMENT IN SHOP / 5 000.00 / 20010523 / 5 000.00
ALL RISKS / 20010509 / CELLPHONE DAMAGED / 3 099.00 / 20010519 / 2 849.00
MONEY / 20010514 / MONEY STOLEN FROM SHOP CASHIERS / 2 684.00 / 20010524 / 2 684.00
MONEY / 20010608 / MONEY STOLEN FROM WAREHOUSE / 1 552.00 / 20010612 / 1 500.00
ALL RISKS / 20010708 / CELLPHONE STOLEN / 2 869.00 / 20010724 / 2 619.00
THEFT / 20011004 / THEFT FROM WORKSHOP / 8 819.00 / 20011028 / 8 819.00
ALL RISKS / 20011011 / CELLPHONE DAMAGED / 5 500.00 / 20011028 / 5 250.00
ALL RISKS / 20011021 / CELLPHONE LOST / 3 189.00 / 20011115 / 2 939.00
THEFT / 20011021 / THEFT FROM OFFICES / 1 185.00 / 20011106 / 1 185.00
ALL RISKS / 20011022 / CELLPHONE DAMAGED / 3 080.00 / 20011106 / 2 830.00
THEFT / 20011201 / BURGLARY AT WORKSHOP / 39 492.00 / 20020105 / 39 492.00
ALL RISKS / 20011224 / CELLPHONE DAMAGED / 4 080.00 / 20020115 / 3 830.00
THEFT / 20011226 / LAPTOP STOLEN FROM OFFICE / 28 500.00 / 20020219 / 28 500.00