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SOUTH AFRICAN QUALIFICATIONS AUTHORITY 
REGISTERED UNIT STANDARD: 

Demonstrate knowledge and understanding of the financial consequences of a claim to an organisation and the carrier of insurance 
SAQA US ID UNIT STANDARD TITLE
120066  Demonstrate knowledge and understanding of the financial consequences of a claim to an organisation and the carrier of insurance 
ORIGINATOR
SGB Insurance and Investment 
PRIMARY OR DELEGATED QUALITY ASSURANCE FUNCTIONARY
-  
FIELD SUBFIELD
Field 03 - Business, Commerce and Management Studies Finance, Economics and Accounting 
ABET BAND UNIT STANDARD TYPE PRE-2009 NQF LEVEL NQF LEVEL CREDITS
Undefined  Regular  Level 5  Level TBA: Pre-2009 was L5  10 
REGISTRATION STATUS REGISTRATION START DATE REGISTRATION END DATE SAQA DECISION NUMBER
Reregistered  2018-07-01  2023-06-30  SAQA 06120/18 
LAST DATE FOR ENROLMENT LAST DATE FOR ACHIEVEMENT
2024-06-30   2027-06-30  

In all of the tables in this document, both the pre-2009 NQF Level and the NQF Level is shown. In the text (purpose statements, qualification rules, etc), any references to NQF Levels are to the pre-2009 levels unless specifically stated otherwise.  

This unit standard does not replace any other unit standard and is not replaced by any other unit standard. 

PURPOSE OF THE UNIT STANDARD 
This Unit Standard is intended for learners who assess long term risk including Reinsurers, Senior Claims Assessors and Senior Underwriters.

The qualifying learner is capable of:
  • Analysing the extent to which a product anticipates changing needs.
  • Researching the history of a product and explaining subsequent changes.
  • Investigating the impact of an extraordinary claim.
  • Investigating the changes required in response to a claim's trend. 

  • LEARNING ASSUMED TO BE IN PLACE AND RECOGNITION OF PRIOR LEARNING 
    Learners should be competent in Communication and Mathematical Literacy at Level 4. It is assumed that learners are competent in the Unit Standards in the FETC: Long-Term Risk Assessment. 

    UNIT STANDARD RANGE 
    The typical scope of this unit standard is:
  • Financial consequences of a claim include, but are not limited to, savings or loss, high risk, inadequate reserves or a change in the reserve basis.
  • Actuarial assumptions relate to product, target market, medical, lifestyle and socio economic assumptions. 

  • Specific Outcomes and Assessment Criteria: 

    SPECIFIC OUTCOME 1 
    Analyse the extent to which a product anticipates changing needs. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    The original basis of a product is analysed with reference to structure, definitions, premium and intended market. 

    ASSESSMENT CRITERION 2 
    Events that could result in an extraordinary claim are interpreted with reference to the changing medical environment, possible legal interpretation and the adequacy of the product. 

    ASSESSMENT CRITERION 3 
    The impact of an extraordinary claim on the policy reserve(s) is analysed for a specific product. 

    SPECIFIC OUTCOME 2 
    Research the history of a product and explain subsequent changes. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    The actuarial assumptions that informed the original product are researched and an assessment is made of the validity of the assumptions over time. 

    ASSESSMENT CRITERION 2 
    Changes during the life of the product are researched and an indication is given of how the medical, legal and social environments have impacted on the product. 

    ASSESSMENT CRITERION 3 
    Data are analysed to anticipate the need for changes in the product. 

    SPECIFIC OUTCOME 3 
    Investigate the impact of an extraordinary claim. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    A new trend in a condition is identified and related to the frequency, potential fraud and associated costs. 

    ASSESSMENT CRITERION 2 
    Possible implications of the trend for product development are identified and reported to the actuarial department. 

    ASSESSMENT CRITERION 3 
    The impact of the trend on claim's management and underwriting is projected for a specific product. 

    ASSESSMENT CRITERION 4 
    The consequences of an observed trend are communicated to the marketing department. 

    SPECIFIC OUTCOME 4 
    Investigate the changes required in response to a claim's trend. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    Possible changes to underwriting principles, policies and practices are suggested based on an identified trend. 

    ASSESSMENT CRITERION 2 
    Possible changes to claims principles, policies and practices are suggested based on an identified trend. 

    ASSESSMENT CRITERION 3 
    The impact of the trend on the budget is investigated with reference to possible increases and savings. 

    ASSESSMENT CRITERION 4 
    The financial relationship with the reinsurer is analysed to suggest possible changes to a reinsurance treaty. 

    ASSESSMENT CRITERION 5 
    Possible changes to a policy wording are proposed with due regard for the legal implications. 


    UNIT STANDARD ACCREDITATION AND MODERATION OPTIONS 
    This Unit Standard will be internally assessed by the provider and moderated by a moderator registered by a relevant accredited ETQA or an ETQA that has a Memorandum of Understanding with the relevant accredited ETQA. 

    UNIT STANDARD ESSENTIAL EMBEDDED KNOWLEDGE 
    N/A 

    UNIT STANDARD DEVELOPMENTAL OUTCOME 
    N/A 

    UNIT STANDARD LINKAGES 
    N/A 


    Critical Cross-field Outcomes (CCFO): 

    UNIT STANDARD CCFO IDENTIFYING 
    The learner is able to identify and solve problems in which responses show that responsible decisions using critical and creative thinking have been made in suggesting possible changes in underwriting and claims policies, principles and procedures based on an identified claims trend. 

    UNIT STANDARD CCFO WORKING 
    The learner is able to work effectively with others as a member of a team in that decisions at this level are seldom the responsibility of an individual. 

    UNIT STANDARD CCFO COLLECTING 
    The learner is able to collect, organise and critically evaluate information in researching and investigating information required by the standard. 

    UNIT STANDARD CCFO COMMUNICATING 
    The learner is able to communicate effectively in communicating the consequences of an observed trend to the marketing department and reporting to the actuarial department. 

    UNIT STANDARD CCFO SCIENCE 
    The learner is able to use science and technology effectively and critically in using a computer to access information and analyse trends. 

    UNIT STANDARD CCFO DEMONSTRATING 
    The learner is able to demonstrate an understanding of the world as a set of related systems by researching the relationship between the medical, legal and social environments and the history of a product. 

    UNIT STANDARD ASSESSOR CRITERIA 
    N/A 

    REREGISTRATION HISTORY 
    As per the SAQA Board decision/s at that time, this unit standard was Reregistered in 2012; 2015. 

    UNIT STANDARD NOTES 
    N/A 

    QUALIFICATIONS UTILISING THIS UNIT STANDARD: 
      ID QUALIFICATION TITLE PRE-2009 NQF LEVEL NQF LEVEL STATUS END DATE PRIMARY OR DELEGATED QA FUNCTIONARY
    Core  49860   National Diploma: Financial Services: Long-Term Risk Assessment  Level 5  NQF Level 05  Reregistered  2023-06-30  INSETA 


    PROVIDERS CURRENTLY ACCREDITED TO OFFER THIS UNIT STANDARD: 
    This information shows the current accreditations (i.e. those not past their accreditation end dates), and is the most complete record available to SAQA as of today. Some Primary or Delegated Quality Assurance Functionaries have a lag in their recording systems for provider accreditation, in turn leading to a lag in notifying SAQA of all the providers that they have accredited to offer qualifications and unit standards, as well as any extensions to accreditation end dates. The relevant Primary or Delegated Quality Assurance Functionary should be notified if a record appears to be missing from here.
     
    1. CKP Development Agency (Pty) Ltd. 



    All qualifications and part qualifications registered on the National Qualifications Framework are public property. Thus the only payment that can be made for them is for service and reproduction. It is illegal to sell this material for profit. If the material is reproduced or quoted, the South African Qualifications Authority (SAQA) should be acknowledged as the source.