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SOUTH AFRICAN QUALIFICATIONS AUTHORITY 
REGISTERED UNIT STANDARD: 

Interpret medical reports on a high risk proposal or client to assess a long term risk 
SAQA US ID UNIT STANDARD TITLE
120070  Interpret medical reports on a high risk proposal or client to assess a long term risk 
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 Claims Assessors and Underwriters who assess long-term risk.

The qualifying learner is capable of:
  • Interpreting medical terminology in order to make an assessment decision.
  • Applying technical knowledge to predict the probability of a claim or future claim.
  • Accessing resources to inform a decision.
  • Evaluating the suitability of information in medical reports from a business perspective.
  • Consulting with relevant parties to agree a decision. 

  • 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:
  • Relevant parties include, but are not limited to, Product Developers, Claims Assessors, Actuaries, Lawyers, Underwriters, Tender Parties, Trustees and Doctors.
  • Commonly used terminology includes, but is not limited to, terminology relating to pharmacology, pathology, histology, anatomy, physiology and graphs.
  • Factors in a medical report include, but are not limited to, environmental and occupational factors and may include avocational and demographic factors.
  • Legal terminology used in policy wordings. 

  • Specific Outcomes and Assessment Criteria: 

    SPECIFIC OUTCOME 1 
    Interpret medical terminology in order to make an assessment decision. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    Terminology used in pharmacology reports is interpreted and used to anticipate a specific condition. 

    ASSESSMENT CRITERION 2 
    Terminology used in medical reports is interpreted and used to assess a risk or make a claim's decision. 

    ASSESSMENT CRITERION 3 
    The implications and consequences of combination and add on conditions are analysed in order to assess a risk and determine or apply an appropriate loading or exclusion. 

    SPECIFIC OUTCOME 2 
    Apply technical knowledge to predict the probability of a claim or future claim. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    The factors in a medical report are analysed and related to the client's lifestyle to determine the validity of the risk. 

    ASSESSMENT CRITERION 2 
    Factors in a medical report that could impact on risk assessment are identified and linked to possible consequences and the probability of a claim. 

    ASSESSMENT CRITERION 3 
    Information needed to create a holistic profile is elicited from a variety of sources. 

    ASSESSMENT CRITERION 4 
    An accepted or standardised practice or underwriting norm is critiqued to determine the validity of the practice. 

    SPECIFIC OUTCOME 3 
    Access resources to inform a decision. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    Additional information required to assess a risk is identified and accessed from appropriate sources. 

    ASSESSMENT CRITERION 2 
    The information is interpreted and applied to make an informed decision. 

    SPECIFIC OUTCOME 4 
    Evaluate the suitability of information in medical reports from a business perspective. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    Additional information requested by a Claims Assessor is evaluated in terms of appropriateness for a specific claim, the medical condition and the cost to company. 

    ASSESSMENT CRITERION 2 
    The information in a medical report is evaluated in terms of appropriateness and credibility of the source and the applicability of the information. 

    ASSESSMENT CRITERION 3 
    Evidence is analysed to ensure that a case is assessed holistically. 

    SPECIFIC OUTCOME 5 
    Consult with relevant parties to agree a decision. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    The parties to be consulted are identified for a specific case. 

    ASSESSMENT CRITERION 2 
    A case is discussed with the relevant parties to clarify information and make a decision. 

    ASSESSMENT CRITERION 3 
    A final decision is communicated and substantiated to the relevant parties. 


    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 access, interpret and apply information to make an informed decision. 

    UNIT STANDARD CCFO WORKING 
    The learner is able to work effectively as a member of a team in consulting with relevant parties and making a joint decision. 

    UNIT STANDARD CCFO ORGANISING 
    The learner is able organise his/her activities responsibly and effectively accessing appropriate information to make an informed decision. 

    UNIT STANDARD CCFO COLLECTING 
    The learner is able critically evaluate information assessing a high risk proposal or client or in making a claims decision. 

    UNIT STANDARD CCFO COMMUNICATING 
    The learner is able communicate effectively in analysing information and discussing a case to clarify information and reach a decision. 

    UNIT STANDARD CCFO DEMONSTRATING 
    The learner is able recognise that there is an interplay of a number of related systems when assessing risk. 

    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.