SAQA 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.
SOUTH AFRICAN QUALIFICATIONS AUTHORITY 
REGISTERED UNIT STANDARD: 

Apply a researched trend to manage disability claims 
SAQA US ID UNIT STANDARD TITLE
120074  Apply a researched trend to manage disability claims 
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  15 
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 and learners in Actuarial learnerships who assess long term risk. It will be useful for learners who assess disability claims for Life Insurance, Group Benefits, COIDA and the Road Accident Fund.

The qualifying learner is capable of:
  • Interpreting information required to assess a disability claim.
  • Applying current knowledge of disability to analyse a claim.
  • Investigating and comparing market decisions on disability conditions.
  • Presenting a plan to manage a specific disability condition. 

  • LEARNING ASSUMED TO BE IN PLACE AND RECOGNITION OF PRIOR LEARNING 
    Learners should be competent in Communication and Mathematical Literacy at Level 4 and have. 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 disability including, but not limited to, total temporary disability, permanent health disability, total and permanent, as defined by different products and policy documents. 

    Specific Outcomes and Assessment Criteria: 

    SPECIFIC OUTCOME 1 
    Interpret information required to asses a disability claim. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    The definition of disability in a specific product is analysed and an indication is given of how the definition will affect the assessment of a claim. 

    ASSESSMENT CRITERION 2 
    A claim is analysed in terms of the medical condition and the disability definition to determine the required evidence. 

    SPECIFIC OUTCOME 2 
    Apply current knowledge of disability to analyse a claim. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    A condition is described with reference to the short- term and long- term prognosis. 

    ASSESSMENT CRITERION 2 
    Trends in data are analysed to determine the current status and treatment of the condition. 

    ASSESSMENT CRITERION 3 
    Reasonable accommodation that may be required in the workplace is identified for a specific medical condition and work environment. 

    SPECIFIC OUTCOME 3 
    Investigate and compare market decisions on disability conditions. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    Market decisions related to a specific condition are analysed to determine trends. 

    ASSESSMENT CRITERION 2 
    The appropriateness of current market trends are evaluated for a specific organisation with reference to specific products, practices and definitions. 

    SPECIFIC OUTCOME 4 
    Present a plan to manage a specific disability condition. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    Information on a case is collated and a recommendation formulated and substantiated for the future management of the claim. 

    ASSESSMENT CRITERION 2 
    The role of the Reinsurer in claims assessing is explained and a decision is made as to whether or not a specific claim should be referred to the Reinsurer. 

    ASSESSMENT CRITERION 3 
    The case is presented to the relevant team. 

    ASSESSMENT CRITERION 4 
    The team decision is documented and communicated to the client. 

    ASSESSMENT CRITERION 5 
    A management plan is compiled indicating follow up periods and requirements. 

    ASSESSMENT CRITERION 6 
    The consequences of inadequate or incorrect documentation are explained from the point of view of the client and the organisation. 


    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 thinking have been made in presenting a plan to manage a disability condition. 

    UNIT STANDARD CCFO WORKING 
    The learner is able to work effectively with others as a member of a team in that claims decisions at this level are usually made by a team. 

    UNIT STANDARD CCFO ORGANISING 
    The learner is able to organise and manage him/herself and his/her activities responsibly and effectively in applying knowledge of disability to formulate a management plan. 

    UNIT STANDARD CCFO COLLECTING 
    The learner is able to collect, organise and critically evaluate information in analysing data and market decisions and formulating a plan to manage a case. 

    UNIT STANDARD CCFO COMMUNICATING 
    The learner is able to communicate effectively in presenting a plan to a team and producing the required documentation. 

    UNIT STANDARD CCFO SCIENCE 
    The learner is able to use science and technology effectively in using a computer and electronic system to access information and assess a disability claim. 

    UNIT STANDARD CCFO DEMONSTRATING 
    The learner is able to demonstrate an understanding of the world as a set of related systems by recognising that problem-solving contexts do not exist in isolation by identifying accommodation requirements in the workplace and determining market trends related to specific conditions. 

    UNIT STANDARD CCFO CONTRIBUTING 
    The learner is able to be culturally and aesthetically sensitive across a range of social contexts in proposing the accommodation required in a disability case. 

    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
    Elective  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.