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 THAT HAS PASSED THE END DATE: 

Process a short term insurance claim 
SAQA US ID UNIT STANDARD TITLE
120123  Process a short term insurance claim 
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 4  NQF Level 04  3 
REGISTRATION STATUS REGISTRATION START DATE REGISTRATION END DATE SAQA DECISION NUMBER
Passed the End Date -
Status was "Reregistered" 		 2018-07-01  2023-06-30  SAQA 06120/18 
LAST DATE FOR ENROLMENT LAST DATE FOR ACHIEVEMENT
2026-06-30   2029-06-30  

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 replaces: 
US ID Unit Standard Title Pre-2009 NQF Level NQF Level Credits Replacement Status
10370  Process a short term personal/ domestic insurance claim  Level 4  NQF Level 04  3   

PURPOSE OF THE UNIT STANDARD 
This Unit Standard is intended for learners who wish to follow a career path in short term insurance. It will be useful for claims clerks, claims advisors, investigators, underwriters and Short Term Intermediaries.

The qualifying learner is capable of:
  • Explaining the process of registering a short term insurance claim.
  • Gathering information required to substantiate a short term insurance claim.
  • Assessing the facts and making a decision to finalise a Short Term insurance claim.
  • Calculating the settlement of a short term insurance claim. 
    		•

    LEARNING ASSUMED TO BE IN PLACE AND RECOGNITION OF PRIOR LEARNING 
    It is assumed that learners are competent in Communication and Mathematical Literacy at Level 3. 

    UNIT STANDARD RANGE 
    The typical scope of this Unit Standard is:
  • Personal, domestic, commercial, business, agricultural and industrial insurance.
  • Classes of short term insurance are buildings, building contents all risks, motor, personal and/or public liability, personal accident, small craft, pleasure craft, travel, business interruption.
  • Check for validity includes, but is not limited to true and complete information, business/personal use, age of the driver, date of the incident, premium, items, claims history and cover.
  • Sources of information include, but are not limited to police reports, previous claims history, witness reports and weather reports. 
    		•

    Specific Outcomes and Assessment Criteria: 

    SPECIFIC OUTCOME 1 
    Explain the process of registering a short term insurance claim. 

    ASSESSMENT CRITERIA     

    ASSESSMENT CRITERION 1 
    The information on a short term insurance policy schedule and policy wording are interpreted and a decision is made against which section of a short term insurance policy to register the claim. 

    ASSESSMENT CRITERION 2 
    The concept of quantum is explained with reference to the implications of the estimated quantum. 

    ASSESSMENT CRITERION 3 
    Reasons why excess applies on a short term insurance policy are explained for different types of claim. 

    ASSESSMENT CRITERION 4 
    Claims that should be referred to the legal/recovery department are identified and substantiated for each referral. 

    SPECIFIC OUTCOME 2 
    Gather information to substantiate a short term insurance claim. 

    ASSESSMENT CRITERIA     

    ASSESSMENT CRITERION 1 
    Possible sources of information required to process a short term insurance claim are named for different scenarios. 

    ASSESSMENT CRITERION 2 
    Supporting documents required to process a short term insurance claim are identified for different types of claims. 

    ASSESSMENT CRITERION 3 
    The status of a short term insurance claim is checked for validity for different insurable perils. 

    ASSESSMENT CRITERION 4 
    The role of an assessor and/or investigator in Short Term insurance claims is explained with examples. 

    SPECIFIC OUTCOME 3 
    Assess the facts and make a decision to finalise a short term insurance claim. 

    ASSESSMENT CRITERIA     

    ASSESSMENT CRITERION 1 
    A decision is made to accept a short term insurance claim or deny liability based on the relevant documentation. 

    ASSESSMENT CRITERION 2 
    The risk associated with a particular short term insurance claim is assessed and communicated to the underwriting department, and an indication is given of why it is important to communicate the risk to the underwriting department. 

    ASSESSMENT CRITERION 3 
    A claim is concluded and the claims decision is communicated and substantiated to the insured and/or the intermediary. 

    SPECIFIC OUTCOME 4 
    Calculate the settlement of a short term insurance claim. 

    ASSESSMENT CRITERIA     

    ASSESSMENT CRITERION 1 
    Average is correctly calculated for different examples of short term insurance claims. 

    ASSESSMENT CRITERION 2 
    Dual insurance is correctly calculated for different examples of short term insurance. 

    ASSESSMENT CRITERION 3 
    Payment is correctly calculated and processed for different examples of short term insurance claims according to the requirements of a specific contract and insurer. 

    ASSESSMENT CRITERION 4 
    The quantum of a claim is calculated for three examples. 


    UNIT STANDARD ACCREDITATION AND MODERATION OPTIONS 
  • Anyone assessing a candidate against this Unit Standard must be registered as an assessor with the relevant ETQA or ETQA where a Memorandum of Understanding (MOU) exists with the relevant ETQA.
  • Any institution offering learning that will enable achievement of this Unit Standard must be accredited as a provider through the relevant ETQA or ETQA where a Memorandum of Understanding (MOU) exists with the relevant ETQA.
  • Moderation of assessment will be overseen by the relevant ETQA according to the moderation guidelines and the agreed ETQA procedures. 
    		•

    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 
    Learners are able to identify and solve problems in which responses show that responsible decisions using critical have been made in deciding against which section of a policy to register a claim and making a decision to finalise a claim. 

    UNIT STANDARD CCFO WORKING 
    Learners are able to work effectively with others as a member of a team, group or organisation in following the standards and procedures of a specific organisation and communicating with the underwriting department, insured and intermediary. 

    UNIT STANDARD CCFO COLLECTING 
    Learners are able to collect, organise and critically evaluate information in gathering information to substantiate a claim and making a decision to finalise a claim. 

    UNIT STANDARD CCFO COMMUNICATING 
    Learners are able to communicate effectively in communicating with the underwriting department and calculating the settlement of a claim. 

    UNIT STANDARD CCFO SCIENCE 
    Learners are able to use science and technology effectively in using a computer to process a claim. 

    UNIT STANDARD CCFO DEMONSTRATING 
    Learners are able to demonstrate an understanding of the world as a set of related systems by knowing why it is important to communicate with the underwriting department and understanding the effect of multiple claims on excess, validity and future underwriting criteria. 

    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 
    This unit standard replaces unit standard 10370, " Process a short term personal /domestic insurance claim", Level 4, 3 credits. 

    QUALIFICATIONS UTILISING THIS UNIT STANDARD: 
      ID QUALIFICATION TITLE PRE-2009 NQF LEVEL NQF LEVEL STATUS END DATE PRIMARY OR DELEGATED QA FUNCTIONARY
    Elective  66610   Further Education and Training Certificate: Short Term Insurance  Level 4  NQF Level 04  Passed the End Date -
    Status was "Reregistered"     		 2023-07-30  As per Learning Programmes recorded against this Qual 
    Elective  57613   Further Education and Training Certificate: Short-Term Risk Management  Level 4  NQF Level 04  Passed the End Date -
    Status was "Reregistered"     		 2012-06-30  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.
     
    NONE 


    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.