FNSSUP401A - Process complex superannuation benefit or insurance claim

FNSSUP401A
Process complex superannuation benefit or insurance claim

This unit describes the performance outcomes, skills and knowledge required to receive applications for complex superannuation benefit payment or insurance claims and ensuring correct funds are allocated to members. Conditions would include claims such as death or disability payment and situations of severe financial hardship. It encompasses the identification of types of benefits and their procedures for processing, knowledge of receiving processes for benefit payments, ability to identify and manage application claim errors, ability to assess and process applications for benefits, ability to process insurance claims and knowledge of claim correspondence required for member communications.This unit is applicable to individuals working within enterprises and job roles subject to licensing, legislative, regulatory or certification requirements including legislation administered by the Australian Securities and Investments Commission (ASIC).

Application

This unit applies where receiving and processing benefit applications and/or insurance claims is a primary function of the work role or one element of a varied work role.

Elements and Performance Criteria

ELEMENT	PERFORMANCE CRITERIA
1. Identify types of benefits and their processes	1.1. Benefit types are identified 1.2. Potential errors in processing benefit types are identified
2. Receive applications for benefit payment and/or insurance claims	2.1. Applications for superannuation benefit payment and/or insurance claim are received via post or electronic means 2.2. Receipt is documented according to organisation procedures 2.3. Applications and/or claims and organisation documents are checked to ensure information is complete and correct 2.4. Applications are checked for eligibility 2.5. Signature on application is verified with original documents
3. Identify and manage application and/or claim errors	3.1. Errors and non-completions in applications and/or claims are identified 3.2. Incomplete or incorrect applications and/or claims are actioned according to organisation requirements 3.3. Applications and/or claims are prepared for processing when required information is obtained
4. Assess and process applications for benefits	4.1. Features and differences of payment types are identified 4.2. Applications are checked against conditions identified in trust deed rules 4.3. Additional information is sourced as required (e.g. from member, doctors, employers etc.) 4.4. Benefit is calculated to include additional fees, charges and/or other factors, using computer system 4.5. Special circumstances are managed according to organisation guidelines 4.6. Taxation issues are managed according to legislation 4.7. Pensions and annuities where relevant to the fund are processed according to organisation guidelines 4.8. Information and calculation results are checked for integrity 4.9. Eligible Termination Payments (ETP) and rollover documentation is issued to members, Australian Taxation Office (ATO) and rollover funds, as required 4.10. Application is processed in accordance with the conditions identified in the trust deed and organisation procedures.
5. Process insurance claims	5.1. Claim applications are checked against conditions identified in trust deed and in accordance with relevant group policies 5.2. Additional information is sourced as required (e.g. from member, doctors, employers, insurers, etc.) 5.3. Trust deed is checked for defined beneficiaries 5.4. Beneficiaries are communicated with as necessary 5.5. Benefit is calculated to include additional fees, charges, taxes and/or other factors 5.6. Results of calculation are checked 5.7. Claim is processed in accordance with the conditions identified in the trust deed, relevant legislation and organisation procedures
6. Provide member communications	6.1. Statements and claim correspondence are provided according to organisation guidelines and compliance requirements 6.2. Processes and outcomes of application/claim are documented in member files 6.3. Instruction for complaints is provided to members as required 6.4. Positive relations are maintained with clients

Required Skills

Required skills

communication skills to:

liaise with others, share information, confirm work requirements, using questioning and active listening as required

use language and concepts appropriate to cultural differences

numeracy and IT skills for:

making financial calculations

accessing and using appropriate software such as word processors, spreadsheets and databases

using internet information

literacy skills to read and interpret documentation from a variety of sources and recording, gathering and consolidating financial information

problem solving skills to address compliance and other issues

learning skills to maintain knowledge of changes to products and relevant legislation

organisation skills, including the ability to plan and sequence work

Required knowledge

organisation policies, objectives and guidelines

components of a superannuation ETP

documentation requirements for processing death and disability payments

documentation requirements of a superannuation ETP

Government Member Benefit Protection Rules

internal and Superannuation Complaints Tribunal (SCT) complaints procedures

preservation rules (before and after July 1999)

procedures for assessing insurance claims and calculating and processing benefit payments

procedures for calculating and processing benefits

procedures for monitoring pension and annuity payments

Reasonable Benefit Limits (RBL) regulations and impacts on taxation

regulations and legislation applying to payments

taxation requirements for:

death

deductions for payments

ETPs under the Income Tax Assessment Act

salary continuance payments

total and permanent disablement benefits

Evidence Required


The Evidence Guide provides advice on assessment and must be read in conjunction with the performance criteria, required skills and knowledge, range statement and the Assessment Guidelines for the Training Package.
Overview of assessment
Critical aspects for assessment and evidence required to demonstrate competency in this unit	Evidence of the ability to: identify types of benefits and manage application and claim errors process insurance claims in accordance with conditions, trust and organisation requirements establish special circumstances and make informed recommendations about benefit payments calculate taxation requirements for benefit payments identify, source and interpret required information to process benefits for lump sum payments, death claims and disablement claims assess and determine benefit entitlements for ETP, death and disablement claims using computer programs.
Context of and specific resources for assessment	Assessment must ensure: competency is demonstrated in the context of the work environment and conditions specified in the range statement either in a relevant workplace or a closely simulated work environment access to and the use of a range of common office equipment, technology, software and consumables access to organisation financial records access to organisation policies and procedures.
Method of assessment	A range of assessment methods should be used to assess practical skills and knowledge. The following examples, in combination, are appropriate for this unit: evaluating an integrated activity, which combines the elements of competency for the unit, or a cluster of related units of competency observing processes and procedures in workplaces verbal or written questioning on underpinning knowledge and skills evaluating samples of work accessing and validating third party reports setting and reviewing workplace business simulations or scenarios.
Guidance information for assessment

Range Statement


The range statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised wording, if used in the performance criteria, is detailed below. Essential operating conditions that may be present with training and assessment (depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts) may also be included.
Benefit types may include:	compassionate death benefits disablement benefits divorce ETP income protection pensions resignation retirement rollover funds severe financial hardship.
Errors and non-completions in documentation may include:	claim documentation is inconsistent or incomplete insufficient detail given member information does not correlate with fund records member information is illegible or missing signature is missing.
Actioned may include:	applications are returned further information is sought.
Special circumstances may include:	compassionate grounds permanent application/temporary residence severe financial hardship.
Organisation procedures may include:	best practice standards codes of practice documentation and filing procedures internal communications legislative requirements regulatory requirements system/computer procedures.
Conditions identified in trust deed may include:	binding or non-binding nominations conditions for benefit payment details of policy taken by member fund guidelines relevant legislation.
Beneficiaries may include:	beneficiaries as identified by local state legislation children who are minors current or ex-spouse custodial children financial dependants legal personal representative non-custodial children.

Sectors

Unit sector

Superannuation

Employability Skills

This unit contains employability skills.

Licensing Information

Not applicable.