Rejecting A Claim (Introduction)

A claim can be rejected at any time provided the claim

• Is pre award

And

• Has not already been withdrawn

The need to reject a claim may arise when you are

• Capturing a claim

Or

• Working an entry on the ‘Verification Failures’ Work List or ‘Incomplete Applications’ Work List

A family claim may need to be rejected if

• Insufficient information has been provided by a claimant to fully complete a claim or resolve a verification failure 28 days after requesting the information

Or

• You establish that the claimant does not satisfy the eligibility criteria

You must use one of the following functions to reject a claim

• CAPTURE APPLICATION

Or

• REJECT APPLICATION for a verification failure

If you use Function REJECT APPLICATION you must enter the reason(s) why the claim is being rejected, so that an appropriate message is entered on the Rejection Notice.

Notes

1. There may be more than one reason why the claim is to be rejected. You must select all the relevant reasons

2. The Enter Reason for Rejection to be shown on notice field in the Rejection Application dialogue box, in Function REJECT APPLICATION is for use by Compliance only. Any entries made in this field are copied onto the Rejection Notice

3. If the claim is to be rejected because you have not had a response to your enquiries to resolve the verification failure, the reason for the rejection is the verification failure and not the fact that the claim is incomplete

4. If the claim is rejected because of the claimant’s failure to provide you with the information you have requested within 28 days, and the information is provided after the claim has been rejected, you should treat it as a change of circumstances