FNSSUP401
Process complex superannuation benefit or insurance claim


Application

This unit describes the skills and knowledge required to receive applications for complex superannuation benefit payment or insurance claims, and ensure correct funds are allocated to members. Conditions would include claims for death, total and permanent disability (TPD), income protection, terminal illness payment and situations of severe financial hardship.

It applies to individuals who use specialised industry knowledge and analytical skills to evaluate and process complex information and data following defined procedures.

Work functions in the occupational areas where this unit may be used are subject to regulatory requirements. Refer to the FNS Implementation Guide Companion Volume or the relevant regulator for specific guidance on requirements.


Elements and Performance Criteria

ELEMENT

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Receive applications for benefit payment and/or insurance claims

1.1 Identify benefit types to determine appropriate steps for processing benefit

1.2 Acknowledge and receipt applications for superannuation benefit payment and/or insurance claim received via post or electronic means

1.3 Document receipt according to organisational procedures

1.4 Check applications and/or claims and organisational documents to ensure information is complete and correct

1.5 Check applications for eligibility

1.6 Verify signature on application with original documents

2. Identify and manage application and/or claim errors

2.1 Identify errors and incomplete applications and/or claims

2.2 Action incomplete or incorrect applications and/or claims according to organisational requirements

2.3 Prepare applications and/or claims for processing when required information is obtained

3. Assess and process applications for benefits and insurance claims

3.1 Check applications against conditions identified in trust deed and organisational procedures

3.2 Source additional information as required from relevant personnel

3.3 Check trust deed for defined beneficiaries and communicate with possible beneficiaries as necessary

3.4 Calculate benefit to include additional fees, charges and/or other factors, using computer system

3.5 Check information, including taxation and calculation results for integrity

3.6 Issue rollover documentation to members, Australian Taxation Office (ATO) and rollover funds, as required

3.7 Process application in accordance with conditions identified in trust deed, relevant legislation and organisational procedures

3.8 Pay benefit following organisational procedures if there is no objection from possible beneficiaries

4. Provide member communications

4.1 Provide statements and claim correspondence according to organisational guidelines and compliance requirements

4.2 Document processes and outcomes of application and/or claim in member files

4.3 Provide instruction for complaints to members as required

4.4 Maintain positive relations with clients

Evidence of Performance

Evidence of the ability to:

process complex superannuation or insurance claims in accordance with conditions contained in the trust deed and organisational requirements

manage applications and claim errors

identify, source and interpret required information to process benefits for lump sum payments, death claims and disablement claims

calculate payments including taxation requirements as required

assess and determine benefit entitlements for death and disablement claims using computer programs.

Note: If a specific volume or frequency is not stated, then evidence must be provided at least once.


Evidence of Knowledge

To complete the unit requirements safely and effectively, the individual must:

describe the key features of organisational policy, objectives and procedures relating to processing complex superannuation benefit or insurance claims

identify features and differences between payment types

describe documentation requirements for processing death and disability payments

outline the steps and procedures for:

assessing claims and calculating and processing payments

monitoring pension and annuity payments

outline the taxation requirements for:

death

deductions for payments

income protection

total and permanent disablement benefits

terminal illness benefit

financial hardship payment.


Assessment Conditions

Assessment must be conducted in a safe environment where evidence gathered demonstrates consistent performance of typical activities experienced in the superannuation field of work and include access to:

common office equipment, technology, software and consumables

organisational financial records

organisational policy and procedures.

Assessors must satisfy NVR/AQTF assessor requirements.


Foundation Skills

This section describes language, literacy, numeracy and employment skills incorporated in the performance criteria that are required for competent performance.

Skill

Performance Criteria

Description

Reading

1.1. 1.4-1.6, 2.1, 3.1, 3.3, 3.6

Analyses and consolidates complex information and data from a range of sources against defined criteria and eligibility requirements

Thoroughly checks information and data for accuracy, completeness and authenticity

Writing

1.2, 1.3, 3.2, 3.3, 4.1-4.4

Accurately records information and data using correct spelling and terminology

Prepares organisational documents and correspondence using language and concepts appropriate for the audience

Oral Communication

3.2, 3.3, 4.3, 4.4

Participates effectively in verbal exchanges, using active listening and questioning, to share, convey and clarify information with a range of people

Numeracy

2.1, 2.3, 3.1, 3.4-3.8

Performs mathematical calculations to analyse complex financial data and requirements, and to process payments and calculate taxation

Navigate the world of work

1.3, 2.2, 3.1, 3.6, 3.7, 4.1

Takes personal responsibility for following explicit and implicit policies, procedures and legislative requirements

Identifies and acts on issues that contravene relevant policies, procedures and legal requirements

Interact with others

3.2, 3.3, 4.3, 4.4

Cooperates with others and contributes to work practices where joint outcomes are expected and deadlines are to be met

Uses a range of strategies and reads verbal and non-verbal signals to establish a sense of connection and build rapport with clients and workmates

Get the work done

1.1, 1.4, 1.5, 2.1-2.3, 3.1-3.8

Takes responsibility for planning, sequencing and prioritising tasks and own workload for efficiency and effective outcomes

Accepts responsibility for addressing less predictable problems and initiates standard procedures in response, applying problem-solving processes in determining a solution

Makes routine decisions and implements standard procedures for routine tasks, using formal decision-making processes for more complex and non-routine situations

Uses a range of digitally based technologies to enter, access or update information to achieve required outcomes


Sectors

Superannuation