An administrator would initiate the claim using either of the following paths:
For a new claim
Processes > Benefits.
Select Claims from the top menu.
To process new claim
Processes > Benefits.
Select Process Benefit Payment from the top menu.
Note:
For the Role of Super User, when the Claims menu item is selected on Core for either an Employer or a Scheme, the system will read for a Global Parameter of WORKFLOWENABLED. If the Description of the Parameter is equal to YES, the Claims menu item will be disabled on Core and can only be accessed through My Work.
If no Global Parameter is found, the system will read for a Scheme Parameter of WORKFLOWENABLED. If the Description of the Parameter is equal to YES, the Claims menu item will be disabled on Core and can only be accessed through My Work.
Select the required employee membership as described under
Processes
Benefits
Claims Administration Overview
Selecting Members
The claim may now be initiated.
Select Claims from the menu on top, followed by the New Claim from the sub-menu on the left.
The Benefit Claim Request screen will be displayed.
If an event with an event category of Disability is selected, the system will display the Illness Type field and allow the user to select an Illness Type.
Capture a date for the Date of Event and Date of Claim Form fields and select the event from the drop-down list. Click SUBMIT.
Note:
The Date of Claim Form field is used for cases where the Accrual Date on the Tax Directive Request must be the date that the claim form was signed by the Member. This is an optional field.
Note:
The event types displayed under the drop-down list are the events selected under the scheme benefit structure. Refer to
Product Launch Requirements
Product Update
Product Update Type: Maintain Scheme Benefit Rules
If the event date entered is after the current month, a confirmation message will be displayed:
Calculation Effective date is > than the current month. Do you wish to continue?
Click OK to continue, or click CANCEL to return to the Benefit Claim Request screen. Enter the correct event date, then click SUBMIT.
If unauthorized income transactions exist for the member, which must first be processed, an error message will be displayed.
Click the hyperlinked here.
If there is no investment balance, or if a zero benefit has been calculated, a message will be displayed, e.g. a member who was incorrectly added without contributions.
If you want to update the membership to a finalized status, click YES.
A message will confirm that the status has been successfully finalized.
To continue without updating the membership to a finalized status, click the hyperlinked here. You will not be able to process the claim any further.
Once all validation has been passed, the Benefit Claim Results screen will be displayed, showing the amount of the benefit.
You are able to view a detailed breakdown of the amount. Refer to View amount breakdown.
Click the hyperlinked here to continue processing the claim. Alternatively, this can be done at a later stage. Refer to
Processes
Benefits
Capturing Exit Notifications
Capturing of Exit Notifications
Complete a Claim.
Completing a Claim
Note:
If a member's date of joining the scheme is incorrect, it may have an effect on the benefit calculation. The date of joining the scheme can only be updated for members whose status is EXIT IN PROCESS. Refer to Accessing an existing member under
Clients
Members
The JU4EA Process New Claim screen will be displayed.
Last Contribution Date
The Last Contribution Date field will be displayed on the JU4EA Process New Claim screen when the Reference Number has been captured or selected through the Search button.
The system will retrieve the Business Transaction with the latest Due Date on the member’s CONTRIBUTION account with an accounting activity of SFCONTRB or on the member’s EXITCONTRB account with an accounting activity of EXITCONTRB.
The system will check for reversals. If there is a business transaction with an accounting activity of SFCONTRBREV or CONTRBNG in the case of the CONTRIBUTION account or EXITCONTNEG in the case of the EXITCONTRIB.
To find the member for whom the benefit payment is required, click SEARCH. After selecting the member, key in the Date of Exit and select the exit Type from the drop-down list. Click SUBMIT. The JU4CN Benefit Payment Process screen will be displayed.
After the claim has been initiated as above, the benefit payment update types may be processed. Refer to
Processes
Benefit
Benefit Payment Update Type
Benefit Payment Update Types (Standard Benefit Rules)
When a claim is processed via the JU4EA Process New Claim screen and the benefit amount is displayed on the JU4CK Results Breakdown Bonus screen, and the Type of Investment for one of the Member’s investment portfolios is BONUS and the Pricing Frequency is MONTHLY, the system will retrieve the business transactions in the Member’s INVESTMEMB account with a Timestamp greater than the Timestamp of the latest Monthly Bonus run.
Interest will be calculated on the business transactions from the Transaction Date or Due Date depending on the value for Interest From on the Scheme Details, to the Date of Event using the Bonus Rate effective for the relevant period.