TCM0080180 - Claims - work lists (VFs - miscellaneous): Verification Failures - Compliance activity

Background

When a claim is captured and the overall risk is deemed serious enough for a pre-award review, the claim will be put onto a Compliance Failures work list.

Once a claim is on the Compliance Failures work list, a user working a Verification Failures work list will be inhibited from working any verification failures relating to that claim, the ‘Navigate’ option on the Manage Verification Failures screen will be greyed out, and the Decision Status will be set to ‘Application Suspended’. In this scenario, the case must be put in BF for two weeks pending Compliance action.

You mustn’t action the verification failure by directly accessing the AMEND Function. By doing this, the case will not be cleared from either the Compliance work list or the Verification Failures work list.

Note: From 6 April 2017, customers will only get the Family Element of Child Tax Credit where they are responsible for a child or children born before that date.

Note: The individual child element of Child Tax Credit will no longer be awarded for third and subsequent children or qualifying young persons in a household, born on or after 6 April 2017, unless it meets the exception criteria.

Guidance

Note: If you are dealing with a claim where the exception marker has been applied to any of the children/young persons included in the claim contact the Exception Team (This content has been withheld because of exemptions in the Freedom of Information Act 2000) For how to check if the exception marker has been applied, use TCM1000314.

Note: If you are dealing with a claim where the customer states they are claiming for a child/young person who is an exception contact the Exception Team (This content has been withheld because of exemptions in the Freedom of Information Act 2000) .

To deal with a claim where a verification failure exists but [Navigate] is greyed out and the Decision Status is set to ‘Application Suspended’, consider steps 1 to 5.

Step 1

If you are working the Verification Failures work list and have accessed the Manage Verification Failures screen, check if the

  • ‘Navigate’ option is greyed out on the toolbar
  • Decision status is set to ‘Application Suspended’
    • If they are, use Function MAINTAIN WORKLIST and set the action date for 14 days in the future, making sure that the Retained checkbox is selected. Then go to Step 2.
    • If not, continue to action the work list item as normal.

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Step 2

On expiry of the action date, check if the ‘Navigate’ option is still greyed out and the Decision Status is still ‘Application Suspended’

  • If they are, go to Step 3.
  • If they are and/or there is an Under Enquiry signal present, go to Step 4.

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Step 3

Contact the relevant Compliance Officer in order to progress the case. You can find the relevant details by using TCM1000022

  • ask them what action date you should set for the work list item
  • use Function MAINTAIN WORKLIST and set the Action Date as requested, making sure that the Retained checkbox is selected. Then go to Step 5.

Note: Once Compliance has completed its action, the verification failures are either cleared by Compliance or they are redisplayed if the case is released for processing.

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Step 4

Use Function MAINTAIN WORKLIST

  • set the Action Date for a further four weeks, making sure that the Retained checkbox is selected
    then, when the action date expires
  • go to Step 5.

Note: Once Compliance has completed its action, the verification failures are either cleared by Compliance or they are redisplayed if the case is released for processing.

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Step 5

On expiry of the four-week action date, check if the ‘Navigation’ option is still greyed out and the Decision Status is ‘Referred for Enquiry’ and/or there is an Under Enquiry signal present.

  • continue to set a four-week Action Date, making sure that the Retained checkbox is selected, until the work list item is removed from the worklist
  • use Function MAINTAIN WORKLIST
  • set the Action Date for a further four weeks, making sure that the Retained checkbox is selected.

Note: Once Compliance has completed its action, the verification failures are either cleared by Compliance or they are redisplayed if the case is released for processing.