Step | Action |
1 | Claim allocated with no response to RFI
Follow up where: - an RFI due date has been reached, and
- the customer has not responded to the RFI
Are the requested documents required to assess the claim? |
2 | Initial RFI date
Check the Document List (DL) screen for the date of the RFI DOC. Is the date of the RFI DOC request more than 13 weeks ago? |
3 | Check if task due date has been extended
Check the Claim Progress DOC for: - previous contact with the customer about the RFI, during which they provided a date they would supply information by, or
- the inability to contact a customer whose record shows that they are at risk or vulnerable
The claim can be rejected if: - the RFI due date has been extended and the due date is in the past, and
- the customer has not provided the required information
Can the claim be rejected? |
4 | Contact attempt required
Make a genuine attempt to contact the customer to determine whether they: - can provide the required information, or have:
- a reasonable excuse for not responding to the request, or
- special circumstances that have impacted their ability to comply with the request
Was contact with the customer successful? |
5 | Successful contact attempt
If the customer: - can provide the information verbally or can upload it immediately, assess the claim. See:
- can supply the required information by the end of the day, hold the claim for one business day. Annotate the Claim Progress DOC. The claim will be allocated after the next business day to be assessed
Procedure ends here. |
6 | Reasonable excuse or special circumstances
Consider if the customer has a reasonable excuse or special circumstances for not providing the information. such as: - A major disruptive event such as a fire, flood, earthquake, vandalism, or crime that affects the person's home
- Living in a remote area which has delayed delivery of the request or obtaining the required information
- Delays obtaining information from a third party
- A major personal crisis such as the death of a family member, the breakdown of a relationship, domestic violence
- Caring duties
- Jury duty
- Not having access to safe, secure and adequate housing
- Language and literacy ability
- An illness, impairment or medical condition
- Drug or alcohol dependency
Does the customer have a reasonable excuse or special circumstances? - Yes, advise the customer their claim will be assessed when they provide the required information. Extend the task due date/s until the earlier of:
- the day after the date the customer advised they can provide the requested information, or
- 13 weeks from the initial request date
- Procedure ends here
- No, go to Step 8
|
7 | Unsuccessful contact attempt
Consider if there are vulnerabilities or risk factors that may impact the customer’s ability to comply with the request for details. See Identifying customer vulnerability and risk issues. Are there vulnerabilities or risk factors for the customer? - Yes, extend the task due date by 7 days. Annotate the Claim Progress DOC with the reason for decision
- No, go to Step 8
|
8 | Reject claim
Reject the claim using the most appropriate rejection code. See: |
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