Over or Underpayment Processing for a Benefit Case

When an over or underpayment is found during reassessment, the eligibility and entitlement engine records the over or underpayment details and initiates over or underpayment processing. Over or underpayment processing for a benefit case is set up at the product level.

Over or underpayment processing for a benefit case can be set up such that a notification is sent to the case owner informing the owner that an over or underpayment has been discovered during reassessment. The case owner can then decide how to proceed with the over or underpayment.

Over or underpayments can also be processed automatically. Automatic overpayment processing differs from automatic underpayment processing. To automatically process an overpayment, the eligibility and entitlement engine automatically creates an overpayment case. To automatically process an underpayment, the eligibility and entitlement engine checks the 'auto underpayment case creation' setting on the associated product.

If the 'auto underpayment case creation' setting is set to true, a secondary check is performed to see if any live (i.e., non-closed or pending closure) liabilities exist for the primary client on the case. This secondary check is governed by an environment variable, so it can be switched off if desired. If any live liabilities exists for the primary client, the eligibility and entitlement engine creates a benefit underpayment case for each nominee on the original case who received a payment; however, the primary client on the benefit underpayment case(s) will be the same as that of the original benefit case.

If the 'auto underpayment case creation' setting is set to false, the eligibility and entitlement engine creates an underpayment financial component on the original case. This underpayment financial component is a once-off financial component with an amount equal to the underpayment.