First contact, defective claims, adverse inference, etc

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    A member of staff has just provided me with his version of what he is doing in relation to first contacts and subsequent claims which has prompted us to question whether we are ‘doing it right’ or not.

    Our procedures are:

    Person rings up for a form.
    Form is issued with a letter asking for the form and all evidence to be provided within one month of the date of the letter.
    Form comes in 2 weeks later but is incomplete.
    We write back and tell them what is missing and also tell them that it is required by the end of the original one month time limit.
    Evidence does not come in so we send a decision letter telling them they do not qualify (using adverse inference).

    Our member of staff is saying that he understood we should give a month from when the form was received, but if the info comes in later than the month given when the form was sent, but inside the month given when we write to ask for missing info, we should process from the form received date.

    Reg 83 of the HB Regs 2006 could be taken both ways.

    Any other opinions?


    Difficult this, but I would treat the claim as made from the date of the telephone call (as it’s been received within a month) but because we now need further information I would give a month from when we received the form

    Kevin D

    The original letter has been treated as an INTENTION.

    [b:03f55609bb]HBR 86(1)[/b:03f55609bb] refers clearly to “….[b:03f55609bb]a person who makes a [u:03f55609bb]claim[/u:03f55609bb][/b:03f55609bb]….”.

    In my view, the clmt has one month from the date of the [u:03f55609bb]claim form[/u:03f55609bb] being received. The intention is not a claim, and never becomes a claim. An intention to claim simply engages a deeming provision by which the claim date is established in some, but not all, circumstances.

    And, if any further info is needed that needs a first time request, the month starts from the request for that info – not from the date the claim form is received.

    Hope the above helps.


    I agree with Kevin, who has mangaged to put what I was trying to say in a post that was running into several pages (and gave up on as it was too complex) into a neat summary

    I’d also add that i don’t think that you can make a ‘first time request’ for info before the claim form has been recieved.


    I’m going for the long post option anyway!

    This is the new dilemma in evidence gathering: are we requesting under Reg 83 or Reg 86?

    The phone call puts a marker down for the effective date of the claim as and when it is eventually received, but it does not establish a claim: the claim still has to be in writing on properly completed form etc.

    To be “properly completed”, the form must be accompanied by evidence referred to in the instructions issued on/with the form: otherwise the claim is defective. If you were an exceedingly strict authority and inclined to take a perverse view of Reg 83, you would note that you “may” offer the claimant the opportunity to make good the defective claim, so presumably you don’t have to. You would then say “Sorry, we have not received a properly completed form within a month of your phone call, so your claim is not effective from that date; indeed, we have not received a properly completed form at all yet so as things stand we won’t be paying benefit. Goodbye”.

    But most authorities don’t operate like that (in fact I hope none do). Most authorities would refer the claim back to be “properly completed” under Reg 83 and would allow a month for this to be done. There is an intriguing question that arises at this stage: suppose the evidence is supplied within a month of that referral back, but not within a month of the original phone call? Would this scupper the phone call as the effective date, and leave the claim effective only from the date on which the form was received? Again, on a strict reading I think that is what would happen, but I would imagine that many authorities do not stand on ceremony over this.

    In summary I think the time limit for making good the defective claim is one month from being invited to do so, but an ultra-strict Council could argue that you don’t have to make any such invitation at all. But there is a parallel time limit to submit a “properly completed” claim within a month of the telephone contact – this is not a time limit to provide information as such, it is a time limit to stake a claim from the date of the phone call as opposed to the date of the written claim.

    If the evidence is not received within a month of the invitation to “complete” the form, the Council is at liberty to make a defective claim decision, whatever one of those is, and the claimant may appeal, for whatever that is worth. Personally I don’t like it.

    There is, of course, an alternative. If you can’t be doing with all this “defective claim” and “properly completed” mumbo jumbo you might instead say this:

    – if something is received in writing within a month of the telephone contact, the claim is good from the date of the phone call whether you need to get further evidence or not
    – request that further evidence under Reg 86
    – if you don’t receive it within a month, make an adverse inference
    – the claimant has a much clearer right to appeal on the substantive matter that you have inferred – income, capital or whatever.

    I think you could even opt for a blend of the two approaches – request the evidence under Reg 83 (invitation to complete form properly) but still rely on adverse inference when it comes to refusing the claim because this is a much more solid kind of decision than the woolly “your claim is defective” routine.

    What do people think about the issue that I touched on earlier – claim “properly completed” within a month of invitation, but not within a month of telephone contact? Would you only make the claim effective form the date on which the incomplete form was received?

    I ring up today and aks for a form, you send me one. Clock ticking, I have until 20 November to submit a “properly completed” form.

    Next Friday (27/10) you receive my written claim, but missing some evidence so as far as you are concerned my claim is defective.

    On Monday 30/10 (because you are razor sharp dealing with post, right?) you invite me to make good my defective claim – I have a month to do this, no doubt about that so far as I can see.

    I provide the evidence on 28 November – within the month allowed to make my claim, er, “effective” but not within a month of the telephone contact. Have I blown it? Will I only be entitled from 30 October (the Monday after the written claim?). On strict reading of Reg 83, I think that’s the way it is.



    We may have to change our procedures slightly!



    Well don’t do it just because I say so!

    Wait and see if I’m wrong first


    One of my colleages has emailed the Adelphi to see what their interpretation is.

    Once we have their reply, we will compare everything then decide the way forward.

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