Terms & Conditions

[mew]

Hello, I’m sure someone out there will be able to point me in the right direction.

No sure of when you have to inform the claimant that their claim has been suspended.

EG

We receive a VF review form today and from a quick glance it appears that their circumstances have changed which will probably result in an o/p. To prevent a LA error overpayment we suspend the claim immediately.

Within the next 7 days a processor will look at the claim and either process the changes or write out for further information.

Do we need to send a letter to the claimant as soon as it is suspended? I can’t find anything in the regs to suggest that we must inform them, after all they do not have the right of appeal against the decision to suspend but as a person affected should we tell them.

It seems silly to send a letter out today telling them it has been suspended and then a couple days later that it is reinstated and a fresh decision is notified.

My only concern that if they are expecting a cheque and its not forthcoming that this will result in an enquiry.

Any opinions very welcome 🙂

Thank you

[markp]

If you write out for further details would you then tell the claimant that the suspension had been done? It would seem prudent to do so as they would then know that nothing is in payment.

I would advise of the suspension in the first instance as you cannot know that a prompt reinstatement will be carried out. If you are able to reassess the claim promptly you could always then explain that the suspension was necessary to prevent any OP from increasing and so that would explain the rapid notifications.

That’s my view on it anyhow.

Do I know what I'm doing? The jury's out on that........................

[mew]

Thank you for your repsonse. We would inform them that the claim is suspended if further info is required.

[Karen]

we always inform the clmt that their claim has been suspended, our suspension letter has a ‘reason’ box that allows us to state why and to request further information,

As Mark said – the claim might not be processed quickly as other factors may crop up and then how would you keep a track of the dates from when the suspension reminder and termination letter should be issued.

our Civica system has an automated suspension feature, so as long as the initial suspension letter is requested by the decision maker the rest are issued automatically up to the termination letter, which the team leaders decide if it should be issued or remain suspended.

From an appeals point of view, even though you can’t appeal a suspension, it’s always good to show a procedure in place prior to the actual termination 😆

[Author]

Posts