Was cancelling claim justified?

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  • #31809
    Neil Adamson
    Participant

    I have a tricky scenario on which I would appreciate some assistance.

    Customer made a claim (CTB only) in 2008 and requested backdating. Claim was put into payment and additional information was requested. This information was not supplied and normally I would have said the correct course of action would be to refuse the backdating request.

    However on this claim so much effort was made to obtain an answer, including home visits, the decision was made to cancel the claim as our visiting section advised us that there were grave concerns that the customer was resident. Whilst I can see the reasoning I am not entirely comfortable with this approach.

    Customer reclaims in 2010 and we backdate to Dec 2009 – leaving no award March 08 to Dec 09. What are my options, if any, for the gap?

    #88958
    Anonymous
    Guest

    Was the ‘cancelation’ decision retrospective? ie, did you cancel right back to the start, creating an overpayment of CTB? If so I think you could revise on grounds of official error. You were originally satisfied that she was resident and paid CTB accordingly, you later received information that suggested she was not resident from the date of the failed visit. I think cancelling back to the start was an official error in that you had no evidence to justify such a decision.

    Alternatively:

    Did you follow the suspension / termination procedure?
    Was the claimant properly notified of the decision, with appeal rights?

    #88959
    Neil Adamson
    Participant

    Sorry for the delay.

    The claim was suspended when it was reviewed and a reminder letter issued.

    When no reply was received claim was terminated from the suspension date and not from the start of the award.

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