6. Reviews and appeals
6.1 Reviews
The compensator, the injured person, or either party's representative may ask CRU to review any aspect of a Certificate at any time. Please put your request in writing giving the reasons why you think the Certificate is wrong.
A review may be made on the following grounds:
- that it was issued in ignorance of, or based on a mistake as to, a material fact; or
- a mistake was made (whether in computation or otherwise) in its preparation; or
- incorrect or insufficient information was supplied to the Secretary of State by the person who applied for the Certificate and in consequence the amount of benefit/lump sum specified in the Certificate was less than it would have been had the information supplied been correct or sufficient; or
- a ground for appeal is satisfied under section 11 of the Act.
When we review a Certificate we look at all the benefits and or lump sum payments we have listed as recoverable, the amounts paid, and the period over which they have been or are likely to be paid. Any errors, omissions or other changes, which may affect the outcome of the review, will be taken into account, even if unrelated to your reasons for requesting the review.
Once the review is complete, we will either confirm in writing that the Certificate is correct or revoke the Certificate and issue a fresh one. If a revised Certificate is issued it will cover the same period as the Certificate it replaces.
We will issue a fresh Certificate showing an increase in the amount of recoverable benefits only where the variation is required because the person who applied for the Certificate, supplied us with incorrect or insufficient information. Where this happens, the compensator will be liable to pay the difference to CRU.
Lump Sums
If we become aware that recoverable lump sums have been paid after a Certificate has been issued, we will issue a revised Certificate to include the lump sum amount and the revised Certificate will supercede any previous certificate.
6.2 Appeals
Leaflet Z2 explains how to appeal against a Certificate. It also contains the form that can be used.
An appeal against a Certificate may be made on the grounds that:
- any amount, rate or period specified in the Certificate is wrong;
- the Certificate shows benefits and or lump sums which were not paid as a result of the accident, injury or disease;
- benefits and or lump sum payments listed which have not and are not likely to be paid to the injured person have been brought into account;
- the compensation payment made was not as a consequence of the accident, injury or disease.
Please note: Any requests for appeal that do not comply with the above grounds will be regarded as invalid and referred to the Tribunals Service for authority to proceed.
An appeal may only be made after final settlement of the compensation claim and payment of recoverable benefits and or lump sum payments has been made.
An appeal must be made within one month of the date on which the compensator makes the full payment of recoverable benefits and or lump sums to the Secretary of State.
For appeal purposes, orders for provisional damages in personal injury cases made under or by virtue of section 32A(2)(a) of the Supreme Court Act 1981, section 12(2)(a) of the Administration of Justice Act 1982, or section 51(2)(a) of the County Courts Act 1984, are to be treated as having been finally disposed of.
Late appeals are determined by the chairperson of the Tribunals Service and may be accepted where there are special circumstances for lateness. Late appeals cannot be accepted 13 months after the date the right to appeal arose.
An appeal may be made by a compensator or by an injured person whose compensation payment has been reduced by the compensator to take account of benefit/lump sum recovery, in accordance with section 8 of the 1997 Act and Regulation 12 of the Social Security (Recovery of Benefits) (Lump Sum Payments) Regulations 2008.
Appeals are heard by an independent tribunal administered by the Tribunals Service.
The tribunal may decide that the amount on a Certificate is correct or that the amount may be either increased or decreased.
Following the decision CRU will either confirm or revoke the Certificate and issue a fresh one.
Where the amount on a Certificate is increased following an appeal the compensator will be liable to pay the balance of recoverable benefits and or lump sum payments to the DWP.
Where the amount on a Certificate is reduced, the balance will be refunded to the compensator.
Where the compensator has offset some of the amount on a certificate (see examples of offsetting in Section 1.2, Listed benefits covered by the scheme) against the compensation paid to the injured party, some or all of the refund may need to be passed on to the injured party.
Any party may make an appeal to the Social Security Commissioners against the decision of an appeal tribunal on the grounds that the decision was erroneous in law. Such an appeal may only be brought with leave of the Appeal Tribunal Chair or the Commissioners. Application for leave to appeal to the Commissioners should be made to the Tribunals Service.
Please note: Sections 10-14 of the Social Security (Recovery of Benefits) Act 1997 and Regulations 9 and 30-58 of the Social Security and Child Support (Decision and Appeals) Regulations 1999 contain information regarding Reviews and Appeals.