Social Security (Recovery of Benefits) Act 1997

Introductory

Cases in which this Act applies

1

• (1) This Act applies in cases where—

• (a) a person makes a payment (whether on his own behalf or not) to or in respect of any other person in consequence of any accident, injury or disease suffered by the other, and

• (b) any listed benefits have been, or are likely to be, paid to or for the other during the relevant period in respect of the accident, injury or disease.

• (2) The reference above to a payment in consequence of any accident, injury or disease is to a payment made—

• (a) by or on behalf of a person who is, or is alleged to be, liable to any extent in respect of the accident, injury or disease, ...

• (b) in pursuance of a compensation scheme for motor accidents, or

• (c) under the Diffuse Mesothelioma Payment Scheme (established under the Mesothelioma Act 2014);

but does not include a payment mentioned in Part I of Schedule 1.

• (3) Subsection (1)(a) applies to a payment made—

• (a) voluntarily, or in pursuance of a court order or an agreement, or otherwise, and

• (b) in the United Kingdom or elsewhere.

• (4) In a case where this Act applies—

• (a) the “injured person” is the person who suffered the accident, injury or disease,

• (b) the “compensation payment” is the payment within subsection (1)(a), and

• (c) “recoverable benefit” is any listed benefit which has been or is likely to be paid as mentioned in subsection (1)(b).

Compensation payments to which this Act applies

2

This Act applies in relation to compensation payments made on or after the day on which this section comes into force, unless they are made in pursuance of a court order or agreement made before that day.

“The relevant period”

3

• (1) In relation to a person (“the claimant”) who has suffered any accident, injury or disease, “the relevant period” has the meaning given by the following subsections.

• (2) Subject to subsection (4), if it is a case of accident or injury, the relevant period is the period of five years immediately following the day on which the accident or injury in question occurred.

• (3) Subject to subsection (4), if it is a case of disease, the relevant period is the period of five years beginning with the date on which the claimant first claims a listed benefit in consequence of the disease.

• (4) If at any time before the end of the period referred to in subsection (2) or (3)—

• (a) a person makes a compensation payment in final discharge of any claim made by or in respect of the claimant and arising out of the accident, injury or disease, or

• (b) an agreement is made under which an earlier compensation payment is treated as having been made in final discharge of any such claim,

the relevant period ends at that time.

Certificates of recoverable benefits

Applications for certificates of recoverable benefits

4

• (1) Before a person (“the compensator”) makes a compensation payment he must apply to the Secretary of State for a certificate of recoverable benefits.

• (2) Where the compensator applies for a certificate of recoverable benefits, the Secretary of State must—

• (a) send to him a written acknowledgement of receipt of his application, and

• (b) subject to subsection (7), issue the certificate before the end of the following period.

• (3) The period is—

• (a) the prescribed period, or

• (b) if there is no prescribed period, the period of four weeks,

which begins with the day following the day on which the application is received.

• (4) The certificate is to remain in force until the date specified in it for that purpose.

• (5) The compensator may apply for fresh certificates from time to time.

• (6) Where a certificate of recoverable benefits ceases to be in force, the Secretary of State may issue a fresh certificate without an application for one being made.

• (7) Where the compensator applies for a fresh certificate while a certificate (“the existing certificate”) remains in force, the Secretary of State must issue the fresh certificate before the end of the following period.

• (8) The period is—

• (a) the prescribed period, or

• (b) if there is no prescribed period, the period of four weeks,

which begins with the day following the day on which the existing certificate ceases to be in force.

• (9) For the purposes of this Act, regulations may provide for the day on which an application for a certificate of recoverable benefits is to be treated as received.

Information contained in certificates

5

• (1) A certificate of recoverable benefits must specify, for each recoverable benefit—

• (a) the amount which has been or is likely to have been paid on or before a specified date, and

• (b) if the benefit is paid or likely to be paid after the specified date, the rate and period for which, and the intervals at which, it is or is likely to be so paid.

• (2) In a case where the relevant period has ended before the day on which the Secretary of State receives the application for the certificate, the date specified in the certificate for the purposes of subsection (1) must be the day on which the relevant period ended.

• (3) In any other case, the date specified for those purposes must not be earlier than the day on which the Secretary of State received the application.

• (4) The Secretary of State may estimate, in such manner as he thinks fit, any of the amounts, rates or periods specified in the certificate.

• (5) Where the Secretary of State issues a certificate of recoverable benefits, he must provide the information contained in the certificate to—

• (a) the person who appears to him to be the injured person, or

• (b) any person who he thinks will receive a compensation payment in respect of the injured person.

• (6) A person to whom a certificate of recoverable benefits is issued or who is provided with information under subsection (5) is entitled to particulars of the manner in which any amount, rate or period specified in the certificate has been determined, if he applies to the Secretary of State for those particulars.

Liability of person paying compensation

Liability to pay Secretary of State amount of benefits

6

• (1) A person who makes a compensation payment in any case is liable to pay to the Secretary of State an amount equal to the total amount of the recoverable benefits.

• (2) The liability referred to in subsection (1) arises immediately before the compensation payment or, if there is more than one, the first of them is made.

• (3) No amount becomes payable under this section before the end of the period of 14 days following the day on which the liability arises.

• (4) Subject to subsection (3), an amount becomes payable under this section at the end of the period of 14 days beginning with the day on which a certificate of recoverable benefits is first issued showing that the amount of recoverable benefit to which it relates has been or is likely to have been paid before a specified date.

Recovery of payments due under section 6

7

• (1) This section applies where a person has made a compensation payment but—

• (a) has not applied for a certificate of recoverable benefits, or

• (b) has not made a payment to the Secretary of State under section 6 before the end of the period allowed under that section.

• (2) The Secretary of State may—

• (a) issue the person who made the compensation payment with a certificate of recoverable benefits, if none has been issued, or

• (b) issue him with a copy of the certificate of recoverable benefits or (if more than one has been issued) the most recent one,

and (in either case) issue him with a demand that payment of any amount due under section 6 be made immediately.

• (3) The Secretary of State may, in accordance with subsections (4) and (5), recover the amount for which a demand for payment is made under subsection (2) from the person who made the compensation payment.

• (4) If the person who made the compensation payment resides or carries on business in England and Wales and the county court so orders, any amount recoverable under subsection (3) is recoverable under section 85 of the County Courts Act 1984 or otherwise as if it were payable under an order of that court.

• (5) If the person who made the payment resides or carries on business in Scotland, any amount recoverable under subsection (3) may be enforced in like manner as an extract registered decree arbitral bearing a warrant for execution issued by the sheriff court of any sheriffdom in Scotland.

• (6) A document bearing a certificate which—

• (a) is signed by a person authorised to do so by the Secretary of State, and

• (b) states that the document, apart from the certificate, is a record of the amount recoverable under subsection (3),

is conclusive evidence that that amount is so recoverable.

• (7) A certificate under subsection (6) purporting to be signed by a person authorised to do so by the Secretary of State is to be treated as so signed unless the contrary is proved.

Reduction of compensation payment

Reduction of compensation payment

8

• (1) This section applies in a case where, in relation to any head of compensation listed in column 1 of Schedule 2—

• (a) any of the compensation payment is attributable to that head, and

• (b) any recoverable benefit is shown against that head in column 2 of the Schedule.

• (2) In such a case, any claim of a person to receive the compensation payment is to be treated for all purposes as discharged if—

• (a) he is paid the amount (if any) of the compensation payment calculated in accordance with this section, and

• (b) if the amount of the compensation payment so calculated is nil, he is given a statement saying so by the person who (apart from this section) would have paid the gross amount of the compensation payment.

• (3) For each head of compensation listed in column 1 of the Schedule for which paragraphs (a) and (b) of subsection (1) are met, so much of the gross amount of the compensation payment as is attributable to that head is to be reduced (to nil, if necessary) by deducting the amount of the recoverable benefit or, as the case may be, the aggregate amount of the recoverable benefits shown against it.

• (4) Subsection (3) is to have effect as if a requirement to reduce a payment by deducting an amount which exceeds that payment were a requirement to reduce that payment to nil.

• (5) The amount of the compensation payment calculated in accordance with this section is—

• (a) the gross amount of the compensation payment,

less

• (b) the sum of the reductions made under subsection (3),

(and, accordingly, the amount may be nil).

Section 8: supplementary

9

• (1) A person who makes a compensation payment calculated in accordance with section 8 or 8A must inform the person to whom the payment is made—

• (a) that the payment has been so calculated, and

• (b) of the date for payment by reference to which the calculation has been made.

• (2) If the amount of a compensation payment calculated in accordance with section 8 or 8A is nil, a person giving a statement saying so is to be treated for the purposes of this Act as making a payment within section 1(1)(a) on the day on which he gives the statement.

• (3) Where a person—

• (a) makes a compensation payment calculated in accordance with section 8 or 8A, and

• (b) if the amount of the compensation payment so calculated is nil, gives a statement saying so,

he is to be treated, for the purpose of determining any rights and liabilities in respect of contribution or indemnity, as having paid the gross amount of the compensation payment.

• (4) For the purposes of this Act—

• (a) the gross amount of the compensation payment is the amount of the compensation payment apart from section 8 or 8A, and

• (b) the amount of any recoverable benefit is the amount determined in accordance with the certificate of recoverable benefits.

Reviews and appeals

Review of certificates of recoverable benefits

10

• (1) Any certificate of recoverable benefits may be reviewed by the Secretary of State—

• (a) either within the prescribed period or in prescribed cases or circumstances; and

• (b) either on an application made for the purpose or on his own initiative.

• (2) On a review under this section the Secretary of State may either—

• (a) confirm the certificate, or

• (b) (subject to subsection (3)) issue a fresh certificate containing such variations as he considers appropriate or.

• (c) revoke the certificate.

• (3) The Secretary of State may not vary the certificate so as to increase the total amount of the recoverable benefits unless it appears to him that the variation is required as a result of the person who applied for the certificate supplying him with incorrect or insufficient information.

• (4) The scheme administrator of the Diffuse Mesothelioma Payment Scheme may not apply for a review under this section.

Appeals against certificates of recoverable benefits

11

• (1) An appeal against a certificate of recoverable benefits may be made on the ground—

• (a) that any amount, rate or period specified in the certificate is incorrect, or

• (b) that listed benefits which have been, or are likely to be, paid otherwise than in respect of the accident, injury or disease in question have been brought into account or.

• (c) that listed benefits which have not been, and are not likely to be, paid to the injured person during the relevant period have been brought into account, or

• (d) that the payment on the basis of which the certificate was issued is not a payment within section 1(1)(a)

• (2) An appeal under this section may be made by—

• (a) the person who applied for the certificate of recoverable benefits, or

• (aa) (in a case where that certificate was issued under section 7(2)(a)) the person to whom it was so issued, or

• (b) (in a case where the amount of the compensation payment has been calculated under section 8 or 8A) the injured person or other person to whom the payment is made.

but the scheme administrator of the Diffuse Mesothelioma Payment Scheme may not appeal under this section.

• (2A) Regulations may provide that, in such cases or circumstances as may be prescribed, an appeal may be made under this section only if the Secretary of State has reviewed the certificate under section 10.

• (2B) The regulations may in particular provide that that condition is met only where—

• (a) the review by the Secretary of State was on an application,

• (b) the Secretary of State considered issues of a specified description, or

• (c) the review by the Secretary of State satisfied any other condition specified in the regulations.

• (3) No appeal may be made under this section until—

• (a) the claim giving rise to the compensation payment has been finally disposed of, and

• (b) the liability under section 6 has been discharged.

• (4) For the purposes of subsection (3)(a), if an award of damages in respect of a claim has been made under or by virtue of—

• (a) section 32A(2)(a) of the Senior Courts Act 1981,

• (b) section 12(2)(a) of the Administration of Justice Act 1982, or

• (c) section 51(2)(a) of the County Courts Act 1984,

(orders for provisional damages in personal injury cases), the claim is to be treated as having been finally disposed of.

• (5) Regulations may make provision—

• (a) as to the manner in which, and the time within which, appeals under this section may be made,

• (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (c) for the purpose of enabling any such appeal (or, where in accordance with regulations under subsection (2A) there is no right of appeal, any purported appeal) to be treated as an application for review under section 10.

• (6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Reference of questions to medical appeal tribunal

12

• (1) The Secretary of State must refer an appeal under section 11 to the First-tier Tribunal.

• (3) In determining any appeal under section 11, the tribunal must take into account any decision of a court relating to the same, or any similar, issue arising in connection with the accident, injury or disease in question.

• (4) On an appeal under section 11 the First-tier Tribunal may either—

• (a) confirm the amounts, rates and periods specified in the certificate of recoverable benefits, or

• (b) specify any variations which are to be made on the issue of a fresh certificate under subsection (5) or.

• (c) declare that the certificate of recoverable benefits is to be revoked.

• (5) When the Secretary of State has received the decision of the tribunal on the appeal under section 11, he must in accordance with that decision either—

• (a) confirm the certificate against which the appeal was brought, or

• (b) issue a fresh certificate or.

• (c) revoke the certificate.

• (6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (7) Regulations . . . may (among other things) provide for the non-disclosure of medical advice or medical evidence given or submitted following a reference under subsection (1).

• (8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Appeal to Social Security Commissioner

13

• (1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (2) An appeal to the Upper Tribunal under section 11 of the Tribunals, Courts and Enforcement Act 2007 which arises from any decision of the First-Tier Tribunal made under section 12 of this Act may be made by—