Reviews, appeals and tribunals: timetable for reviews
In principle, any request for a review or reconsideration should be made within 45 days of receipt of the disputed decision. In practice, we would not refuse to reconsider a decision where the request to do so is made after 45 days except in the most exceptional circumstances.
Once we have reviewed a decision, a further review can only be requested if there are fresh facts or other matters.
We are obliged to review any decision covered by the list in section 59(1) if requested to. Once a request has been made, we have 45 days to complete the review and respond. If we do not reply to the person who asked for the review within that time limit, we are assumed (by section 59(7)) to have confirmed the original decision - a ‘deemed decision’:
|(7) In a case where-|
(a) it is the duty under this section of the Commissioners to review any decision, and
(b) they do not, within 45 days beginning with the day on which the review was required, give notice to the person requiring it of their determination on the review,
|they shall be assumed for the purposes of this Part to have confirmed the decision.|
Where a decision is to be confirmed, out of courtesy this should be done in writing rather than by simply allowing the 45 days to elapse.
We could, in exceptional circumstances, (for instance if we need to obtain further information or consult technical experts etc), ask the insurer if they would be willing not to exercise their right of appeal until sometime after the review period has expired. They have the right to refuse this request however and every effort must be made to deal with the review in the time allowed.
When new information is produced allowing a second or subsequent review, the 45-day clock starts afresh. However, if the insurer confirms that they are not seeking a further review and agree not to exercise the right of appeal at the end of the original review period, in order to allow due consideration to the new information, we can treat it as part of that original review. Much depends on the content of the new information and when it is received. If received towards the end of the review period, it is likely that a further review period will be necessary.
The timetable relating to reviews of decisions can be summarised as follows.
|Day 1||Decision given|
|Day 45||Last day in principle to seek a review|
If a request for a second or subsequent review is made, the clock starts again.
|Day 1||Review requested|
|Day 45||Last day for us to give decision. If decision not given, original decision is assumed to have been confirmed.|
Remember to follow the new procedures contained in Appeals, Reviews and Tribunals guidance (ARTG) from 1 April 2009. See IPT09140 for a summary of the changes.