National Insurance Act 1965

Determination of certain matters by insurance officers, local tribunals or Commissioner.

67 Certain questions to be determined by insurance officers, local tribunal or Commissioner.

(1) Subject to the provisions of this Act, any question arising under this Act—

(a) as to the right to benefit; or

(b) whether a person would by reason of the provisions of, or of any regulations made under, section 22(2) or (3) of this Act have been disqualified for receiving either unemployment benefit or sickness benefit if he had otherwise had a right thereto,

shall be determined in accordance with the provisions of sections 68 to 72 of this Act by an insurance officer, a local tribunal constituted under section 77 of this Act or the National Insurance Commissioner.

(2) Subsection (1)(a) of this section shall not apply to any question to which section 64(1) or 74(1) of this Act applies.

68 Submission of claims and questions to insurance officers.

(1) Insurance officers for the purposes of this Act shall be appointed by the Minister, subject to the consent of the Treasury as to number, to act for such areas or otherwise as the Minister directs, and may include officers of the Ministry of Labour appointed with the concurrence of the Minister of Labour and officers of the National Assistance Board appointed with the concurrence of that Board.

(2) Any claim for benefit under this Act and any question to which section 67(1) of this Act applies shall be submitted forthwith to an insurance officer, who shall take the claim or question into consideration and, so far as practicable, dispose of it in accordance with this section and any regulations under section 75(2) of this Act within fourteen days of its submission to him.

(3) Subject to section 71 of this Act, the insurance officer may in the case of any claim or question so submitted to him—

(a) decide it in favour of the claimant; or

(b) decide it adversely to the claimant; or

(c) refer it to a local tribunal.

(4) Where an insurance officer refers a case to a local tribunal in accordance with subsection (3)(c) of this section, notice in writing of the reference shall be given to the claimant.

(5) Different aspects of the same claim or question may be submitted to different insurance officers under the foregoing provisions of this section, and for that purpose those provisions and the other provisions of this Part of this Act with respect to the determination of claims and questions shall have effect subject to any necessary modifications.

69 Appeals from insurance officer to local tribunal.

(1) Where the insurance officer has decided any claim or question adversely to the claimant, the claimant may appeal to a local tribunal, and the claimant shall be notified in writing of the decision and the reasons therefor and of his right of appeal under this section:

Provided that where any question to which section 64(1) of this Act applies has arisen in connection with the decision of the insurance officer, and has been determined, and the insurance officer certifies that the decision on that question is the sole ground of his decision, no appeal shall lie without leave of the chairman of the local tribunal.

(2) An appeal against a decision of an insurance officer shall be brought by giving notice of appeal at a local office within twenty-one days after the date of that decision or within such further time as the chairman of the local tribunal may for good cause allow.

(3) A notice of appeal under this section shall be in writing and shall contain a statement of the grounds upon which the appeal is made.

(4) In this and the next following section, the expression "local office" means any office appointed by the Minister as a local office for the purposes of this Act.

70 Appeals from local tribunal to National Insurance Commissioner.

(1) Subject to the provisions of this section, an appeal shall lie to the National Insurance Commissioner from any decision of a local tribunal at the instance of—

(a) an insurance officer;

(b) the claimant;

(c) an association of employed persons, or any other association which exists to promote the interests and welfare of its members, where in either case—

(i) the claimant at the time of the appeal is a member of the association and was so immediately before the question at issue arose; or

(ii) the question at issue relates to the right to benefit by virtue of the insurance of a deceased person, and that person was a member of the association at the time of his death.

(2) An appeal to the Commissioner must be brought within three months from the date of the decision of the local tribunal, or such further period as the Commissioner may in any case for special reasons allow, and such an appeal shall be brought by giving notice in writing in a form approved by the Minister stating the grounds of the appeal—

(a) in the case of an appeal by an insurance officer, to the claimant; and

(b) in the case of an appeal by the claimant or an association such as is mentioned in subsection (1)(c) of this section, at a local office.

(3) If it appears to the Commissioner that any appeal under this section involves a question of law of special difficulty, he may direct that the appeal shall be dealt with, not by the Commissioner alone, but by a tribunal consisting of any three of the Commissioner and the deputy Commissioners appointed under section 78 of this Act; and if the decision of any such tribunal is not unanimous, the decision of the majority shall be the decision of the tribunal.

(4) If it appears to the Commissioner that any appeal under this section involves a question of fact of special difficulty, the Commissioner may direct that in dealing with the appeal or any part thereof he shall have the assistance of an assessor or assessors specially qualified and selected from a panel appointed for that purpose.

(5) The Commissioner may, if he thinks fit, refer any question arising for his decision to a registered medical practitioner for examination and report.

71 Reference of special questions.

(1) If on consideration of any claim or question an insurance officer is of opinion that there arises any question to which section 64(1) of this Act applies, he shall—

(a) refer the latter question for determination in accordance (subject to any necessary modifications) with sections 64 to 66 of this Act; and

(b) deal with any other questions as if the question so referred had not arisen:

Provided that the insurance officer may—

(i) postpone the reference of or dealing with any question until other questions have been determined;

(ii) in cases where the determination of any question disposes of a claim or any part thereof, make an award, or decide that an award cannot be made, as to the claim or that part thereof without referring or dealing with, or before the determination of, any other question.

(2) Subsection (1) of this section shall apply to a local tribunal and the Commissioner as it applies to an insurance officer, except that a local tribunal or the Commissioner, instead of themselves or himself referring a question in accordance with subsection (1)(a) of this section, shall direct it to be so referred by an insurance officer.

72 Review of decisions of insurance officer, local tribunal or Commissioner.

(1) Any decision under sections 67 to 70 of this Act of an insurance officer, a local tribunal or the National Insurance Commissioner may be reviewed at any time by an insurance officer or, on a reference from an insurance officer, by a local tribunal, if—

(a) he or they is or are satisfied, and, in the case of a decision of the Commissioner, satisfied by fresh evidence, that the decision was given in ignorance of, or was based on a mistake as to, some material fact; or

(b) there has been any relevant change of circumstances since the decision was given; or

(c) the decision was based on the decision of any question to which section 64(1) of this Act applies, and the decision of that question is revised in accordance with the provisions of section 66 of this Act.

(2) A question may be raised with a view to such a review as aforesaid by means of an application in writing to an insurance officer, stating the grounds of the application.

(3) On receipt of any such application, the insurance officer shall proceed to deal with or refer any question arising thereon in accordance with the provisions of the said sections 67 to 70.

(4) Any decision given on a review under this section, and any refusal to review a decision under this section, shall be subject to appeal in like manner as an original decision, and the provisions of the said sections 67 to 70 shall, subject to the necessary modifications, apply in relation to any decision given on such a review as they apply to the original decision of a question.