Suspicious Minds

The genesis of this issue yesterday marks a worrying trend which replicates experience from our appeals casework. It goes something like this:

The LAA assert an interpretation of contract, sometimes a longstanding provision such as Sufficient Benefit Test or, as here, something more recent.

They either refuse to engage in any meaningful discussion on the point or, as here, do not provide reasonable guidance.

Next comes chancing the point, on a case-by-case basis, before an ICA, knowing that the only time the firm will have a fair and meaningful hearing is if, ultimately, they litigate. Usually cost risk precludes this and recent experience suggests that the LAA are aggressive litigators, being backed by “tax payers money”.

They act as gatekeepers of their own appeals procedures and have a vested interest in blocking the clarification of obvious and legitimate points of dispute*.

Consequently the same issues rattle around, like loose change in a tumble drier, despite, on occasion, the point having been tested at ICA appeal. This is non-precedent setting so can be continually ignored when a decision goes the wrong way.

With the live issue we are therefore left with a vague, implied threat:

You risk large amounts of costs if you do not report (undefined) “suspicions” regarding benefits and the client is subsequently potted for benefit fraud. A reasonably detailed outline of the case, let alone a judgment, is not supplied – presumably the firm has not just rolled over with 20 grand at stake?

Of course no consideration of the interaction of this contractual requirement with professional and regulatory responsibilites is included.

We can all divine the intent of this.

How this represents “mutual trust and co-operation” is another matter.

* Andrew, at Crimeline, and I have had endless conversations about this – a morning between the pair of us and the LAA could list the top 10 or 20 such issues, resolve as many as possible and prepare an agenda for a Cost Appeal Committee hearing, for the rest. That annoying meercat has a catchphrase for this type of thing.

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