Objections to eligibility

Although the CISAS Consumer Services Team carry out an initial assessment on the validity of a CISAS application, this may not cover all instances in which a case may be outside our scope, as further evidence may be required to prove this.

1. If a CP has evidence which proves that the entirety of a CISAS application falls into one or more of the thirteen reasons for rejecting a claim detailed above, this evidence must be provided as part of an objection within ten working days of the application being sent to the CP. CPs must specify the grounds on which they consider the application to fall entirely outside the scope of CISAS when uploading their objections and any evidence to the portal.
2. Upon receipt of an objection, CISAS will refer the matter to an In-House adjudicator for a determination to be made as to the validity of the application.
3. If the objection is upheld, the customer will have 10 working days to supply evidence to the contrary or the case will be withdrawn and no fee will be charged.
4. If the objection is rejected, the CP will be given a time extension of two working days to either defend or settle the claim.
5. When making an objection the CP should raise only those matters which relate to the eligibility of the application to enter the Scheme. For example, if there is not an applicable Rule it is likely that the submission relates to liability, rather than eligibility and therefore no objection should be made.
6. After an objection is rejected, a second objection should only be made if the company feels that the In-House Adjudicator has misinterpreted the company’s objection, or if the Rule/focus of the objection changes from the previous objection or new evidence has come to light. If the company feels the In-House Adjudicator has misinterpreted the objection, the company is advised to provide additional explanation.
7. Where a dispute arises as to the validity of an application, the decision of CISAS will be final.