A new National Health Insurance Appeals Tribunal has been appointed for a period of two years with effect from 1 July 2023 to 31 March 2025.
The Appeals Tribunal comprises of Chairman Mark A Fulford, a leading Attorney and Managing Partner of F Chambers Law firm; Bishop Coleta A. Williams III, Bishop of the Abundant Life Ministries International church; and Mrs. Jena Janse, a Real Estate professional.
Commenting on the Tribunal re-establishment, Minister of Health and Human Services Hon. Shaun Malcolm, stated: "There are claims that need adjudicating dating back to as far as two years. I have chosen this team as they are all known to me as dedicated persons, who can get the job done," Malcolm said, adding: "I have full confidence that the tribunal will deliver justice swiftly and will deal with the backlog of claims immediately. The public can have faith in knowing that their claims will be heard.”
Commenting on the work of the Tribunal, Chairman Mark A Fulford stated: "The business of adjudicating on health care is near always a matter of life and death decision, and it is my view that we will do all we can within the remit of the law and our terms of reference to adjudicate on matters in a fair, impartial and swift manner.
"We will deliberate with the level of seriousness that is deserving of such a tribunal. It is my vision that we modernize, and where possible, make electronic the process and work of the Tribunal, to provide a more people-centered approach to adjudicating these claims.”
About the Appeals Tribunal: (1) Where any question arises as to—(a) registration;(b) contribution;(c) eligibility to receive benefit; (d) benefits; or (e) a claim, that question shall be considered in the first instance by the Chief Executive Officer who may, after making necessary inquiry, determine the question or refer it to the Board for determination, if he considers it expedient to do so.
(2) Where a person is aggrieved by the Chief Executive Officer’s decision on a question under sub-regulation (1), that question shall be referred to the Board for determination on the application of the aggrieved person. In such a case the Chief Executive Officer shall submit to the Board a report of his inquiry and his findings thereon.
(3) The decision of the Board on a question, under sub-regulation (1) shall be given in writing and shall specify the reason on which the decision is based: Provided that, if the Board considers that a question is of sufficient importance or that a question of law may arise therefrom, the question may be referred to the tribunal for decision.
How to Appeal: (1) A person who is aggrieved by a decision of the Board may appeal against that decision to the tribunal. (2) An appeal shall be brought by giving notice of appeal in writing to the Board not later than twenty-one days after the date on which the decision against which the appeal is made was issued to the person, or within such longer period, not exceeding sixty days, as the chairman of the tribunal may, in special circumstances, allow.
(3) The notice of appeal shall include a statement of the grounds upon which the appeal is made.
(4) The board shall refer the appeal as soon as practicable to the tribunal by written notice of reference, and shall forthwith send a copy of the notice to the appellant.
(5) The decision of the tribunal on the appeal shall be referred to the board, and the board shall thereupon confirm or revise the decision against which the appeal was made in accordance with the decision of the tribunal.
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