CCM4335 - Pre-award examinations: Action: The claim cannot be accepted

Where you do not accept the explanations provided by the claimant you will make a S14 decision rejecting their claim.

You must write to the claimant(s) to let them know about your decision. You should always write to them even if you have spoken to them and explained the position on the phone.

You should use the standard letter template TCC75. The letter tells the claimant that you reject their claim and they will soon receive a formal notification of this.

Note: If you are rejecting the claim because the customer has not replied to your opening letter, you can not use this as the reason for rejecting the claim on the letter. You must consider the risk and evidence held and your response to the customer must reflect that.

Where the claim has been made by a couple in a joint household, only one letter should be sent addressed to both claimants. When sending out joint letters the claimants must still be part of a couple and residing at the same address. If they are part of a couple but residing at different addresses or no longer part of a couple, then a separate letter must still be sent to each claimant.

If the claimant has authorised an agent to act for them remember to send a copy of the letter to the agent.

You should take the necessary system action to reject the claim as soon as possible after you send the letter, see CCOM20115, and close the case on TCW on the same day you make the decision. The system will send out a formal decision notice. The claimant then has 30 days to appeal against your decision.

If the claimant appeals, see CCM4345. If the claimant does not appeal you can close the case - see CCOM20125.