Most Common Reasons a CICA Claim May be Rejected

You may be wondering why your claim is rejected by the CICA? or want to know the most common reasons why CICA may reject your claim.

The Criminal Injuries Compensation Authority have several criteria that potential Applicants must meet in order to be eligible to claim. With our experience and dealing with CICA on regularly, we will tell you the most common reasons a claim may be rejected by CICA and the likelihood of a successful appeal based on the reason for rejection.

It is worth noting that when you contact us here at Criminal Injury Solicitors we go through a series of questions initially to make sure that you will meet the CICA eligibility criteria. By asking these questions, it allows us to undertake a risk assessment for the case for us, and also allows us to advise you, the claimant, on whether or not you would be successful in claiming. We generally ask these at the very beginning of the phone call, so that you don’t feel as though you are sharing personal and other triggering information for nothing.

Most Common Reasons Why CICA May Reject a Claim:

Was not reported to the police – If a case is not reported to the police, the CICA would be unable to assess the claim. This is because one of the foundations of evidence that the CICA primarily look at, is the police evidence.

Did not cooperate with the police – Similarly, if a claimant did not cooperate with the police, the CICA may reject the case. This means that if the Applicant was difficult, or refused to provide evidence or information to the police that led to the investigation being hindered or dropped. However, this also expands to if the Applicant chose not to press charges. Although we understand that sometimes survivors may feel intimidated, threatened or worried about pressing charges, the CICA see dropping charges as a form of non-compliance, as the scheme states that an individual must do everything they reasonably can to bring the Assailant to justice. If the police or CPS drop the charges/case, this wouldn’t affect your ability to claim.

Not a blameless victim – Unfortunately this reason exists and applies to all types of CICA claims, including fatal injury claims. Being categorised as not a blameless victim means that the claimant themselves instigated or carried out actions that led to the incident in which they were injured. For example, if a claimant threw the first punch, and suffered a broken jaw, they would be unable to claim, as they instigated the fight which led to them being injured. The way this is normally proven is through police evidence of CCTV or numerous witness statements.

Unspent criminal convictions- This is probably the most common reason we see at Criminal Injury Solicitors. When we first receive an enquiry we always ask the potential Claimant about their criminal history. The reason we do so is to determine if this will interfere with making a CICA claim. If the conviction is recent, we use an online website to check if the outcome given is spent or unspent, and if it is unspent, how long it will take to become spent. Spent means that the conviction no longer has any impact on anything you might apply for that could be impacted by a conviction, for example a job or claim. Unspent means that the conviction is still ongoing and while it is, may impact your application chances for certain types of jobs and claims. With that being said, the CICA do not go based off of the conviction itself, but more so the outcome given as punishment. For example, if someone was caught speeding and given a 12 month ban, it would not be spent for 24 months, as the ban itself is 12 months, plus another 12 months unspent period as per the Rehabilitation of offenders act 1974. Sadly, we have encountered several cases where the Applicant has failed to notify us of a recent conviction they have, meaning their claim has been rejected. It is absolutely crucial to remember that once a claim is rejected, you cannot resubmit it at a later date. Therefore, it would be more beneficial in some circumstances to hold off a couple of months and make a claim once a conviction is spent, as opposed to submitting it while the conviction is still unspent. It is also key to remember that a prison or suspended sentence given of 4 years or more is never spent, meaning any individual with this would be unable to claim.

Outside of the 2 year limit – One of the CICA criteria is that an application must have been submitted within 2 years of it being reported to the police. Normally, the CICA ask for an explanation and evidence as to why the case was submitted outside of the 2 year limit. If the evidence or reason provided is not satisfactory, the CICA would reject the case.

Did not happen in the UK – Another of the CICA’s criteria is that the crime that occurred must have happened within England, Scotland or Wales. If it happened in NI or another country, the process is different.

Was not reported to police as soon as reasonably practicable – The CICA expect the majority of crimes that are being claimed for, to have been reported to the police within a matter of days. There are some exceptions to this, for example if the victim was a child or if they suffered a severe injury which meant that they needed immediate medical treatment first. Reasons such as being fearful or worried, although understandable, are not acceptable.

Failing to assist a claims officer or representative – This reason applies when a case has been submitted and the applicant fails to respond or provide requested information after numerous attempts to retrieve it, either by the CICA or a representative.

A previous application was already received – This means that an application for the same incident has already been received by the CICA. You cannot claim for the same incident twice through the CICA.

Injuries are not listed within the tariff in the CICA scheme – This means that the injuries attempted to claim for are too minor and are not listed within the CICA scheme.

The Assailant may benefit from the award – This is very rare but if for any reason the Applicant is still living with the Assailant, or the Assailant has access to any funds the CICA may award, then they will reject the case.

Now, let’s take a look at some examples of reasons that are appealable, and others which are not so much:

Outside of the 2 year limit – Providing that there is consistent evidence to back this up, this reason can often be quite easily appealed. The CICA consider several factors when it comes to this, including age, capacity and health. If, for example, an individual was a child at the time it occurred, the can report it at 18 and then submit a CICA claim. Similarly, if an individual was severely mentally ill and spent years in a treatment unit and recently only feels well enough to make a claim, they likely would be exempt from the 2 year limit. 

Was not reported to the police as soon as reasonably practicable – Again, providing there is evidence to support, this reason for rejection can usually be appealed successfully. Again, being a minor at the time the incident occurred would be an acceptable reason for reporting it late, as would receiving emergency medical treatment. The CICA would not expect an individual to put reporting the incident before receiving treatment. If an individual needed hospital treatment for several weeks, and they were gravely ill for the first couple, the CICA would accept this as a reason to delay. However, after the Applicant felt well enough they would be expected to contact the police. The medical records would reflect when the Applicant should contact the police.

Unspent convictions – This is a reason that has next to a 0% chance of success when appealing. The CICA are very strict with their guidelines and are not lenient when it comes to convictions. The only possible successful reason you may have for appealing convictions is if these were arrests or charges under the mental health act. However, the charge record and medical records of the Applicant would need to reflect this considerably.

Not a blameless victim – Again, this reason is very difficult to appeal and virtually impossible if the CICA have solid evidence to show that the applicant instigated the incident. 

• Did not cooperate with the police – This reason could possibly go either way when rejecting. The police are incredibly busy and sometimes information is missed. If the CICA do reject a case on these grounds, and the Applicant has evidence to support they have tried to cooperate with the police, the CICA may look to reassess the matter. Sufficient evidence, as an example, could be an IOPC letter if a complaint has been launched, or even an email from the police themselves apologising about any issues or delays. However, if the Applicant has outright chosen not to provide information or dropped the charges, the CICA would reject the matter.

Even if any of the above reasons apply to you, please contact us and we can still assess the matter and advise you on the likelihood of your claim being accepted. Please ensure that you are open and honest with us, we are not here to judge, only to help you!