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Private Health Insurance & Full Welfare Benefits

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13 years 2 months ago #66856 by Miranda
Hi, hope you can help me!

Does anyone know the rules regarding using full out of work disability benefits to pay for Private Health Insurance policies? Is this allowed, under what circumstances may it be permitted or not etc? Would appreciate the specific area of law relevant to this where possible please. I'm not sure where to begin finding this out myself.

Many thanks,
Miranda :)

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  • Survivor
13 years 2 months ago #66880 by Survivor
By out of work disability benefits, do you mean IB/IS/ESA, or do you mean benefits paid by an employer or insurance company?

If the former, there is, to my knowledge, no reason why you may not pay for PHI out of your benefits.

However, I cannot cite an authority for this. As a general principle, you may do something so long as the law forbids it, so it may be that there is no law that can be cited but maybe someone else can help with that.

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13 years 2 months ago #66889 by Miranda
Thank you, Survivor,

Yes I do mean those kinds of benefits and DLA. Someone who subsists exclusively on welfare benefits in one form or another.

I was wondering if the there are any circumstances where they might infer it's a luxury, and was not intended to be used for such purpose.

I notice that, for example, social services will fully take into account any income gained from a PHI in their assessments of your care needs. But people using such care services don't necessarily need to be claiming benefits and I doubt few would expect welfare benefits claimants to have PHI.

So I am wondering if there exist any rules related to this type of thing, or if it would be covered elsewhere under the rules under a more general heading?

It's important because up until now, I have had PHI arranged thro someone else, and they have paid fully on my behalf. Unfortunately, they can no longer maintain it, which means that if I wish to carry it on myself, then I must pay for it. I most certainly do wish to continue it, for lots of reasons, one being the fact that if it isn't maintained then my pre-existing conditions will not be covered in future policies should I take one out at a later date again, and this is a huge risk for me. Obviously, this will have to come out of benefits money, hence my concern.

I need a definitive answer really, if someone is able to help.

Many thanks

Miranda

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13 years 2 months ago #66890 by Gordon
Miranda

Like Survivor, I am not aware of any restrictions, even in the fine print, regarding what you spend your money on, however, I would suggest you speak to someone at your local CAB or Welfare Rights, before committing to any payments.

You might also ask about the implications such a policy might have if you ever claim an Income Related benefit such as ESA(IR) or Income Support, as you may be subject to deductions from your benefit, on the basis of income from this PHI policy, even if you are not actually receiving any.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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13 years 2 months ago #67037 by Miranda
Hi,

I appreciate the comments thus far, thank you. I am making use of all available sources of advice, support and actual claimant's experiences as much as possible, including contacting the CAB.

The CAB couldn't be definitive about this issue in terms of pin-pointing any specific legislation. They said there is a possibility it could trigger a fraud investigation into my income sources, on the basis that benefits are obviously not designed for this purpose, so where am I getting the extra money from (believe me this will all be done on benefits, I have no other income whatsoever and nor do I have the gumption to attempt cheating the system). Clearly, this is something I would be very keen to avoid since I have enough day to day stress and difficulties to deal with already but may be a risk I have to bear.

I haven't been moved over to the ESA system yet, and that is also a source of near future concern for me. I have read and heard about the too many horror stories about this process. It is also therefore, quite possible that my benefits could be downgraded as a result, and force me to cancel the PHI anyway, which really would not be good in my case. I'm waiting for that ominous envelope to arrive, have been for some time!

Has anyone had any direct experience of the DWP or its associated agencies querying any expenditure that they might deem excessive or improbable on benefits alone? If so, what was your experience of it, what was the outcome?

Many thanks again, your help is much appreciated,

Miranda :)

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