The government has introduced a new life assurance scheme for eligible frontline health and social care workers during the COVID-19 pandemic. The new life assurance scheme is available for staff who have been and are providing “hands on personal care for people who have contracted coronavirus or who work in health or social care settings where the virus is present”.

The purpose of the scheme is to recognise that there is a significantly increased risk to staff and their health and well-being in responding to the pandemic. The scheme, therefore, covers “coronavirus related deaths of workers in frontline health and social care roles during the outbreak”.

A £60,000 payment will be made to the estate of eligible individuals.

The NHS Business Services Authority has produced guidance for both claimants and employers located in England and Wales. The full scheme rules (NHS and Social Care Coronavirus Life Assurance Scheme 2020 Rules (England)) can be accessed here.

Employer Responsibilities:

Scheme Awareness

Employers are required to tell their employees about the scheme and distribute communication materials provided by the NHS Business Services Authority. All sub-contractors and temporary staff should also receive communication materials.

If an employer is made aware of a death where there could be potential eligibility for a claim, employers are required to contact the next of kin of the deceased directly. Employers have a responsibility to explain the scheme to the next of kin and the process that is required to be followed, where a claim is appropriate.

Application Process

Employers are responsible for overseeing the completion of the claim form and payment details. The claimant should be signposted to the NHS Business Services Authority Claim Form. Applications can only be made on paper and will not be accepted online.

Employers should inform claimants that the form should be completed by the legal personal representative or a solicitor acting for the estate. The claimant is then required to send to the employer the completed form and original supporting documents. The employer is required to certify on the form that the deceased was eligible for the scheme and that the death was a qualifying death. Once this has all been completed, the employer should send the claim form and supporting documents to the NHS Business Services Authority.

Employer Authorisation Checks

Employers are required to check that the deceased person is likely to be eligible for the life assurance scheme and that the death falls within the criteria of a qualifying death before submitting a claim. Further information about eligibility criteria can be found here.

Employed by NHS, a provider reg with CQC for PC or AFPWRNOPC or under the following contracts:

The guidance states that “all eligible employees or registered healthcare volunteers must have been working for an NHS body, [a provider registered with CQC for personal care or accommodation for persons who require nursing or personal care] or working for an organisation that supports the delivery of, either:

• An APMS contract
• A commissioning contract
• A contract or agreement between an NHS trust or foundation trusts and a higher education provider covering the provision of NHS services
• A General Dental Services contract
• A General Medical Services contract
• An integrated care provider contract
• A local authority contract for the provision of health or social care services
• An NHS standard contract
• An NHS standard sub-contract
• A PDS agreement
• A PMS agreement
• A primary medical and dental services contract

In addition to the Employment and Contract eligibility requirement, the Secretary of State must be satisfied that on the basis of evidence, the individual was exposed to a high risk of contracting coronavirus in circumstances where they could not reasonably avoid that risk due to the nature and location of their work.”

Supporting documents

The claimant should provide the employer with a completed claim form and the original supporting documents. The supporting documents are:

• The death certificate; and
• Grant of probate or letters of administration

Employers must inform the claimants that the claims can be assessed for eligibility without the Grant of Probate or Letters of Administration, but payment cannot be made without one of those documents being provided to the NHS Business Services Authority.

Where there is more than one legal representative listed on the Grant of Probate/Letters of Administration, you should check that each legal personal representative has completed a claim form annex declaring their agreement that the life assurance lump sum to be paid to the claimant, the named legal personal representative or the solicitor who completed the claim form.

Payments

The NHS Business Services Authority will process the application and pay the lump sum of £60,000 into the bank account of the estate or issue a cheque to the claimant. The NHS Business Services Authority (“NHSBSA”) will notify the employer that the lump sum has been paid.

In terms of timescales, payment will be made within 30 days of the certified claim form and supporting documentation being received from the employer to the NHSBSA. The claimant will be entitled to interest on the unpaid amount if the sum is not paid within the 30 days.

If you require assistance with the new NHS and Social Care Coronavirus Life Assurance process, please do get in touch with our healthcare team where we can discuss how we can support you through the process. Email online.enquires@la-law.com or call 01202 786135.