Sickness Benefit Claims Procedure

If you need to make a claim you have to complete a sickness claim form. This form contains two sections, one for you to complete and one for your GP. You should always have a claim form to hand and under the rules of the Society you are required to notify this office within 72 hrs of commencement of incapacity in the case of immediate benefit and within 13 weeks in the case of deferred, 26 weeks benefit. Rule Book.

Payment of any fee to your GP for completion of the Society’s claim form is the members responsibility and any cost incurred for the provision of any additional medical reports would normally be the responsibility of the Society. During any claim you may be requested to complete additional progress forms and attend for examination by a medical practitioner selected by the Society.

Notify a Claim

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Claims for sickness benefit will not be allowed if the claim arises wholly or partly by virtue of any of the following:

  • Intemperance
  • Disorderly Conduct
  • Intoxication
  • Wilful self-inflicted injury
  • Taking or using any drug not prescribed by a medical practitioner to aid recovery from a specified illness or injury
  • Sterilisation other than on medical grounds
  • Involvement in war, invasion, riot or usurped power
  • Flying other than as a fare-paying passenger on a recognised air route
  • Pregnancy
  • Any hazardous pursuit not disclosed in any application form or otherwise notified to the Society
  • Acquired Immuno-Deficiency Syndrome [AIDS] arising from infection by any Human Immuno-Deficiency Virus [HIV or an AIDS-related condition due to any HIV virus.
    The definition of AIDS shall be that used by the World Health Organisation at any time or that used by any successor body of other such governmental or international organisation as the Committee shall decide.
    Infection shall be deemed to have occurred where blood tests indicate in the opinion of the Society’s Medical Consultant either the presence of any Human Immuno-Deficiency virus or antibodies to such a virus.
    If in the opinion of the Medical Consultant of the Society a member claiming benefit should undergo a blood test to establish whether or not that member is infected by any HIV virus or AIDS then the Society shall so inform the member and the member shall undergo such test as frequently as required by the Society and shall sign all necessary documents and authorisation to permit such tests to be made and a copy of or the original pathological report to be sent to the Society’s Medical Consultant.
    In the event that the member refuses to undergo such tests or to co-operate in obtaining such tests then the Society shall be entitled to refuse payment of Sickness Benefit until a blood test showing that the member is not infected by any HIV virus or AIDS.
  • Any Surgery or treatment not certified to be necessary on health grounds.

Any member who has received benefit and is subsequently discovered to have been incapacitated by virtue of a condition specified above shall be liable to expulsion from the society and the amount of any benefits received by such member deducted from his Apportionment.

Travelling / Residing Abroad

Members travelling or residing outside the UK are not entitled to claim Sickness Benefit whilst abroad but should any member be advised to go abroad by his medical attendant for the recovery of his health, his Sickness Benefit shall be allowed on the production to the Secretary, before his departure, of a certificate from his medical attendant to this effect and indicating the period covered, the Committee having the power to require such conditions to be fulfilled as they deem necessary.

A member may subsequently continue to be eligible for Sickness Benefit whilst they are working in the European Union providing: –

  • they have given prior notice to the Secretary, specifying the nature of the employment, of their intention so to do
  • that the notice has been acknowledged by the Secretary and
  • they continue to pay their contributions in sterling

Any such benefits payable will be made in sterling.

member failing to comply with the above will be liable to forfeit their Sickness Benefit to the Society for the period they are abroad.

A member on taking up temporary residence outside England, Ireland, Scotland, Wales, the Channel Isles and the isle of Man may apply to the Society for their membership to be held in suspense in which case their monthly contribution will cease to be due or payable and they will cease to be eligible for Sickness Benefit and to receive their annual Share Apportionment from the month they ceased to pay their contributions. They will continue to be entitled to receive Capital Apportionment.

On returning to England, Ireland, Scotland, Wales, the Channel Isles and the isle of Man, a member may, on production of a Medical Certificate of good health, recommence to pay their monthly contribution and they will be entitled to Sickness Benefit and Share Apportionment as from the month they commence to pay their contributions.

In the event of a membership being held in suspense for 10 years, at the expiry of that period the membership shall, if the Committee so decides, be terminated and there shall be paid to the member the amount standing to their credit less any forfeiture due and specified elsewhere in these rules.