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The Ministry of Finance of Trinidad and Tobago is organized into divisions in order to achieve the range of responsibilities entrusted to it.

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National Insurance Appeals Tribunal

REQUEST FOR PROPOSALS FOR A BUSINESS PROCESS REVIEW ON THE STRUCTURE AND OPERATIONS OF THE NATIONAL INSURANCE APPEALS TRIBUNAL (NIAT)

Provision was made for the establishment of the Appeals Tribunal under Section 60 of the National Insurance Act Chapter 32:01 for the purpose of receiving, processing, hearing and determining appeals from persons who are not satisfied with any decision of the National Insurance Board in respect of claims for benefits and/or other matters under the said body and is not under the control of the National Insurance Board or any other state agency or department of Government. It operates with complete independence and is funded by monies approved by parliament through the Appropriation Act.

 

Provisions in the Act

 

The Act as it relates to the National Insurance Appeals Tribunal provides for the following:

  • Establishment of the National Insurance Appeals Tribunal.
  • Appointment of Members
  • Division of the Country into Administrative Divisions
  • Making of regulations for the smooth and orderly conduct of Hearing and Determination of Appeals

 

His Excellency the President appoints suitable persons from time to time for a specified period to constitute the appeals Tribunal. A three (3) year term of office for the Chairman and a two (2) year term of office for members has been a normal practice. The functions of the Appeals Tribunal are regulated by the National Insurance (Appeals) Regulations as set out in Legal Notice No. 131 of 1980, which came into effect on July 15, 1980 now consolidated into the National Insurance Act Chapter 32:01.

 

Role

 

The role of the National Insurance Appeals Tribunal is succinctly but effectively described in the Mission Statement as "to act as the first line of adjudication between the Appellant and the National Insurance Board ensuring timely determination of Appeals based on Openness, Fairness and Impartiality and to pursue ways and means for the continued development of Appeals Tribunal to keep astride with the international standards of Social Security appeals machinery." Tribunals have been preferred to courts for settling disputes in the social services on grounds of speed, cheapness, accessibility and informality. These characteristics assist the Appellant in exercising his rights more effectively.

 

 

The decisions of the National Insurance Appeals Tribunal are subject to review by the courts on Appeal or by Judicial Review

Non-Statutory Committees established by the National Insurance Appeals Tribunal

In acknowledgement of the onerous administrative and technical functions of the office of the Registrar and in an effort to assist in creating and sustaining a structural policy for the development of the fullest potential of the function, the following tripartite committees were established by the National Insurance Appeals Tribunal:

 

Administrative Committee

Terms of Reference
The Administrative Committee is required to examine the administrative practices employed by the Tribunal with a view of making recommendations to the Ministry for improvement in terms of staffing, office accommodation, office equipment, financial resources and upgrading human resources through training both locally and overseas for staff and Tribunal Members.

 

Legislative Review Committee

Terms of Reference
The Legislative Review committee is required to examine existing National Insurance Legislation and make recommendations to the Tribunal with a view to getting in Ministry to make required and desired amendments for the more effective functioning of the organizations i.e. the Board and the Tribunal.

 

Public Information Committee

 

Terms of Reference
The Public Information Committee is charged with the responsibility of examining the method of Public Information employed by the Board and ascertain whether the required information is reaching its target and having the desired effect and to make recommendations and suggestions through the Ministry for improving the information flow.

The above committees meet periodically to deal with policy related to the terms of reference and are chaired by a member appointed by the Tribunal and serviced by the Clerk III as Secretary of the committees. Meetings are divided between the three (3) administrative divisions and the decision and policy recommendations are submitted to the Registrar for consideration of the Ministry.

 

The Regulations provide basically for the following:

  • Procedures for Appealing
  • Grounds for Appealing, that is on questions of facts only. On questions of Law an appeal lies with the High Court
  • Processing of Appeals
  • Arranging for the convening of Hearings at designated places
  • Conduct of Hearing of Appeals
  • The right of representation before the Tribunal
  • The composition of the Appeals Tribunal and quorum at a Hearing
  • The expert advice of the Chef Medical officer on Appeals of a medical nature
  • The format for communicating Decisions of the Tribunal
  • In general, procedures to be followed by the Registrar in conducting the business of the Tribunal

Functions of the Division

  1. Receive, register and process Appeals from Appellants.
  2. To forward a copy of each Appeal to the National Insurance Board in accordance with Regulation 14 of the Appeals Regulations. The National Insurance Board shall within three (3) weeks reconsider its decision and if satisfied that the claim is valid one will settle it. Otherwise it would join issue with the Appellant, in which case the Appeal is then heard by the Tribunal.
  3. To arrange for a hearing, if the National Insurance Board decides to contest the Appeal by serving Notice on the National Insurance Board and the Appellant of the date and place of the Hearing.
  4. To refer to the Chief Medical Officer for Medical advice such Appeals which require expert medical opinion and explanation, and to convene a Medical Appeals Tribunal, if the circumstances so warrant, in which case the Chief Medical Officer is required to sit on the Tribunal.
  5. To communicate the Decision of the Tribunal after a Hearing to the National Insurance Board, the Appellant and the Minister of Finance under whose purview the Tribunal resides.
  6. To regulate generally the work of the Appeals Tribunal, so as to ensure that justice is efficiently administered to those affected.
  7. To generate an Annual Administrative Report which constitutes a review of the functions for the purpose of information and evaluation of the performance of the Tribunal. This report is submitted to the President.
  8. To conduct an Annual General Meeting to facilitate a critical analysis of the functions of the Tribunal and to ensure that the functions conform with and remain consistent to the mission.
  9. To arrange for the conduct of periodical retreats to upgrade Tribunal Members and Staff on the technical aspects and developments in National Insurance operations, more particularly in the technical aspects of benefits which form the basis Appeals.
  10. To instruct through the Ministry or in conjunction with the Ministry, the office of the Chief State Solicitor and assist in the preparation of the Tribunal’s response to Judicial Review matters before the high court.

     

Composition of the Appeals Tribunal

 

The Act provides for the appointment of the Appeals Tribunal as follows:

  1. An Independent person as Chairman who is in the opinion of His Excellency the President, is independent of Government, Labour and Business (i.e. a neutral person).
  2. Three (3) persons nominated by the associations, mostly representative of Business, one from each Administrative Division.
  3. Three (3) persons nominated by the associations mostly representative of Labour, one from each Administrative Division.
  4. Three (3) persons nominated by the Government, one from each Administrative Division.
  5. The Chief Medical Officer in the Public Service of the country.

 

For Administrative purposes, the country has been divided into Three (3) Divisions as follows:

  1. Northern Division which includes the counties of St. George, St. David, St. Andrew and Caroni.
  2. Southern Division which includes the counties of Nariva, Mayaro, St. Patrick and Victoria.
  3. The Island of Tobago forming the Tobago Division

 

The Appeals Tribunal in each Division comprises of the Chairman who presides over all Hearings and has full responsibility for the affairs of the Tribunal together with three (3) members, one each nominated from Business, Labour and Government.

Procedural Aspects of the Tribunal

  • The Regulations provide that such persons who are aggrieved with any decision of the National Insurance Board have the right to appeal. This is done either by completing the prescribed form (Notice of Appeal Form-1) or in writing signed by the Appellant and shall contain the grounds of Appeal. Following receipt of an Appeal, the process includes registration, notification to the National Insurance Board, Hearing of the Appeal and issuing of a Decision.
  • Regulation 13(1) of the Appeals Regulations prescribes a maximum time limit of six (6) months from the date of the National Insurance Board’s decision within which an Appeal must be lodged. Appeals are completed in triplicate using the prescribed form. When, however an Appeal is filed out of time, but within one (1) year of the date of the National Insurance Board’s decision, the Chairman shall decide whether or not it should be entertained.
  • Forms are available free of charge at the National Insurance Board Service Centres located at Arima, Barataria, Chaguanas, Couva, Gulf City, Point Fortin, Port-of-Spain, Princes Town, Rio Claro, Sangre Grande, Siparia, South Regional (San Fernando), St. James, Tunapuna and Tobago (Roxborough & Scarborough) where Appeal Boxes have been placed for collection of Appeals by the Registrar. Appeal forms are also available at the Tribunal’s office, Port of Spain.
  • An officer of the National Insurance Board who in any way hinders a person desirous of appealing against a decision of the National Insurance Board from obtaining the Appeal form is liable to have disciplinary action taken against him.
  • The National Insurance Board shall, where a Notice of Appeal has been served on it, advise the Chairman not later than three (3) weeks after such service, whether it has reconsidered its decision which gave rise to the Appeal or whether it intends to join issue with the Appellant

The National Insurance (Appeals) Regulations provide for the following:

Registrar

The Registrar shall:

  • Ensure that Appeal Boxes are cleared in the afternoon of the last working day of each week.
  • Ensure that a copy of every Appeal lodged or received is served on the National Insurance Board, in accordance with section 4 (4) of the Act. 
  • Give not less than twenty-one (21) days written Notice of time and place of the Hearing of an Appeal to Members of the Appeals Tribunal, the Appellant and the National Insurance Board.
  • Ensure that all documents required at a Tribunal Hearing are available and shall prepare sufficient number for use at the Hearing. Documents for use at a Hearing shall be numbered by the Registrar and copies of a document shall bear the same number as the original document

Hearings

  • The Minister shall by Notification specify the places in each area designated for Hearing of Appeals. An Appeal shall be heard by the Appeals Tribunal sitting in the area in which the Appellant resides and an Appeal involving questions of a medical nature shall be heard by a Medical Appeals Tribunal sitting in the same

Designated places for Tribunal Hearings are currently as follows:

Tribunal’s Office – Level 2, Maritime Building
# 29 10th Avenue, Barataria
San Fernando – Social Welfare Office,
#82 Independence Avenue,
San Fernando.

Tobago – Division of Infrastructure,
Public Utilities Office
Shaw Park, Tobago

  • At a Tribunal Hearing, the Appellant and the National Insurance Board may be represented by an Attorney-at-law or any person qualified or competent to represent either party and may call and question witnesses.
  • Tribunal Hearings are public. The Chairman may at the request of the Appellant decide that the Hearing be in private in which only Members of the Appeals Tribunal and their clerk may be present when it is being considered.
  • Where an Appellant requests that a Hearing be in private, the Chairman may decide that part of it be heard in private and part in public.
  • The National Insurance Board shall not at a Hearing of an Appeal disclose that proceedings on any charge involving dishonesty on the part of the Appellant are being contemplated.

     

Appeals Tribunal

  • The quorum of the Appeals Tribunal consists of the Chairman and two (2) other Members.
  • The quorum of the Appeals Tribunal consists of the Chairman, the Chief Medical Office and two (2) other Members.
  • In convening an Appeals Tribunal the Chairman shall select members living in the following area:
  • a) North Trinidad, where the Appeals Tribunal is to sit in North Trinidad
  • b) South Trinidad, where the Appeals Tribunal is to sit in South Trinidad
  • c) The Island of Tobago, where the Appeals Tribunal is to sit in Tobago

 

Where a Member selected by the Chairman from the area in which the Tribunal is to sit is unable to attend, and the formation of a quorum is thereby rendered impossible, the Chairman may select in such Member’s stead a Member from another area and nominated in the same manner as the Member originally selected, to serve an the Tribunal.

  • The Appeals Tribunal may determine an Appeal in the absence of the Appellant or other interested person to whom the required Notice of Hearing has been given, where no reasonable explanation is submitted for his absence.
  • The Appeals Tribunal is not bound by strict rules governing the admissibility of evidence, but where the Appellant or otherwise is available to give evidence, on question of fact in issue they must be called, and a statement intended to support such evidence is inadmissible in such event.
  • In any Appeal involving questions of a medical nature the Medical Appeals Tribunal shall be guided on the medical issues by the advice and explanations given by the Chief Medical Officer.
  • Where it is convenient to do so, the Chairman may forward to the Chief Medical Officer for advice any documents related to the medical issues in any Appeal and may consider the reply of the Chief Medical Officer even before convening a Tribunal to deal with the Appeal.

The Chief Medical Officer

  • Every member of the Appeals Tribunal other than the Chief Medical Officer in a Medical Appeals Tribunal may vote
  • Before an Appeal involving questions of a medical nature is determined, the Chief Medical officer shall advise the Chairman either orally or in writing on-a) Whether or not the Appeals Tribunal should obtain further expert medical advice;b) Who should furnish the advice; andc) Whether the Appellant’s doctor or the National Insurance Board’s medical adviser should be invited to attend.
  • Where evidence of a medical nature is given to a Medical Appeals Tribunal the Chief Medical Officer shall evaluate this evidence and explain it to other members.
  • The Chief Medical officer shall advise the Chairman on which medical documents shall be treated in a confidential manner and may where he considers it appropriate advise non-disclosure of any medical report relating to the Appellant. In this regard, the Chairman shall direct the Registrar with respect to the medical document in accordance with the advice of the Chief Medical Officer and the Registrar shall comply with such direction.

Decision

The Appeals Tribunal shall in recording its Decision set out the reasons therefore and its findings on the questions of fact material to the Appeal. The Decision is recorded and signed by all the Members of the Appeals Tribunal.

Copies of the Decision of the Appeals Tribunal are forwarded forthwith by the Registrar to the Appellant, the National Insurance Board and the Minister.

Where the Appeals Tribunal in recording its Decision or findings issues a directive to the National Insurance Board, The Board shall comply with such directive within one (1) month of the date of the receipt of the Decision

 

Mission Statement

The National Insurance Appeals Tribunal Mission Statement is "to act as the first line of adjudication between Appellants and the National Insurance Board ensuring timely determination of Appeals based on Openness, Fairness and Impartiality and to pursue ways and means for the continued development of the Appeals Tribunal to keep astride with international standards of the Social Security appeals machinery."

Current Membership of the National Insurance Appeals Tribunal

Name of Member StatusProfession Occupation Appt DateExpiry Date
Mr Eugene Tsoi-a-Fatt  Chairman Attorney-at-Law 28/01/2012 27/01/2015
Mr. Regis Caruth  Member (GORTT) Teacher 27/09/2011 26/09/2013
Mr Roger Kawalsingh Member (GORTT)  Attorney-at-Law   27/09/2011 26/09/2013
Mr Kenneth Jones Member- Business    Marketing/Sales   27/09/2011 26/09/2013
Mrs Cheryl-Ann Jordan     Member- Business   Human Resource Manager    27/09/2011 26/09/2013
Mr Wayne Moze Member- Business  Businessman  27/09/2011 26/09/2013
Dr. Akenath Misir Member ex-officio Chief Medical Officer 27/09/2011  
Ms Lydia Peters  Member- Labour  Labour Relations  27/09/2011  26/09/2013
Ms Alicia Roberts Member- Labour  Fleet Supervisor  27/09/2011 26/09/2013
Ms Mynie Sirjue Member- Labour   Accountant   27/09/2011 26/09/2013
         

For further information on the National Insurance Appeals Tribunal (NIAT) please contact their offices at:

Ministry of Finance and the Economy 
Level 2
Eric Williams Finance Building 
Independednce Square
Port of Spain

Tel: 627-9700 ext: 1203;1204

 

Notice of Appeal Forms

Location of NIAT Appeal Boxes