Special features
Investigating whether a benefit overpayment has taken place
If it comes to a benefit provider’s attention that an overpayment may have taken place, a decision maker considers the available evidence. This may involve an investigation interview with the client, checking official records, using formal ‘requests for information’ (eg, seeking copies of bank statements), magistrates’ court-mandated surveillance and ‘open source material’, such as social media accounts. In deciding whether an overpayment has occurred, the benefit provider considers if the client:
•misrepresented (a written or oral statement in support of a claim is incorrect) a material fact; or
•failed to disclose (did not answer a direct question correctly or report a change in circumstances) a material fact.
The terms ‘misrepresentation’ and ‘failure to disclose’ apply to innocent errors, omissions and deliberate fraud.
Decision that a benefit overpayment has taken place
If it is decided that there has been an overpayment, the original decision to award benefit is revised or superseded.
Benefit overpayments run from the date of the:
•award, if the cause is information not disclosed or the wrong information is applied on application; or
•‘effective date’ of a change of circumstance. (The effective date occurs when the change impacts on payment, which is not necessarily the date when the change occurred.)
The decision that an overpayment has taken place is in three parts:
•new or revised entitlement to benefit;
•assessment of the recoverability of overpayment;
•recoverability decision.
Liability
The person who claimed the benefit is generally the liable person.
In the cases of couples:
•status-based and contribution-based benefits are claimed by one person in the relationship;
•for all income-based benefits, ‘joint and several liability’ applies.
In certain circumstances, a third party can be held liable for the overpayment:
•the executor (or beneficiaries) of the estate for a deceased claimant;
•an appointee dealing with the claimant’s finances;
•a landlord (if HB/UC housing element was paid direct to the landlord).
In liability decisions regarding landlords, the DWP makes a decision based on how the overpayment took place. If it was:
•due to a change of address, the overpayment is recoverable from both the claimant and/or the landlord;
•a result of a misrepresentation or failure to disclose, the overpayment is recoverable from the person(s) who failed to disclose or misrepresented the material fact.
Notification
The benefit provider must send the liable person a formal letter. The notification must contain prescribed information, including:
•how it was caused;
•the period of the overpayment;
•the amount of the overpayment;
•evidence of how the overpayment has been calculated;
•whether some or all of the overpayment can be offset and, if so, how offsets have been applied.
Advisers should ask for a copy of the overpayment letter and check it carefully when advising clients whether to challenge an overpayment decision.
Penalties
In addition, the letter may state that a civil penalty has been imposed. A civil penalty may be imposed where:
•the overpayment arose as a result of the claimant negligently making an incorrect statement, and they failed to take reasonable steps to correct the error;
•where the claimant failed to disclose information about their claim without a reasonable excuse;
•where the claimant failed to inform the DWP of a relevant change of circumstances without a reasonable excuse.
A civil penalty signifies that the overpayment is not been treated as being fraudulent.
Fraud
If it is considered that an overpayment was made because of fraud, in addition to the overpayment being recovered, the client can be prosecuted or given the option of paying a penalty instead of going to court. See CPAG’s Welfare Benefits and Tax Credits Handbook for further information.
Right to recover
An overpayment is always recoverable if it is caused by the client failing to disclose or misrepresenting a material fact or by proven fraud, or if the overpayment was paid to a third party.
However, if the cause is the benefit provider making a mistake in awarding benefit, that is deemed to be an official error, and for DWP-administered benefits is never recoverable.1CPAG v SSWP [2010] UKSC 54 The exception to the rule is any overpayment of new-style benefits (UC, contribution-based JSA and contributory ESA). These benefits are always recoverable, regardless of the overpayment being caused by an official error.2s71ZB(1) Welfare Reform Act 2012; art 5(3A) Welfare Reform Act (Commencement No.8) Order 2013 No.358 In cases of official error and HB overpayments, unless the claimant or payee (eg, a landlord or agent of the landlord) could reasonably have been expected to realise that it was an overpayment, the overpayment is unrecoverable.3Reg 100(2) Housing Benefit Regulations 2006 No.213; reg 81(2) Housing Benefit (Persons who have attained the qualifying age for pension credit) Regulations 2006 No.214; Sandwell MBC v NK (HB) [2016] UKUT 140 (AAC); Towerwall Property Management v Wirral MBC (HB) [2012] UKUT 191 (AAC)
Reducing the balance of the overpayment
An overpayment balance may be reduced by offsetting underlying entitlement to another benefit (which otherwise would have been in payment). This is a complex area and specialist benefit advice should be sought.
On the separation of a couple, the amount of an overpayment of UC is divided 50/50 between the pair.