About the scheme
The scheme is time-limited. Deaths which occurred before the announcement of the scheme will also be considered.
The scheme will close on 30 June 2022. Claimants have until 30 September 2023 to submit claims for deaths that occurred while the scheme was open.
The scheme rules allowed a six-month window following the expiry of Section 45 to allow claimants time to bring forward outstanding claims in respect of deaths which occurred whilst the scheme was open. This window has now been extended from 30 June 2023 to 30 September 2023.
The scheme is non-contributory which means there is no cost to staff or employers.
This scheme is separate to the NHS Pension Scheme and any other pension scheme. If the deceased was also a member of the NHS Pension Scheme then NHS Pension death benefits may also be paid. You will need to complete separate claim forms. The forms will be provided by the NHS Employer or can be found on the bereavement page of our NHS Pensions website.
Who’s covered
The scheme covers staff who:
- are employed by an NHS body
- work for organisations that support the delivery of NHS services, including outsourced or subcontracted services
- work on an NHS contract, agreement or arrangement including primary care medical, dental, pharmaceutical or ophthalmic/eye care services and including their staff are engaged in work related to the provision of care and support services either provided or arranged by a local authority as part of its social services activity or delivered in registered care homes or registered domiciliary support services
Staff can be:
- full-time or part-time
- permanent or temporary, including agency workers and locums
- retired staff who return to NHS or other employment
- students taking up paid frontline roles
- students on placement or registered healthcare volunteers
Within social care, the scheme covers staff employed or engaged in relation to the activity of local authorities in the exercise of their social services functions and other services commissioned by local authorities to provide care and support. Also covered are people employed or engaged in work related to the provision of care and support in care homes and domiciliary support services which are registered by Care Inspectorate Wales (CIW).
Personal assistants employed via direct payments to work with adults or disabled children are included in this scheme.
The coverage of the scheme is broadly drawn across NHS and social care sector employers given the variety of roles and locations, and the ways these may change in response to the pandemic.
Eligibility criteria for the scheme can be found in the NHS and Social Care Coronavirus Life Assurance (Wales) Scheme 2020 eligibility factsheet (PDF: 199KB).
You can also read our eligibility factsheet in Welsh (PDF: 196KB).
Eligibility is work-related, where Welsh Ministers can reasonably conclude that the person contracted coronavirus in the course of performing their duties.
Eligibility criteria
For a claim to be accepted, Welsh Ministers must be reasonably satisfied on the basis of evidence that:
- coronavirus disease was wholly or mainly the cause of death
- the individual was exposed to a high risk of contracting coronavirus disease in circumstances where they could not reasonably avoid that risk because of the nature and location of their work
- the individual was likely to have contracted coronavirus in the course of their work
- the individual first exhibited symptoms of coronavirus within the period of 14 days (or such other period on the basis of medical evidence) of being exposed to coronavirus in the course of their work
- the death of the individual occurred prior to the Scheme end date
Circumstances that are likely to fall within these criteria are where the individual was:
- testing or diagnosing whether a person is infected with or contaminated by coronavirus
- coming into close proximity by reason of caring for, supporting, treating, or providing other care or clinical service to a person who has, or is suspected of having, coronavirus or coronavirus disease
- engagement with a person in relation to the carrying out of social care functions who has, or is suspected of having, coronavirus or coronavirus disease
- providing any other type of service within the same environments where those services are delivered
Where the individual was performing duties that do not fit these scenarios, or if it’s difficult to establish the presence of coronavirus in the workplace, the claimant is invited to explain why they think the individual was exposed to a high risk of contracting coronavirus because of the nature and location of their work. The claimant’s explanation will be appropriately considered.
Where the person was providing health or social care services directly to people with coronavirus and the performance of those functions was likely to have contributed to the person’s death but coronavirus is not listed on the deceased’s death certificate Welsh Ministers may, using discretionary powers, deem the death eligible.
Claims process
If you believe you may be eligible to make a claim and you have not heard from the deceased’s employer about the claims process, use our NHS and Social Care Life Coronavirus Assurance Scheme 2020 (Wales) claim form (PDF: 452KB) for individuals working in the NHS or social care services in Wales.
You can also use our claim form in Welsh (Word: 212KB).
If you need to speak to someone about the process of making a claim, contact us.
The claim form should be completed by the legal personal representative for the deceased or a solicitor acting on behalf of the estate.
The claim form will need to be certified by the deceased’s employer.
To complete the form, you’ll need:
- details of the deceased
- details of the legal personal representative or solicitor
- employment information about the deceased
- the cause of death, as listed on the death certificate
- payment details
The legal personal representative or solicitor will also need to provide the employer with the death certificate and either:
- an original Grant of Probate
- original Letters of Administration
Claims will be processed to confirm eligibility of payment whilst claimants obtain either a Grant of Probate or Letters of Administration, but payment cannot be issued without either of these being received.
If there’s more than one legal personal representative, each person (other than the claimant, if they’re also a legal personal representative) must complete a claim form annex to confirm they agree with the payment details provided on the claim form.
The employer will send the claim form, along with copies of the supporting documentation to us.
Payment
Once we have received the completed form from the employer, completed all eligibility checks and received all supporting documentation, including the Death Certificate and either Grant of Probate or Letters of Administration, we'll process the application and pay the life assurance lump sum. The life assurance lump sum will be paid into the bank or building society account of the Estate or we will issue a cheque to the claimant.
We’ll notify the claimant and all Legal Personal Representatives that the life assurance lump sum has been paid.
We’ll also notify the employer that the life assurance lump sum has been paid.
Where payment is due, payment will be made within 30 calendar days of us receiving an authorised claim form and supporting documentation from the claimant and the employer.
If the life assurance lump sum is not paid within 30 calendar days, we’ll pay interest on the unpaid amount.
Interest will be paid at the bank base rate. However, if the life assurance lump sum was not paid within 30 days as a result of some act or omission on the part of the claimant or employer, no interest will be paid.
Complaints and disputes
To complain or raise a dispute about the administration of the NHS and Social Care Coronavirus Life Assurance Scheme, send us a completed NHS and Social Care Coronavirus Life Assurance Scheme disputes application form (PDF: 243 KB).
View the NHS and Social Care Coronavirus Life Assurance Scheme disputes guidance (Word: 75 KB) for more information about the disputes process.
Details on where to send the completed disputes application is in the guidance document and application form.
Rejected claimants may appeal the outcome of their claim. Their appeal will go to the relevant minister.
The rejected claimant must explain why they believe their case has been incorrectly rejected and send this, along with any additional evidence they have to support their case, to nhsbsa.coronaviruslifeassurancescheme@nhs.net.
The NHSBSA will pass the appeal to the Discretion Panel who will meet to reassess the appealed case, taking into account any new information presented, before passing a recommendation onto the relevant minister for final determination.
Contact us
The employer of the deceased is there to support you through the claim process.
They will authorise your claim and will send it to us on your behalf.
If you have any questions about the NHS and Social Care Coronavirus Life Assurance (Wales) Scheme 2020 claims process, speak with the employer.
If they are not able to help, you can contact us and an administrator will call you back.
Contact our NHS and Social Care Coronavirus Life Assurance (Wales) Scheme 2020 helpline by:
Telephone: 0300 330 3331
Outside UK: +44 (0)191 283 8904
Find out about call charges