National Insurance (Determination of Claims and Questions) Regulations


Published: 1974-10-07

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National Insurance (Determination of Claims and Questions) Regulations
NATIONAL INSURANCE [CH.350 – 129






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NATIONAL INSURANCE (DETERMINATION OF

CLAIMS AND QUESTIONS) REGULATIONS
(SECTION 27, 49, 50 and 62)

[Commencement 7th October, 1974]

PART I
PRELIMINARY

1. These Regulations may be cited as the National
Insurance (Determination of Claims and Questions)
Regulations.

2. (1) In these Regulations, unless the context other-
wise requires —

“Act” means the National Insurance Act;
“appeal tribunal” means a tribunal constituted under

regulation 7 and the Schedule to these Regula-
tions;

“claimant”, in relation to the review of an award or
decision, includes a beneficiary under the award
or affected by the decision;

“degree of disablement” means the loss of faculty,
suffered as a result of the relevant injury,
assessed in whole numbers as a percentage of
that loss of faculty;

“determining authority” means, as the case may
require, the Board or the Director, an appeal
tribunal or a medical referee or a medical appeal
board appointed or constituted in accordance
with any Regulations for the time being in force;

“grant” means any benefit which is payable in one
sum and not by periodical payments;

“invalid” means a person who is incapable of work as a
result of a specified disease or bodily or mental
disablement which is likely to remain permanent,
and the work “invalidity” shall be construed
accordingly;

“local office” means an office appointed by the Board
as a local office for the purposes of the Act;

“medical appeal board” means a medical appeal
board constituted under regulation 24;

S.I. 64/1974

Citation.

Interpretation.

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“medical examination” includes bacteriological and
radiological tests and similar investigations, and
references to being medically examined shall be
construed accordingly;

“medical officer of the Board” means such medical
officer in the employment of the board as may be
designated by the Board to perform on its behalf
executive duties in connection with the determi-
nation of medical questions;

“medical question” means any question set out in
paragraph (1) of regulation 19;

“medical referee” means a registered medical practi-
tioner appointed to act as a medical referee
under regulation 21;

“paragraph” means a paragraph of a regulation;
“Part” means a Part of these Regulations;
“question” includes for the purposes of Part III, a

claim for benefit or assistance;
“registered medical practitioner” means a person

registered under the Medical Practitioners Act;
“relevant accident”, “relevant injury” and “relevant

disease”, in relation to any benefit, mean
respectively the accident, injury or disease in
respect of which that benefit is claimed or
payable and “relevant loss of faculty” mean the
loss of faculty resulting from the relevant
accident, injury or disease;

“reserved question” means any question set out in
regulation 3 for the determination of which the
procedure in paragraph (1) of regulation 4 has
been followed;

“Schedule” means the Schedule to these Regulations.
(2) In these Regulations, unless a contrary intention

appears, references to a regulation are references to a
regulation of these Regulations.

(3) Any notice or other document required or
authorised to be given or sent to any person under the
provisions of these Regulations shall be deemed to have
been given or sent if it was sent by post to that person at
his ordinary or last known postal address.

Ch. 224.

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(4) Any power given in these Regulations to extend
the period during which anything is required to be done
under these Regulations or to dispense with any of the
requirements thereof may be exercised in any case,
notwithstanding that the period during which the thing is
required to be done has expired.

PART II
DETERMINATION OF QUESTIONS BY

THE BOARD
3. Subject to the provisions of these Regulations the

following reserved questions arising under or in connection
with the Act, that is to say —

(a) whether a person is or was an insured person;
(b) whether a person is or was an employed person

as defined in section 2 of the Act;
(c) as to the class or category of insured persons in

which a person is to be included;
(d) whether the contribution conditions for any

benefit are satisfied, or any question otherwise
relating to a person's contributions;

(e) who is or was liable for payment of contributions
as the employer of any insured person,

shall be determined by the Board whose decision shall be
final.

4. (1) Any person desiring to obtain the decision
of the Board on any question mentioned in regulation 3
shall deliver or send to the Board an application for the
purpose in writing in a form approved by the Board and
shall furnish such particulars as the Board may require for
the purpose of the consideration and determination of any
such question.

(2) The Board shall take steps to bring any such
application and any such particulars to the notice of any
person appearing to it to be interested therein and to obtain
from such person such particulars within such time and in
such form as it considers reasonably necessary for the
proper determination of the question.

(3) The Board may, if it thinks fit, before determining
the question, appoint a person to hold an inquiry into the
matter and to report to it thereon and any person so
appointed may, by summons, require persons to attend at

Questions for
determination by
the Board.

Procedure for
determination of
questions by the
Board.

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any such inquiry to give evidence or to produce documents
reasonably required for the purpose of the inquiry and may
take evidence on oath and, for that purpose, administer
oaths.

(4) For the purpose of the determination of any
question under regulation 3 of these Regulations, the Board
may, by summons, require any person to attend upon the
Board to give evidence or to produce documents
reasonably required for the purpose of determining that
question and may take evidence on oath and, for that
purpose, administer oaths.

(5) Reasonable notice of the date and place of the
holding of such an inquiry shall be given to the applicant
and to any person notified of the application in accordance
with paragraph (2).

(6) The applicant and any person appearing to the
Board or to the person holding the inquiry to be interested
in the application shall be entitled to attend and be heard
at the inquiry, and to be represented by any other person,
and the procedure thereat shall, subject to this regulation,
be such as the person holding the inquiry shall determine.

(7) The Board shall give notice in writing of its
decision together with the reasons therefor to the applicant
and to any persons appearing to it to be interested therein
and may publish its decision in such manner as it thinks fit.

5. (1) Any question of law arising in connection
with the determination by the Board of any such question
as is mentioned in regulation 3 may, if it thinks fit, be
referred by the Board for decision to the Supreme Court.

(2) In the event of the Board determining in
accordance with paragraph (1) to refer any question of
law to the Supreme Court, it shall send notice in writing
of its intention so to do to the applicant and to any other
person appearing to it to be interested therein.

(3) Any person, aggrieved by the decision of the
Board on any question of law which is not referred to the
Supreme Court, may appeal from that decision to the
Supreme Court, in accordance with rules of court made
pursuant to section 49(4) of the Act, and the appellant and
any other person appearing to the Board to be interested
shall, on request, be furnished with such a statement of the
grounds of the decision as will enable them to determine
whether any question of law has arisen upon which they
may wish to appeal.

Reference to
Supreme Court
by Board of
questions of law;
appeals against
decisions of
Board on
questions of law.

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(4) Without prejudice to the right of any other
person, the Board shall be entitled to appear and be heard on
any such reference or appeal.

6. (1) The Board may, on new facts being brought
to its notice or if it is satisfied that the decision was given
in ignorance of, or was based on a mistake as to, some
material fact, review a decision given by it in accordance
with this Part of these Regulations:

Provided that any such decision shall not be reviewed
while an appeal is pending against the decision of the
Board on a question of law arising in connection therewith
or before the time for appealing has expired.

(2) The provisions of regulation 5 shall apply in
relation to a decision on review as they apply to the
original determination or decision.

PART III
DETERMINATION OF CLAIMS AND
QUESTIONS BY THE DIRECTOR OR

AN APPEAL TRIBUNAL
7. (1) The following questions, that is to say —
(a) any question as to the right to benefit or

assistance;
(b) any other question arising under or in connec-

tion with the Act, not being a reserved question
under Part II of these Regulations or a medical
question to be determined under Part IV hereof,

shall be submitted to the Director who shall consider the
question and, so far as practicable, dispose of it in
accordance with these Regulations within fourteen days
from the date when it was submitted to him.

(2) If on consideration of a question the Director is of
opinion that no reserved or medical question arises then —

(a) if he is satisfied that the question ought to be
determined wholly in favour of the claimant, he
may determine the question accordingly;

(b) in so far as he is not so satisfied he may either —
(i) refer the question (so far as is practicable,

within fourteen days from the date on which
it was submitted to him) to an appeal
tribunal, constituted as laid down by the
Schedule, for its decision; or

Review of
decision of the
Board.

Submission of
question to
Director.

Schedule.

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(ii) himself determine the question in whole or
in part adversely to the claimant.

(3) Where the Director refers a question to an
appeal tribunal in accordance with paragraph (2), notice
in writing of such reference shall be given to the claimant.

(4) Subject to the provisions of the Act and these
Regulations, the Director may delegate to any officer of the
Board the power to carry out on his behalf any of his
functions under this regulation.

(5) Every delegation under paragraph (4) shall be
revocable by the Director and no delegation shall prevent
the exercise of the Director of any function.

8. (1) If the Director has determined a question in
whole or in part adversely to the claimant, the claimant
shall, subject to the provisions of this regulation, have the
right to appeal in respect of the decision to an appeal
tribunal and shall be notified in writing of the decision and
the reason therefor and of his right to appeal therefrom:

Provided that where a reserved question has arisen in
connection with the decision of the Director and has been
determined by the proper authority, and the Director
certifies that the decision on that question is the sole
ground of his decision, no appeal shall lie without the leave
of the chairman of the appeal tribunal.

(2) An appeal against a decision of the Director
must be brought by giving notice of appeal at an office of
the Board within twenty-one days after the date of that
decision or within such further time, not exceeding four
months, as the chairman of the appeal tribunal may allow.

(3) A notice of appeal shall be in writing and shall
contain a statement of the grounds upon which the appeal
is made.

9. (1) Reasonable notice of the time and place of
the hearing before an appeal tribunal shall be given to the
claimant and to any other person who may appear to the
chairman of the tribunal to be interested and, except with
the consent of the claimant, the appeal tribunal shall not
proceed with the hearing of any case unless such notice has
been given.

Appeals to
appeal tribunal.

Time and place
of hearings
before appeal
tribunal.

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(2) If a claimant or other person to whom notice of
hearing has been duly given in accordance with these
Regulations should fail to appear either in person or by
representative at such hearing and has not given a
reasonable explanation for his absence, the tribunal may
proceed to determine the case, or may give such directions
with a view to the determination of the case as it may think
proper.

10. (1) Every hearing by the appeal tribunal shall be
in public except in so far as the chairman of the tribunal
may otherwise direct if he is of the opinion that intimate
personal and financial circumstances may have to be
disclosed or that consideration of public security are
involved.

(2) The following persons shall be entitled to be heard
at the hearing of any case by an appeal tribunal —

(a) the claimant;
(b) the Director,

and any person appearing to the tribunal to be interested
shall have the right to be present notwithstanding that the
hearing of the case is not in public.

(3) The chairman of an appeal tribunal may, by
summons, require any person to attend at any such hearing
to give evidence or to produce documents reasonably
required for the purpose of the hearing and may taken
evidence on oath and, for that purpose, administer oaths.

(4) Any person who by virtue of the provisions of
this regulation has the right to be heard at the hearing of
the case by an appeal tribunal, may be represented at the
hearing by some other person (whether having professional
qualifications or not) and, for the purpose of the hearing,
any such representative shall have all the rights to which
the person whom he represents is entitled under these
Regulations.

(5) Any person who exercises the right conferred by
this regulation to be heard at the hearing may call
witnesses and shall be given an opportunity of putting
questions directly to any witness called at the hearing.

(6) For the purpose of arriving at its decision, or
discussing any question of procedure, an appeal tribunal


Hearings before
appeal tribunal.

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may, notwithstanding anything in this regulation, order all
persons (not being members of the tribunal or an officer of
the Board acting as clerk to the tribunal) to withdraw from
the sitting of the tribunal.

11. (1) An appeal tribunal shall —
(a) record in writing, in such form as may from time

to time be approved by the Board, all its
decisions (whether on an appeal or on a reference
from the Director); and

(b) include in the record of every decision (which
shall be signed by all the members of the
tribunal) a statement of the reasons for its
decision including its findings on all questions
of fact material thereto.

(2) Where the members of the tribunal are unable to
reach a unanimous decision on any case, the decision of the
majority of the members thereof shall be the decision of the
tribunal.

(3) As soon as may be practicable after a decision
has been reached, a copy of that decision shall be sent to the
claimant and to the Director and to any other person who
appears to the appeal tribunal to be interested.

12. (1) Any question of law arising in connection
with the determination by an appeal tribunal of any
question (whether on an appeal or on a reference from the
Director) may, if it thinks fit, be referred by the appeal
tribunal to the Supreme Court.

(2) In the event of the appeal tribunal determining in
accordance with paragraph (1) to refer any question of law
to the Supreme Court, it shall send notice in writing of its
intention to do so to the applicant and to any other person
appearing to it to be interested therein.

(3) Any person aggrieved by the decision of an
appeal tribunal on a question of law which is not referred
to the Supreme Court in accordance with paragraph (1),
may appeal from that decision to the Supreme Court in
accordance with rules of court made pursuant to sub-
section (4) of section 49 of the Act, and the applicant and
any other person appearing to the appeal tribunal to be
interested shall, on request, be furnished with such a
statement of the grounds of the decision as will enable
them to determine whether any question of law has arisen
upon which they may wish to appeal.

Decision of
appeal tribunal.

Reference to
Supreme Court
of questions of
law; appeals
against decisions
of appeal
tribunal on
questions of law.

S.I. 36/2005.

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(4) Without prejudice to the rights of any other
person, the Director and the chairman of the appeal
tribunal shall be entitled to appear and be heard an any
such reference or appeal.

13. (1) Any decision under this Part made by the
Director or an appeal tribunal may be reviewed at any time
by the Director or, on a reference from the Director, by an
appeal tribunal, if —

(a) either he or the tribunal is satisfied that the
decision was given in ignorance of, or was based
on a mistake as to, some material fact;

(b) there has been any material change of circum-
stances since the decision was given; or

(c) the decision was based on the decision of any
reserved or medical question and the decision on
that question has been revised.

(2) A request for such a review may be made by
means of an application in writing to the Director stating the
grounds of the application.

(3) On receipt of any such application, the Director
shall proceed to deal with or refer any question arising
thereon in accordance with the Act and these Regulations.

(4) Any decision given on a review under this
regulation, and any refusal to review a decision under this
regulation, shall be subject to appeal in like manner as an
original decision, and the provisions of this Part shall,
subject to the necessary modifications apply in relation to
any decision given on a review as they apply to the original
decision on a question.

14. (1) Subject to the provisions of this regulation
and regulation 17, benefit or assistance shall be payable in
accordance with an award, notwithstanding that an appeal
is pending.

(2) Where it appears to the Director that a question
has arisen whether —

(a) the conditions for the receipt of benefit or
assistance payable under an award are or were
fulfilled; or

(b) an award of benefit or assistance ought to be
revised in accordance with these Regulations,

Review of
decisions of
Director and
appeal tribunal.

Payment of
benefit or
assistance.

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[Original Service 2001] STATUTE LAW OF THE BAHAMAS

he may direct that payment of benefit or assistance shall be
suspended in whole or in part until that question has been
determined.

15. (1) Where on review a decision is revised so as to
make benefit or assistance payable, or to increase the rate of
benefit or assistance, the decision on review shall have
effect as from the date of the application for the review:

Provided that, if in any case the claimant proves that
on a date earlier than the date on which the application for
the review was made, he was (apart from satisfying the
condition of making a claim therefor) entitled to benefit or
assistance under the National Insurance (General Benefits
and Assistance) Regulations or the National Insurance
(Industrial Benefits) Regulations, or both of those
Regulations, he shall not be disqualified by virtue of the
foregoing provisions of this paragraph for receiving any
benefit or assistance to which he would have been entitled
in respect of the period between the earlier date and the
date on which the application for the review was made.

(2) Notwithstanding anything contained in this
regulation, the following provisions shall have effect —

(a) the proviso to paragraph (1) of this regulation
shall apply subject to the condition that no sum
on account of benefit or assistance shall be paid
to any person in respect of any part of the period
referred to in that proviso which is earlier than
six months before the date of the application for
the review;

(b) the decision on review shall not have effect for
any period before the date on which the original
decision took effect or would have taken effect
if an award had been made;

(c) if the said decision on review was based on a
material change of circumstances subsequent to
the date on which the original decision took
effect, it shall not have effect for any period
before the date declared by the director or the
appeal tribunal, as the case may be, to be the
date on which such material change took place.

(3) For the purpose of this regulation, where a
decision is reviewed at the instance of the Director under
paragraph (1) of regulation 13, the date on which it was
first decided by the Director that the decision should be
reviewed shall be deemed to be the date of the application
for the review.

Reviews of
decisions
involving
payment or
increase of
benefits or
assistance other
than grants.

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STATUTE LAW OF THE BAHAMAS [Original Service 2001]

(4) In this regulation, “benefit” does not include a
grant.

16. (1) A decision shall not be reviewed so as to
make a grant payable unless the claimant proves that the
application for review was made not later than four years
from the date of the decision.

(2) The provisions of paragraph (3) of regulation 15
shall apply in the application of paragraph (1) of this
regulation as they apply in the application of paragraphs
(1) and (2) of that regulation.

17. (1) Where a grant is awarded by a decision on
review or appeal in lieu of a pension previously awarded,
such decision shall direct that any payments made on
account of such pension shall, in so far as they do not
exceed the amount of the grant, be treated as being made
on account of the grant.

(2) Where any benefit (other than a grant) or
assistance is awarded by a decision on review or appeal in
lieu of another kind of benefit or assistance previously
awarded, that decision shall, (in relation to any payments
made on account of benefit or assistance previously
awarded) —

(a) direct that, in so far as the amount thereof does not
exceed the amount of any arrears payable by way
of the benefit or assistance so awarded, such
payments shall be treated as having been made on
account of such arrears; and

(b) to the extent by which the amount thereof
exceeds the amount of the said arrears, direct
that such payments shall (except in so far as they
are required to be repaid under this regulation)
be treated as having been made on account of
sums becoming payable after the date of the
decision on review or appeal by way of the
benefit or assistance awarded thereby.

(3) Where on review or appeal a decision is revised,
or is reversed or varied so as to make benefit or assistance
not payable or to reduce the amount of benefit or assistance,
the decision given on the review or appeal shall require
repayment to the Fund of any benefit or assistance paid in
pursuance of the original decision to the extent to which
it —

Review of
decisions
involving
payment of
grants.

Adjustment of
benefit.

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(a) would not have been payable if the decision on
review or appeal had been given in the first
instance; and

(b) is not directed to be treated as paid on account of
the benefit or assistance awarded by the decision
on review or appeal.

(4) Where —
(a) on appeal against an award of benefit or

assistance a decision is reversed or varied, so
that such benefit or assistance is not payable at a
lesser rate; and

(b) on review, the decision on that appeal is revised
so as to make such benefit or assistance payable
or payable at a higher rate from a date before the
decision on appeal,

any benefit or assistance paid in pursuance of the award
before the decision on appeal shall (to the extent to which
it would not have been payable if the decision on appeal
had been given in the first instance) be treated as having
been paid on account of any benefit or assistance made
payable for the same period by the decision on review,
except in so far as it has, in pursuance of the decision on
appeal, been repaid or treated as paid on account of the
benefit or assistance awarded by that decision.

(5) Where, in accordance with a decision given on a
renew or appeal, any benefit or assistance is required to be
repaid to the Fund then, without prejudice to any other
method of recovery, such benefit or assistance shall be
recoverable by deduction from any benefit or assistance
which is then payable to the person by whom it is to be
repaid, or which becomes payable to that person in respect
of any part of the period of six months immediately
following the day on which the decision is given.

18. (1) If on consideration of a question the Director
is of the opinion that a reserved question arises he shall —

(a) refer the reserved question to the Board to
determine the same; and

(b) deal with any other question as if the reserved
question had not arisen:

Provided that the Director may —
(i) postpone the reference of a reserved question or

dealing with any question until after other
questions have been determined;

References of
questions.

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STATUTE LAW OF THE BAHAMAS [Original Service 2001]

(ii) in cases where the determination of any question
disposes of a claim or any part thereof, make an
award, or decide that an award cannot be made
as to the claim on that part thereof, without
referring or dealing with, or before the determi-
nation of, any other question.

(2) The foregoing provisions of this regulation shall
apply to an appeal tribunal in the same manner as they
apply to the Director, except that an appeal tribunal instead
of itself referring a question for determination in
accordance with subparagraph (a) of paragraph (1) of this
regulation, shall require it to be referred to the Director.

PART IV
DETERMINATION OF MEDICAL

QUESTIONS
19. (1) The following medical questions may be

determined in accordance with this Part of these Regula-
tions —

(a) whether a person is, or was, an invalid as defined in
regulation 2;

(b) whether the relevant accident has resulted in a
loss of faculty;

(c) at what percentage the degree of disablement
resulting from the relevant loss of faculty is to
be assessed and what period is to be taken into
account by the assessment;

(d) whether the relevant injury has resulted from the
relevant accident;

(e) whether the death of a person has resulted from
the relevant accident;

(f) whether a person is, or was, suffering from a
prescribed disease;

(g) whether, in the case of a person who is suffering
from a prescribed disease and who has previously
suffered from that prescribed disease, his
condition is to be treated as having recrudesced,
or, due to further exposure as a risk of his
occupation, the prescribed disease has developed
afresh;

Reference of
medical
questions.

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[Original Service 2001] STATUTE LAW OF THE BAHAMAS

(h) whether a person is, or was, incapable of work;
(i) whether or not a person is permanently incap-

able of work;
(j) whether a person whose age is in doubt is, or is

not, likely to be the age he alleges;
(k) whether the disease from which a person is

suffering is or is not a sequela to an employment
injury;

(l) any other medical question which may arise in
any case.

(2) Any medical question referred to in subparagraphs
(a), (b) and (c) of paragraph (1) shall be referred to and
determined by a medical referee or, on appeal, by a medical
appeal board in accordance with these Regulations.

(3) The Director may refer any other medical
question to a medical referee for decision and where such
medical question is so referred, it shall be determined by a
medical referee or, on appeal, by a medical appeal board in
accordance with these Regulations.

(4) Subject to these Regulations, the decision of a
medical appeal board on a medical question shall be final.

20. Where the case of a claimant for disablement
benefit has been referred by the Director for determination
of the medical question in subparagraph (c) of paragraph
(1) of regulation 19 and, on that or any other subsequent
reference, the degree of disablement is provisionally
assessed, the medical question arising in that case shall
again be referred to a medical referee not later than the end
of the period taken into account by the provisional
assessment.

21. (1) A medical referee shall be selected by the
medical officer of the Board from a panel of medical
referees prepared by him and approved by the Board.

(2) A person shall not act as a medical referee for the
purpose of the consideration of a medical question in any
case if he —

(a) is or may be directly affected by that case; or
(b) has taken any part in such case as a registered

medical practitioner, who has attended the
claimant in respect of a condition out of which
the medical question has arisen, or to whom any


Further reference
where extent of
disablement is
provisionally
assessed.

Medical referees.

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STATUTE LAW OF THE BAHAMAS [Original Service 2001]

medical question has been referred for examination
and report; or
(c) is, or was during the material period, an

employer of the claimant; or
(d) has taken any part in such case as a witness; or
(e) is a Senator or a Member of Parliament.
22. (1) Reasonable notice of the time and place at

which a medical referee will consider any medical questions
referred to him shall be given to the claimant and if, after
such notice has been given, the claimant fails to appear, the
medical referee may not, without his consent, proceed to
determine the medical questions referred to him.

(2) No person shall be entitled to be present during
the consideration of any medical question by a medical
referee other than the claimant and any other person whom
the medical referee may, with the consent of the claimant,
allow to be present as being a person who, in the medical
referee's opinion, is likely to assist him in the
determination of that question.

(3) A medical referee shall have power to make or,
through the medical officer of the Board, arrange for, any
necessary medical examination to assist him in determining
the medical question.

23. (1) A medical referee shall on each medical
question record his decision in writing in such form as may
from time to time be approved by the Board and shall
include in such record, which shall be signed by him, a
statement of his findings on all questions of fact material to
the decision and shall send the form to the Director.

(2) As soon as may be practicable after receipt of
the decision of the medical referee, the Director shall send
written notice of that decision to the claimant. The notice
shall be in such form as may be approved by the Board
from time to time and shall contain a summary of the
findings of the medical referee.

24. (1) A medical appeal board shall be appointed by
the medical officer of the Board from a panel of registered
medical practitioners prepared by him and approved by the
Board for the purpose and shall consist of three members of
whom one shall be appointed as chairman.

Notice of
consideration by
medical referee.

Notice of
decision of
medical referee.

Constitution of
medical appeal
board.

NATIONAL INSURANCE [CH.350 – 143






[Original Service 2001] STATUTE LAW OF THE BAHAMAS

(2) The members of a medical appeal board shall hold
office for such period as the Board may direct and the Board
may at any time terminate the appointment of any member of
a medical appeal board.

(3) A registered medical practitioner shall not act as
a member of a medical appeal board for the purpose of the
consideration of any medical question arising in a case if
he —

(a) is or may be directly affected by that case; or
(b) has taken any part in such case as a medical

referee, or as a registered medical practitioner
who has attended the claimant in respect of a
condition out of which the medical question has
arisen, or to whom any question has been
referred for examination and report; or

(c) is, or was during the material period, an
employer of the claimant; or

(d) has taken any part in such case as a witness; or
(e) is a Senator or Member of Parliament.
(4) A medical appeal board shall not determine any

medical question referred to it or brought before it if any
member thereof is unable to be present at the consideration
of any such question.

(5) Where the members of a medical appeal board
are unable to reach a unanimous decision on any case, the
decision of a majority of the members thereof shall be the
decision of the Board.

25. (1) This regulation shall have effect where the
Director has referred a medical question to a medical
referee for determination.

(2) If a claimant is dissatisfied with the decision of a
medical referee, he may appeal against that decision in
accordance with regulation 26 and the medical question
shall be referred to a medical appeal board.

(3) If the Director is of opinion that any decision of
a medical referee ought to be considered by a medical
appeal board and he notifies a medical appeal board in
accordance with regulation 26, then the medical question
shall be referred to a medical appeal board and the said
board may confirm, reverse or vary the decision in whole
or in part as on an appeal.

Appeals from
decisions of
medical referees.

CH.350 – 144] NATIONAL INSURANCE






STATUTE LAW OF THE BAHAMAS [Original Service 2001]

26. (1) An appeal by a claimant against a decision of
a medical referee shall be brought by his giving notice of
appeal at an office of the Board within three months after
the notice of that decision has been given in accordance
with regulation 23 or within such further period as the
chairman of a medical appeal board may allow.

(2) A notice of appeal shall be in writing and shall
contain a statement of the grounds upon which the appeal
is made.

(3) For the purpose of securing the reference of a
medical question to a medical appeal board in accordance
with paragraph (3) of regulation 25, where the Director is
of opinion that a decision of a medical referee ought to be
considered by a medical appeal board, the Director may
notify a medical appeal board of his opinion in that respect
within three months after the date of that decision or such
longer period as the chairman of the medical appeal board
may for good reason allow.

27. (1) For the purpose of determining any medical
question referred to it, a medical appeal board shall hold a
hearing which may be held in public if the medical appeal
board so decides.

(2) Reasonable notice of the time and place at which
a medical appeal board will hear a case shall be given to the
claimant and to the Director and, except with the consent of
the claimant, the medical appeal board shall not proceed
with the hearing unless such notice has been given.

(3) The chairman of a medical appeal board may, by
summons, require any person to attend at any such hearing
to give evidence or to produce documents reasonably
required for the purpose of the hearing and may take
evidence on oath and, for that purpose, administer oaths.

(4) if a claimant to whom notice of hearing has been
given in accordance with paragraph (2), fails to appear at
the hearing, the medical appeal board may proceed to
determine the medical question notwithstanding his
absence, or may give such directions with a view to the
determination of the medical question as it may think
proper having regard to all the circumstances including any
explanation for the absence:

Provided that if a reasonable explanation for his
absence has been given by him or on his behalf, the


Notice of appeal
and notification
to the Board.

Hearing by
medical appeal
boards.

NATIONAL INSURANCE [CH.350 – 145






[Original Service 2001] STATUTE LAW OF THE BAHAMAS

medical appeal board shall not, without his consent,
determine the medical question in his absence unless the
hearing has first been adjourned for at least one month and
reasonable notice of the time and place of the adjourned
hearing has been given to him.

(5) In any case where there is before a medical
appeal board medical advice or evidence relating to the
claimant which has not been disclosed to him and in the
opinion of the chairman of the medical appeal board the
disclosure of that advice or evidence would be harmful to
the claimant's health, such advice or evidence shall not be
required to be disclosed to him but the medical appeal board
shall not by reason of such non-disclosure be precluded
from taking it into account for the purposes of its
determination of the medical question.

(6) The Director and the claimant shall have the
right to be heard at a hearing by a medical appeal board
and each may be represented by some person duly
authorised by him and, for the purpose of the hearing, any
such representative shall have all the rights and powers to
which the person whom he represents is entitled under
these Regulations.

(7) Any person who exercises the right conferred by
this regulation to be heard at a hearing by a medical appeal
board, may call witnesses and shall be given an opportu-
nity of putting questions directly to any witness called at
the hearing.

(8) A medical appeal board shall have power to make,
or through the medical officer of the Board, to arrange for,
any necessary medical examination to assist it in determining
the medical question.

28. (1) A medical appeal board shall on each
medical question record its decision in writing in such form
as may from time to time be approved by the Board and
shall include in such record, which shall be signed by all
the members of the medical appeal board, a statement of
the reasons for its decision, including its findings on all
questions of fact material to the decision.

(2) Written notice of the decision of a medical appeal
board (in such form as the Board may from time to time
approve) shall be sent to the claimant as soon thereafter as
practicable and shall contain a summary of the record of that
decision made in accordance with paragraph (1) of this
regulation.

Record and
notice of decision
of medical appeal
board.

CH.350 – 146] NATIONAL INSURANCE






STATUTE LAW OF THE BAHAMAS [Original Service 2001]

29. (1) If on consideration of a medical question, a
medical appeal board is of opinion that —

(a) no question other than a medical question arises,
it may determine the medical question accord-
ingly;

(b) a question other than a medical question arises,
it may proceed to determine the medical
question and refer the other question, including
any question of law, to the Director to be dealt
with pursuant to Part II of these Regulations if it
is a reserved question, or to Part III if it is not a
reserved question.

(2) If a medical appeal board has purported to make
a decision on a medical question, which includes a decision
on any other question including a question of law, the
Director may deal with that other question under these
Regulations as if it had been referred to him under
subparagraph (b) of paragraph (1) of this regulation.

30. (1) Under this Part of these Regulations any
decision made on a medical question by a medical referee or
a medical appeal board, whether provisional or final, may be
reviewed at any time by a medical referee or, on a reference
from the Director, by a medical appeal board, if —

(a) the determining authority is satisfied that the
decision was given in ignorance of, or was based
on a mistake as to, some material fact;

(b) there has been any material change of
circumstances relating to the medical question,
since the decision was given including, in the
case of any assessment of the degree of
disablement, any substantial or unforeseen
aggravation of the result of the relevant injury; or

(c) the decision was based on the determination or
purported determination of a question (other
than a medical question) and that determination
has been revised.

(2) An application to the Director for a review of
any decision that is mentioned in paragraph (1) of this
regulation shall be made in writing and shall state the
grounds thereof.

Medical and
other questions.

Review of
decisions of
medical referee
or medical appeal
board.

NATIONAL INSURANCE [CH.350 – 147






[Original Service 2001] STATUTE LAW OF THE BAHAMAS

(3) On receipt of such an application, the Director
shall refer any medical question arising thereon to the
appropriate determining authority in accordance with this
Part of these Regulations.

(4) Any decision given on a review under this
regulation by a medical referee, and any refusal by a
medical referee to review a decision under this regulation,
shall be subject to appeal in like manner as an original
decision, and the provisions of this Part shall, subject to the
necessary modifications, apply in relation to any decision
given on a review as they apply to the original decision of
the medical question.

31. On a review of any assessment on account of
unforeseen aggravation under subparagraph (b) of para-
graph (1) of regulation 30, the period to be taken into
account in revising any assessment may include any period
(not exceeding three months before the date of the
application for the review) if the medical referee or the
medical appeal board is satisfied that throughout the period
there has been substantial unforeseen aggravation of the
results of the injury since the making of the assessment
under review.

PART V
MISCELLANEOUS

32. (1) Where in any proceedings —
(a) for an offence under the Act; or
(b) involving any question as to the payment of

contributions under the Act; or
(c) for the recovery of any sums due to the Fund,

any question arises which, under the Act or Regulations
made thereunder, is to be determined by the Board or the
Director or an appeal tribunal or a medical appeal Board,
or by the Court in the event of an appeal on a point of law,
the decision by the appropriate determining authority shall,
unless an appeal under these or any other Regulations is
pending or the time for so appealing has not expired, be
conclusive for the purpose of those proceedings.

(2) If any such decision under paragraph (1) has not
been obtained and the decision of the question is necessary
for the determination of the proceedings, the question shall


Period to be
taken into
account by
assessment
revised on
grounds of
unforeseen
aggravation.

Decisions to be
conclusive for
purpose of
proceedings
under Act, etc.

CH.350 – 148] NATIONAL INSURANCE






STATUTE LAW OF THE BAHAMAS [Original Service 2001]

be referred to the appropriate determining authority, as the
case may require, in accordance with the procedure
(modified where necessary) prescribed in these or any
other Regulations.

(3) Where any such appeal as is mentioned in
paragraph (1) of this regulation is pending, or the time for
so appealing has not expired, or where any question has
been referred under paragraph (2) hereof, the authority
dealing with the case shall adjourn the proceedings until
such time as a final decision upon the question has been
obtained.

33. (1) There shall be paid to persons required to
attend on the consideration of a case before a determining
authority such travelling or other allowances as the Board
may by resolution declare and such sums shall be properly
payable out of the Fund.

(2) There shall be paid such other expenses incurred
in connection with the work of a determining authority in
the determination of questions under these Regulations as
the Board may by resolution declare and such sums shall be
properly payable out of the Fund.

(3) In this regulation, reference to travelling or other
allowances, include a reference to compensation for loss of
remuneration:

Provided that such compensation shall not be paid to
any person in respect of any time during which he is in
receipt of remuneration under the Act.

34. Subject to the provisions of the Act and of these
Regulations, the procedure of the Board when determining
a reserved question and the procedure of an appeal
tribunal, a medical appeal board or a medical referee shall
be such as the respective chairman or the medical referee
(as the case may be) shall determine.

SCHEDULE (Regulation 7)

APPEAL TRIBUNAL
1. An appeal tribunal shall consist of —

(a) one person drawn from a panel of persons chosen by the
Board to represent employers, in accordance with paragraph
3 of this Schedule; and

Authority for
payment of
expenses.

Chairman of
Board, appeal
tribunal, medical
appeal board and
medical referee
to determine
procedure.

NATIONAL INSURANCE [CH.350 – 149






LRO 1/2010 STATUTE LAW OF THE BAHAMAS

(b) one person drawn from a panel of persons chosen by the
Board to represent insured persons, in accordance with
paragraph 3 of this Schedule; and

(c) a chairman who, subject to the provisions of this Schedule,
shall hold office for such period (not exceeding two years)
as the Minister may determine, and shall be eligible for
reappointment.
2. (1) The chairman of an appeal tribunal shall be a counsel

and attorney of at least five years' standing and the Minister may
appoint one or more persons to perform the functions of
chairman.

(2) The members of a panel shall be appointed by the
Board so, however, that before appointing members to either of the
panels, the Board may take into consideration any recommendation
from —
(a) a confederation, representative of employers and employers'

associations or, in the absence of such a confederation, such
employers and associations of employers as in the opinion of
the Board are representative of employers generally; and

(b) an association of registered trade unions, or, in the absence
of such an association, such registered trade unions as, in
the opinion of the Board, are representative of insured
persons generally.
3. As far as practicable, the members of each panel shall be

summoned by the Board to serve in turn on an appeal tribunal for
which the panel is established:

Provided that no person shall sit on a tribunal during the
consideration of a case —
(a) in which he appears as the representative of the claimant; or
(b) by which he is or may be directly affected; or
(c) in which he has taken any part as an employer or as a witness;

or
(d) if he is a Senator or a Member of Parliament.

4. An appeal tribunal may, with the consent of the claimant
but not otherwise, proceed with any case in the absence of any
member other than the chairman and in any case the chairman
shall, if the number of members of the tribunal is an even
number, have a second or casting vote.

5. Members appointed to a panel pursuant to this Schedule
shall, subject to the provisions of this Schedule, hold office for
such term and on such conditions as may be determined by the
Board.

6. The Minister may, if he considers it expedient so to do,
at any time revoke the appointment of a chairman of an appeal
tribunal and the Board may, if it considers it expedient so to do,
at any time revoke the appointment of any member of a panel.

CH.350 – 150] NATIONAL INSURANCE






STATUTE LAW OF THE BAHAMAS LRO 1/2010

7. No member of the Board shall be eligible for
appointment as a chairman or member of an appeal tribunal.

NATIONAL INSURANCE (FINANCIAL AND
ACCOUNTING) REGULATIONS

(SECTION 44 and 62)

[Commencement 7th October, 1974]
1. These Regulations may be cited as the National

Insurance (Financial and Accounting) Regulations.
2. (1) In these Regulations, unless the context other-

wise requires —
“the Act” means the National Insurance Act;
“expenditure” means payment out of the Fund under

the provisions of subsection (3) of section 41 of
the Act;

“income” means payments into the Fund under the
provisions of subsection (2) of section 44 of the
Act;

“other securities” means investments made under the
provisions of paragraph 4 of the Third Schedule
to, or under section 44(6) of, the Act;

“paragraph” means a paragraph of a regulation;
“Part” means a Part of these Regulations;
“Reserve” means any one of the Reserves constituted

under regulation 20;
“Schedule” means a Schedule to these Regulations;
“trustee securities” means investments made under

the provisions of paragraph 3 of the Third
Schedule to the Act.

(2) In these Regulations, unless a contrary intention
appears, references to a regulation are references to a
regulation of these Regulations.

PART I
FINANCIAL ORGANISATIONS

3. The benefits and assistance to be provided by the
Fund shall be grouped into four branches —

S.I. 69/1974
S.I. 90/1982
S.I. 58/1985
S.I. 83/1998
S.I. 36/2005
S.I. 41/2009

Citation.

Interpretation.



S.I. 36/2005.

S.I. 90/1982.
Third Schedule.

Third Schedule.

Benefit branches.
S.I. 58/1985.

Related Laws