Nursing Care Fee Recovery

If an individual is in a nursing or care home because of physical or mental health needs, the cost of their care should be covered by the NHS Continuing Healthcare funding scheme, regardless of the individual’s wealth.

However, with around 40% of Britain’s 440,000 care home residents self-funding their care, thousands of families in England and Wales could be wrongly paying care fees. Therefore, if you or a relative are paying care home fees, you could be due a refund.

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Retrospective eligibility

To claim retrospective eligibility, we need to show that an individual’s health and nursing care needs were more than what a social services department could provide.

If that’s the case, then their primary need would be for health and they would have been entitled to full NHS funding. In England we can consider unassessed period of care from April 2012 and in Wales a claim can be no longer than 12 months from the date an application is made.

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Free no-obligation assessment

We offer a free assessment to help you decide whether you’d like to proceed with a case to reclaim wrongly paid care fees or not.

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Frequently Asked Questions

The process will depend on a number of factors, such as whether you are starting your claim from scratch or if you are coming to us to appeal a negative decision; whether you are claiming on behalf of a loved one who has since passed away or has just moved into long-term care.

If you believe that you or a family member has wrongly paid care fees, then the first step is to complete our questionnaire. This will be assessed by our Nursing Care legal team who will be able to advise on whether or not you have a case, and if so, what the process will be. This initial questionnaire is free to complete and there is no obligation on you to proceed with a claim should you decide not to.

There are a number of different ways in which a claim may be funded. Which method of funding is most appropriate will depend on personal circumstances. We will always discuss funding with you before you become a client. Usually, a claim will be funded in one of the following ways:

  • Contingency Fee Agreement (no win, no fee)
    The majority of the clients we work with are on a no win, no fee structure and we will offer this whenever and wherever possible. This means that if your case is successful, we will take a percentage of the money you recover. If the claim is pursued and lost, you pay us nothing. The percentage we take and the terms will be explained in full before you are taken on as a client.
  • Private funding
    In this case you are responsible for legal expenses incurred on your behalf and will be billed on a monthly basis. You will be required to cover the legal costs of your opponent if your case is unsuccessful.

We deal with a wide range of clients across England and Wales.

The application process for NHS Continuing Healthcare is very complex. Although you don’t need to work with a solicitor to get the funding, working with an expert in the field will significantly increase your chances of getting NHS Continuing Healthcare eligibility.

Integrated Care Boards in England and Health Boards in Wales can often make arbitrary NHS care funding decisions based on the ability to pay rather than health needs. As a result you may not receive NHS care funding, even if you are eligible.

Many of our clients start working with us after starting to work through the process themselves, but struggle with the complicated system. Working with our team will give you the best chance of securing the correct decision.

There are a number of companies offering this service who do not have our experience and in some cases are not solicitors. A Legal Ombudsman report released in July 2011 revealed that thousands of people may be receiving sub-standard services from unregulated companies offering consumer financial products. Hugh James is regulated by the Solicitors Regulatory Authority (SRA) and complies with the solicitor’s code of conduct.

We understand that instructing a solicitor may be daunting, but unlike advocacy firms, as solicitors we must be open and transparent about our costs. There cannot be any hidden charges.

Following a free initial assessment of your case, we offer a number of funding options.

In most cases, our clients are offered the choice of a ‘no win no fee’ Contingency Fee Agreement and an hourly rate basis. The Contingency Fee Agreement is popular with our clients as it provides certainty; they know exactly what we will charge if we win the case and it makes no difference how much time we spend pursuing the claim to a successful conclusion. In addition, there is peace of mind that if we pursue the claim and we lose, you do not pay us anything.

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You will receive and email off us with further information.