Claim reasons

Benefit limit reached

The scheme says a specific per-item, per-person or per-family cap applies to this claim.

Build my letter

Words you might see
  • “a sub-limit applies”
  • “annual limit”
  • “per-family limit”

Questions to ask

  1. Which sub-limit was applied, and where is it published for my option?
  2. How much of that sub-limit had been used before this claim, and by which claims?
  3. Does the sub-limit apply where the service is a Prescribed Minimum Benefit, and how was that assessed?
  4. Please provide the benefit schedule showing that sub-limit for the current year.
Details to have ready
  • Whether other members of your household have claimed against the same limit.

All claim reasons

Pryse is not a law firm and does not act for you. Nothing here is a determination of your rights or legal advice, and no registered scheme rule is quoted. The questions ask your scheme to provide its own.