Criminal Injuries Compensation Authority (CICA)

4. Mr E complains about CICA. He says that:

• CICA initially came to the wrong decision in his June 2022 claim and did not give him the opportunity to receive his medical diagnosis prior to making a decision

• CICA took too long to process its review of his claim. Following his appeal of its 2022 decision, it did not decide his claim until May 2025.

5. As a result, Mr E told us he could not afford to pay for medical treatment that was not available to him on the NHS.

6. By bringing this complaint to us, Mr E is seeking an explanation and financial remedy in line with a level four or five on our Scale.

7. Mr E was a victim of a violent crime and made a claim to CICA. It refused his claim in June 2022.

8. In August 2022, Mr E appealed and CICA requested further information.

9. In April 2023, Mr E provided the medical evidence CICA had requested. CICA reviewed this information in July 2023, and requested further information from Mr E’s psychiatrist.

10. Mr E provided this on 2 August 2023.

11. On 4 January 2024, Mr E complained to CICA about the time his application was taking.

12. On 15 January 2024, CICA responded. It explained that, while it can process some claims within 12 months, complex cases can take longer.

13. It also said each piece of evidence it had received from Mr E to date had been processed within three months.

14. On 16 January 2024, CICA sought further information about Mr E’s ongoing counselling treatment, which he provided by phone on 8 February 2024.

15. On 8 February 2024, CICA sent Mr E’s claim to a senior decision maker for assessment.

16. On 30 April 2024, Mr E raised a formal complaint with CICA about the length of time his claim had taken to process and said CICA had taken five months to process the latest piece of evidence he had provided. He also questioned why CICA considered his claim complex. Mr E chased his complaint on 1 May.

17. On 15 May, CICA responded to Mr E’s complaint. It acknowledged and apologised for the delay but explained the action it had taken so far was necessary and each claim is judged on its own merits, so they could not give a timescale for completion of the application.

18. On 16 May 2024, Mr E escalated his complaint to stage 2. On 20 May CICA responded confirming the complaint had been escalated.

19. On 23 May 2024, a CICA senior decision maker requested further evidence, including up-to-date medical records, as the medical records it had dated from 2022.

20. On 24 May, CICA responded to stage 2 of Mr E’s complaint, reiterating its stage 1 response.

21. On 23 July 2024, CICA uploaded Mr E’s up-to-date medical records.

22. On 24 August 2024, CICA issued a Police National Computer (PNC) check. To comply with the CICA scheme, an award can be withheld or reduced if the applicant has unspent convictions. It received this evidence from the police on 7 September.

23. On 28 October 2024 CICA responded to Mr E and explained it anticipated a Senior Decision Maker would assess his claim within 8-10 weeks. It also said it processes most information it receives within six months and therefore considered the time elapsed reasonable.

24. CICA reached its review decision on 13 May 2025. It awarded Mr E £6750.

25. On 6 June 2025 CICA confirmed it had closed Mr E’s stage 3 complaint and signposted him to our organisation.

June 2022 decision

27. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the events complained about had a negative effect which the organisation has not put right. Having done so we have found CICA has already done what we would expect to put this right.

28. Mr E says CICA made the wrong decision in June 2022 because it did not allow him time to obtain a diagnosis before deciding his claim. We have not investigated the correctness of that decision.

29. This is because Mr E exercised his right to seek a review, and CICA reconsidered the claim in light of further information and made an award. This is the process we would expect.

30. When an organisation makes a decision based on the information available at the time, and later revises that decision following additional evidence, this does not in itself indicate fault.

31. It reflects that the position has developed as more information has become available. The review process exists to allow decisions to be reconsidered in this way. We are satisfied that Mr E was able to access that process and that his claim was reconsidered accordingly.

32. This approach is consistent with the Ombudsman’s Principles of Good Administration, which state that putting things right may include reviewing decisions. In this case, CICA reviewed its earlier decision at Mr E’s request and reached a different outcome.

33. We recognise that the circumstances surrounding Mr E’s claim, and the initial decision made, may have caused him distress. However, for the reasons set out above, we would not expect CICA to have done more in these circumstances.

34. Even if we were to investigate this issue, we could not decide whether the original decision was right or wrong, we would only ask CICA to reconsider it. As this has already happened, it would not be appropriate for us to investigate this element of Mr E’s complaint further.

Delays in 2025 decision/Communication

35. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not found any indications that CICA has got something wrong.

36. Mr E complains that CICA took too long to reach a decision on the review of his claim.

37. The Criminal Injuries Compensation Scheme 2012 sets out the rules for deciding claims, but it does not prescribe specific timescales for how long CICA should take to administer or review a claim. In the absence of a set timeframe, we have considered whether CICA acted reasonably in the circumstances.

38. Following Mr E’s appeal in August 2022, CICA began a review of its earlier decision. This involved requesting and considering further medical evidence over a period of time. The evidence shows that CICA requested additional information in April 2023, which Mr E provided.

39. CICA reviewed that information in July 2023 and then sought further details about Mr E’s psychiatrist, followed by a request for a medical report in September 2023. Mr E provided that report in November 2023, and CICA considered it in January 2024.

40. It then sought further information about his ongoing counselling, which Mr E provided in February 2024, and the claim was referred to a senior decision maker due to its complexity as a psychological injury claim.

41. In May 2024, the senior decision maker requested updated medical records, as the records held were from 2022. These were provided in July 2024. CICA then conducted a Police National Computer check in August 2024, before progressing the claim to a final decision in May 2025.

42. While the overall period taken to reach a decision was lengthy, the evidence shows that CICA took action at each stage of the process. The time taken appears to reflect the need to obtain and consider multiple pieces of medical evidence, including updated records, and to assess the claim at a senior level.

43. We note there were periods where progress was slower, in particular between February and May 2024. CICA acknowledged this delay in its complaint response and apologised. However, aside from this period, we have not seen evidence of significant or unexplained inactivity. Much of the elapsed time is accounted for by the time taken to obtain evidence and to consider it once received.

44. CICA also responded to Mr E’s complaint and provided explanations about the time taken, including that more complex claims can take longer to process and that evidence is considered in stages. While Mr E clearly found the process frustrating, the evidence does not show that CICA failed to progress the claim or that the time taken, in the round, was unreasonable in the context of the work required.

45. As well as the time taken to process Mr E’s claim, we have looked at CICA’s responses to his complaints. CICA responded to Mr E’s complaint in January 2024 and set out the steps it had taken to progress his claim, including the evidence it had requested and when it had been assessed. It explained that each piece of evidence had been considered within around three months and that further information had been necessary to assess his injuries. It also explained that more complex claims can take longer to determine.

46. CICA’s response to Mr E’s complaint in May 2024 provides further context for the time taken. It explained that claims involving psychological injury require specific medical evidence, including a confirmed diagnosis and prognosis from an appropriate specialist, and that such claims are often more complex and take longer to assess.

47. It also explained that Mr E’s claim had been referred to a Senior Decision Maker and that further evidence had been required to ensure the claim could be assessed in line with the requirements of the Scheme. While CICA acknowledged that the time taken was longer than it would ideally expect and apologised for this, it also set out the steps it had taken to progress the claim and prioritised it for assessment. This supports our view that, while there were some delays, the time taken was due to the need to obtain and assess appropriate evidence rather than a failure to act.

48. CICA’s further response in May 2024 also addressed Mr E’s concerns about delay and clarified the distinction between matters that can be considered under its complaints process and those which must be addressed through the statutory review and appeal routes.

49. It reiterated that more complex claims, particularly those involving psychological injury, can take longer to assess and confirmed that Mr E’s claim had been awaiting consideration by a Senior Decision Maker. It also apologised for the time taken and confirmed that further evidence was required to progress the claim. This indicates that CICA continued to engage with Mr E’s concerns, provided explanations for the time taken, and progressed the claim.

50. CICA’s later response in October 2024 further explained the steps taken to progress Mr E’s claim, including the receipt of updated medical records, the completion of a Police National Computer check, and the ongoing assessment process.

51. Where there were minor delays or issues with communication, CICA acknowledged these and apologised. The response also explained that information was being assessed within around six months due to workload pressures, which is consistent with the timescales seen in the handling of Mr E’s claim. Overall, the evidence shows that CICA continued to progress Mr E’s claim throughout.

52. In its final complaint response in June 2025, CICA explained that it prioritised progressing the claim to a decision rather than escalating the complaint further, and acknowledged it had not made this clear at the time. It apologised for any distress caused and signposted Mr E to the appropriate routes of appeal and complaint. This indicates that CICA did engage with Mr E’s concerns and provide a substantive response.

53. CICA’s published guidance states: “You’ll usually get a decision within 12 months, but it can take longer. CICA will only contact you if they need more information or to tell you the outcome of your application.” Looking at the evidence, the pattern of contact and the overall timescale in Mr E’s case are consistent with this.

54. We also note that Mr E’s concerns that CICA decided his initial 2022 claim too quickly, and then took too long to obtain further evidence when he appealed its decision, both arise from the same evidential process. The time taken to gather and assess additional information during the review was a necessary part of reconsidering the claim and does not, in itself, indicate fault.

55. Mr E has questioned why CICA considered his claim to be complex. The evidence shows that his claim related to psychological injury and required multiple pieces of medical evidence, including a diagnosis, a medical report, and updated medical records, and CICA said this is why it considered his claim complex.

56. During the review process, CICA sought further information at several stages and referred the claim to a senior decision maker. This indicates that the claim required detailed assessment and additional evidence over time. In our view, it was reasonable for CICA to treat the claim as complex in these circumstances.

57. Mr E has said that, as a result of the time taken, he was unable to access medical treatment that was not available on the NHS. We recognise the impact this had on him. However, the purpose of the Criminal Injuries Compensation Scheme is to provide financial compensation where eligibility criteria are met, rather than to fund specific treatment.

58. While we appreciate Mr E’s position and sympathise with his difficulties accessing medical treatment, a CICA award is not guaranteed, and we cannot say that the time taken by CICA was the reason Mr E was unable to access the treatment he describes.

59. Mr E has also raised concerns about CICA’s communication. We recognise that he found the process frustrating and that there were periods where he did not receive updates. However, the evidence shows that CICA responded to his enquiries and complaints, provided explanations about the steps it was taking, and contacted him when further information was required or decisions were made.

60. This is consistent with CICA’s general approach of contacting applicants only when there is a substantive update. While communication may not have been as frequent as Mr E would have liked, we have not seen evidence that CICA failed to respond or kept him uninformed about the progress of his claim.

61. Following the award, Mr E appealed to the First-tier Tribunal about the amount of compensation he was awarded under the scheme. We note this for context. Decisions about entitlement and the level of an award fall to the tribunal, and we have not considered this aspect of Mr E’s complaint and, under the Parliamentary Commissioner Act 1967, are prevented from taking a view on matters where a tribunal is available.

62. For the reasons set out above, we have not found that CICA got anything wrong in how it handled Mr E’s claim. Although the process was lengthy, this was due to the need to obtain and assess appropriate evidence. As such, it would not be appropriate for us to investigate this complaint further.

1. We have carefully Mr E’s complaint about the Criminal Injuries Compensation Authority (CICA).

2. We are sorry to hear about the circumstances that led to Mr E’s application to CICA. We recognise the impact that being a victim of a violent crime can have and strongly sympathise with the difficulties he has described.

3. We have carefully considered the information available to us about how CICA handled Mr E’s claim and its communication with him. While we understand his concerns, we have seen no indication that CICA did anything wrong in dealing with his application.