Frequently Asked Questions

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What is the current situation with Comprehensive Sickness Insurance (CSI)?

On 10 March 2022, the European Court of Justice issued a ruling which says that where people had access to the UK’s National Health Service (NHS), they met the requirement for Comprehensive Sickness Insurance (CSI).


Just a few weeks earlier, the Government had introduced an amendment to the Nationality and Borders bill, as a result of our campaign, and your letter writing to fix the CSI legacy.


We have now seen a message from the Home Office to the Immigration Law Practioner’s Association (ILPA), dated 21 March 2022 (our emphasis):


“I wanted to update you on the nationality provisions in the Nationality and Borders Bill. The Bill has just completed Third Reading in the Lords and will return to the Commons this week.


I wanted to flag the new provision we have introduced on lawful residence, and to offer to answer any questions you may have.


The new clause relates to naturalisation applications for British citizenship under sections 6(1) or 6(2) of the British Nationality Act 1981, and applications to register as a British citizen under section 4(2), all of which have requirements that the person should not have been in breach of immigration laws during the residential “qualifying period”.


The lawful residence requirement has been a cause of concern for EEA nationals who were granted indefinite leave to remain (ILR) under the EU Settlement Scheme, but had been resident here as students or self-sufficient persons without Comprehensive Sickness Insurance.  As you know, the 1981 Act includes limited discretion to overlook periods of unlawful residence in the UK, and our guidance includes such persons in the examples of when we would normally expect to exercise discretion.  However, that discretion can only be used in the special circumstances of a particular case and so caseworkers often need to ask for further information.  Although no applications have been refused because a person did not have CSI, we are aware that our existing guidance does not give the reassurance that some EEA nationals and their family members would want.


The amendment is intended to benefit all applicants and not just those who acquired ILR under the EU Settlement Scheme. It will mean the Home Secretary does not have to enquire into lawful residence at all where the applicant has ILR or indefinite leave to enter (ILE), however it was acquired. This will, of course, avoid us looking at periods of residence already considered in earlier applications.


We believe the change will additionally provide the certainty which people have asked for; will end the confusion over differing requirements between EUSS and nationality; will reduce the evidence required to be supplied with an application to begin with; and will aid the processing of cases in a fair and sensible manner.


You may have seen that the wording of the amendment is to “allow the Secretary of State to treat a person who has indefinite leave to enter or remain as meeting certain residence requirements”. This recognises that there may be exceptional cases when we chose not to do so. This might, for example, be in cases where new information comes to light that would have affected the original ILR/ILE decision had it been known at the time. However, this is expected to be a very rare occurrence.


The good character guidance will be amended in line with this change, and so that personal immigration transgressions for those already granted ILR or ILE similarly do not lead to an application failing solely on that basis.  But it is only personal immigration history which may be overlooked: issues such as criminality will still be considered. Equally, we will still be assessing the length of absences from the UK during the residential qualifying period.


We will, of course, update guidance and application forms to reflect the change of approach in due course, and hope to be able to share our draft guidance on the new routes with you following Royal Assent.”


It is not yet clear how the UK Government will deal with the European Court of Justice ruling, but this will likely affect many areas including nationality, naturalisation, registration, access to benefits and more.


In the meantime, if you believe you are affected, or you have suffered loss because of past decisions where the Home Office said you did not meet the CSI requirement, please see our campaign-page https://www.csi-justice.org.uk.