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Health & disability

Making a claim and dealing with ACC

How ACC processes the claim

Who decides whether to grant my claim?

ACC’s service centre staff will make an initial decision about whether you’re covered. You’ll then get a letter telling you about this initial decision.

The ACC service centre staff then decide what level of risk your claim involves. This will affect how they manage the claim from then on:

  • No risk – Simple claims involving only medical fees are seen as “no-risk” cases and are paid immediately.
  • Low-to-medium risk – Low-risk and medium-risk cases, where claimants need additional assistance, are managed by case coordinators in one of ACC‘s four contact centres.
  • High-risk – High-risk cases, where there is a serious injury requiring significant involvement from ACC or lengthy time off work, are managed by case managers in ACC branches.

What is the time limit for processing a claim?

Accident Compensation Act 2001, ss 56, 57, 58

For standard claims, ACC has 21 days after receiving a claim to process that claim and make a decision about your entitlement. They can extend the time for making the decision if they need more information, but they can’t extend it to more than four months after you lodged your claim.

For complicated claims, ACC has two months to make a decision after receiving a claim. Complicated claims are claims involving:

  • a mental injury caused by rape or other sexual crimes, which ACC calls “sensitive” claims, or
  • personal injury caused by a work-related gradual process, disease or infection, or
  • treatment injuries, or
  • late claims (claims lodged later than 12 months after the date of your accident or injury).

If ACC needs more information, it can extend the time for making the decision by up to two months. You and ACC can also agree to extend the time further, but ACC have to decide about your claim within nine months after you lodged it.

Note: If ACC don’t meet the deadlines for processing your claim, the law says you’re covered for your injury, just as if ACC had approved your claim.

How ACC processes “sensitive claims” (mental harm caused by sexual abuse)

The ACC scheme provides cover for mental harm caused by rape and sexual abuse. ACC calls these types of claims “sensitive claims,” and they’re dealt with by a special ACC unit – the Sensitive Claims Unit. For information about when you’ll be covered by ACC and what therapy and financial help you may be entitled to (see: “Sexual abuse: Cover for resulting mental harm”).

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Accident compensation (ACC)

Where to go for more support

Community Law

Your local Community Law Centre can provide free initial legal advice and information.

Find your local Community Law Centre online: www.communitylaw.org.nz/our-law-centres

Accident Compensation Corporation (ACC)

ACC’s website provides information to help you navigate the ACC system. It includes information on the claims process, possible entitlements and how to resolve an issue with ACC.

Website: www.acc.co.nz

General questions 
Email: information@acc.co.nz
Phone: 04 816 7400
Claims helpline: 0800 101 996

Sensitive claims
Email: sensitiveclaims@acc.co.nz
Phone: 0800 735 566
Free therapy services for sensitive claims: www.findsupport.co.nz

Deaf services email: deaf@acc.co.nz

Language and cultural services phone:  0800 101 996

Request your personal information:  www.acc.co.nz/contact/request-for-personal-information

Way Finders

Way Finders is a free nationwide independent service that can provide you with general or specific advice about ACC and help you navigate the system.

Website: www.wayfinders.org.nz 
Email: info@wayfinders.org.nz
Phone: 0800 273 030

Talk Meet Resolve (TMR)

Talk Meet Resolve is a free independent nationwide service that can assist you in resolving your dispute with ACC.

Website: www.talkmeetresolve.co.nz
Email: info@talkmeetresolve.co.nz
Phone: 0800 119 221

Complete the webform: www.talkmeetresolve.co.nz/contact

Medical Council of NZ

The Medical Council of New Zealand is responsible for ensuring doctors are competent and fit to practise. The website contains a register of practising doctors.

Website: www.mcnz.org.nz

Health and Disability Commissioner

The Health and Disability Commissioner website sets out your rights under the Code of Health and Disability Services Consumers’ Rights and how you can make a complaint to the Commissioner.

Website: www.hdc.org.nz
Email: hdc@hdc.co.nz
Phone: 0800 119 221

To make a complaint online: www.hdc.org.nz/making-a-complaint/make-a-complaint-to-hdc

Privacy Commissioner

The Privacy Commissioner website provides information about your rights and responsibilities under the Privacy Act 2020 and the Privacy Principles. It also outlines the role of the Privacy Commissioner and how to make a privacy complaint.

Website: www.privacy.org.nz
Email: enquiries@privacy.org.nz
Phone: 0800 803 909

To make a complaint online: www.privacy.org.nz/your-rights/making-a-complaint

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