When you’re covered by ACC, and when you’re not
Injuries caused by medical treatment: “Treatment injuries”
Accident Compensation Act 2001, ss 32, 33 Case: Accident Compensation Corporation v Robertson [2011] NZACC 327
You’re covered by ACC if you suffer an injury while getting medical treatment from a doctor or other health professional. The cover doesn’t include things that are a necessary part or ordinary consequence of the treatment. You’ll also be covered if the medical staff failed to give you medical treatment when you needed it. There are some exceptions to this, for example if a health professional failed to diagnose a condition earlier, you won’t be covered if earlier treatment would not have changed the outcome.
You don’t have to show that the doctor or other health professional made a mistake when they treated you.
If you get an infection as a result of a treatment injury, and you pass that infection directly to someone else (for example, your partner or child), that person could also be covered by ACC for that infection.
You won’t be covered if your injury was mostly caused by an underlying health condition, or by you unreasonably withholding or delaying your consent to treatment. You also won’t be covered if your injury was caused by a lack of medical services as a result of resourcing decisions made in the health sector – for example, if a hospital emergency department has been closed down.
Am I covered if I get an injury or reaction caused by a vaccination?
Physical injury resulting from a vaccination, including the COVID-19 vaccine, may be covered if you meet the criteria for a “treatment injury”. The injury has to be clearly caused by the vaccination and not just be an ordinary consequence of the treatment.
For example, an ordinary consequence of a vaccination would be inflammation and pain around the site of the injection, flu-like symptoms or fatigue and is unlikely to be covered. Infections (such as cellulitis or septic arthritis) due to the vaccination resulting in injury are not ordinary consequences and are likely to be covered, if you can prove the injury was a direct cause of the vaccine.
