Disputes and Reviews with ACC

ACC provides accident cover to all New Zealanders, residents and temporary visitors to our lovely country, New Zealand. This is why those same groups can’t sue for personal injury.

Are you unhappy with a decision ACC has made?

You can apply for a review if you disagree or are unhappy with a decision ACC has made about your claim.

Who can apply for an ACC review?

• A  client, or their representative, in relation to any of ACC’s decisions on a claim
• An employer challenging a work injury decision
• Any levy payer disagreeing with the levy paid or payable
• A registered health professional, or organisation, disputing their involvement in an injury caused by medical error (for decisions relating to claims lodged with ACC prior to 1 July 2005).

How can we assist you with your review?

• We can complete and lodge the review with ACC before the specified timeframe.
• We will discuss with you about what supporting documentation is required to support the review. eg: medical file, claims file, and review the need to obtain further evidence
• We will prepare and submit the review, including submissions
• We will attend the review hearing with you either by phone or in person

All New Zealanders have the fundamental right to challenge unfair decisions made by ACC over claims. We are here to provide that support so that the process is easy for you.  Timing and preparation are critical with reviews.

ACC has made a decision about my injury claim and they refuse to cover my costs or rehabilitation. “What can I do”?

If you have been denied ACC cover and are unhappy with the decision you are given under the INJURY PREVENTION, REHABILITATION, AND COMPENSATION ACT 2001 you have the right for a formal review. You have three months to lodge this review with ACC. This is where we can help you.

You must follow this review procedure, as you cannot use any other remedy in court or in the Disputes Tribunal. There is, however, a right of appeal to the courts after you have been through the review process. The Code of ACC Claimants Rights is there to provide you with support and ensure that you are fairly treated.

Examples of decisions that can be challenged at a review:

1. Was the decision made not to cover your claim?
2. Was the decision made not to provide you with any entitlements?
3. Was the decision made around limiting your entitlements?
4. Did ACC respect you in the dealing with your claim within an acceptable timeframe?
5. Did ACC issue you with a debt decision letter advising you of a debt to The Corporation?
6. Are you unable to pay a debt and they have declined to write the debt off?
7. Have you had your entitlements suspended?

What’s the review hearing all about?

ACC uses Fairway Resolution ltd to carry out its reviews. Fairway was formed as an independent subsidiary company of ACC out of ACC's old review section.

The Fairway Reviewer may:

• Disagree with ACC's decision and may provide its own decision or provide some direction to both parties to gain a resolution.
• Agree with ACC’s decision and dismiss your application for review

Who can attend the review hearing?

We can represent you at the review.

 You, ACC, Your employer and other support people may also attend.

Can I appeal the reviewer's decision?

Yes, you have a right of appeal to the District Court (unless the review was of a breach of the Code of ACC Claimants' Rights). You must file your appeal within 28 days of receiving the reviewer's decision. You can appeal to the High Court from the District Court's decision.