If you get injured in New Zealand, even if you are visiting from overseas, ACC can help with treatment and other support.
What do I need to do?
- If you or someone you care for is injured, get treatment as soon as possible. Don’t wait until you feel better, as this can often make the injury worse and your recovery longer.
- Your health professional (doctor, physiotherapist, dentist, nurse etc) will help you fill out an ACC claim form and send it to us.
- When ACC receives your claim form, we’ll contact you by phone or letter to let you know if your claim is accepted.
What if I am taken to hospital?
- When you are admitted to hospital, a claim form will be sent to ACC on your behalf.
- When ACC receives your claim form, we’ll contact you by phone or letter to let you know if your claim is accepted.
If you were taken to hospital by an emergency service within 24 hours of being injured, ACC will cover the transport costs in the majority of cases. See Ambulance and emergency care for more information.
Serious injury
If you have suffered a serious injury that results in significant permanent disability or loss of function, you will be assigned to a support coordinator in the National Serious Injury Service.
What information does ACC need from me?
To help us decide if the injury is covered, the following information must be supplied on your ACC claim form:
- your surname and first name
- your home address
- date of birth
- date of accident
- description of accident
- whether a motor vehicle was involved
- whether the accident occurred at work
- your employment status at the time of the accident, ie non-earner, employee, self-employed or other (such as shareholder employee, contracted employee or commission-only salesperson)
- your employer’s name and address (if the claim is due to a work accident)
- your signature (or that of your legal guardian or representative) and date signed
- diagnosis of your injury (the health professional will enter this information)
- what affect the injury has on your ability to work (if applicable, your health professional will complete this)
- your health professional’s signature and date signed.
If we need you to supply further information, we will send the form or a letter to you with a request for the missing information.
Remember that you have a role in the decision-making process, by providing ACC with as much information as you can about your situation, and attending meetings and assessments when asked, to enable a timely decision on cover and assistance. You can nominate someone to represent you at meetings or in communications with ACC.
Consent
After ACC has made an initial decision to cover your claim, we may need to get further information about you from other sources, such as medical details from treatment providers. We cannot collect this information without your consent (but the lack of information may impact on our ability to make a decision on your entitlement to other assistance).
To obtain your consent, ACC will send you a form to complete and sign, and will discuss any concerns with you.
How does ACC decide if I am covered?
When your claim is received by ACC, it is registered and given a unique claim number. Most claims are assessed at the registration centre and either accepted or declined based on individual circumstances and the criteria listed in Am I covered?
As a guide, ACC will consider questions such as:
- Has there been an accident, as defined by the Accident Compensation (AC) Act (external link)?
- Was it a personal injury?
- Was there an external force or resistance?
- Is it an acceptable injury code/diagnosis?
- Did the injury occur in New Zealand as defined by the AC Act (external link)?
- Was the claim lodged within 12 months of the date of injury?
- Is it a work-related gradual process claim?
ACC will contact you by phone or letter to let you know the decision on your claim. If cover is accepted, we will advise what assistance you are entitled to, eg a number of subsidised visits to a physiotherapist for treatment of a sprain. You may also be advised to contact your ACC client services contact or case coordinator to discuss what assistance is available.
An ACC client services contact is generally assigned if your injury needs treatment and/or assessment over a period of time, or if significant contact with ACC is required to help you access the right assistance.
If your claim is declined, we will tell you why. It may be because the injury is:
- a non-work related disease or infection (including conditions you may have been born with), or
- a non-work related gradual process, or
- due to the ageing process.
In some cases cover is declined if you fail to respond to ACC with further information when requested. If you disagree with our decision, you can ask for a review. See What if I have problems with a claim?
How long might ACC take to decide?
The majority of claims are assessed at the registration centre within 21 days of being lodged.
Sometimes a decision on a claim cannot be made within 21 days because additional information is required. If that happens in your case, ACC will extend the timeframe for making a decision, up to a maximum of four months from the date the claim was lodged. You will be told about the extension as soon as possible.
Some claims require more investigation or assessment by a specialist unit within ACC, such as mental injury as a result of sexual abuse, physical injury suffered in the course of medical treatment, death caused by an accident, or if your injury is work-related gradual process.
What happens next?
Seek further treatment as required
If you need further treatment, such as counselling, surgery or medical treatment, talk to your health professional first. They’ll work out what treatment you need and, if necessary, apply to us for help meeting the costs. See Treatment costs for more information.
Seek other help as required
For all other types of help, talk to us about your needs. We can give you more information about our services, including how to apply. For example:
If you … |
then ACC may be able to help with… |
|---|---|
need extra help while you recover from your injury |
|
can’t work while you recover because of your injury |
compensation for lost salary or wages |
have a long term impairment |
Note:
Because no two injuries are the same, the type of assistance ACC is able to offer varies depending on individual circumstances. It is important to talk to us to confirm if you are eligible for particular services.
See Contact ACC Claims for our contact details, or find out more at What support can I get?
What if I have a work-related injury?
Employees
You may want to use a provider recommended to you by your employer and who is familiar with your workplace’s activities. The health provider will help you complete an ACC45 claim form and forward it to ACC.
We will advise you and your employer if your injury is classified as work-related or not. For work-related injuries where you are eligible for compensation for loss of earnings, the first week of earnings will be paid by your employer. The second and subsequent weeks are ACC’s responsibility.
If your employer is an accredited employer and your claim is accepted as a work-related injury, your employer or their claims administrator will provide the same help as ACC would if we were managing your claim.
Self-employed
All self-employed people are required to have injury cover with ACC. You can make a claim for some work-related conditions, however, if you need time off work, you cannot receive weekly compensation for the first week. After this, if you are eligible, your weekly compensation payments will begin as soon as ACC receives all the information needed to calculate it.
If you have ACC CoverPlus Extra cover, your weekly compensation will already have been calculated as part of the application process. Otherwise, standard ACC CoverPlus cover provides for weekly compensation based on 80% of your past year’s earnings.
Volunteer work
If you are injured while doing voluntary work, it is classified as a non-work injury and your claim will be considered as such.
If you are in paid employment and have to take more than a week off work because of an accident you had doing volunteer work, you may be eligible for weekly compensation. As with other non-work injuries, the first week is not paid by either your employer or ACC.
If you are not in paid employment, you are not entitled to weekly compensation because you have not ‘lost’ any weekly income.
See Contact ACC Claims for our contact details, or find out more at What support can I get?
Related legislation
Accident Compensation (AC) Act 2001
• Section 20: Cover for personal injury suffered in New Zealand (external website)
• Section 25: Accident (external website)
Last updated: 16January2009