FairWay review process legal and appropriate

Released 06/07/2018

Our clients, and the public in general, can have complete confidence that ACC is administering its dispute resolution process legally and appropriately. FairWay has proper, and duly documented, legal authority to deliver review services and decisions.

Part 5 of the Accident Compensation Act 2001 (the Act) requires us to engage reviewers, and arrange the allocation of reviews. We do this through a contract with FairWay to support delivery of an independent dispute resolution management service.

Flowchart of the actions taken during the review process

Our contract with FairWay

Under the contract, when we receive a review application from a claimant we send a letter to FairWay instructing them to allocate a reviewer. By engaging FairWay to appoint reviewers, and allocate reviews, we are strengthening the arms-length and independent nature of those reviewers, which is consistent with our duties under the Act to ensure the independence of the dispute resolution process.

That contract – signed by our Chief Executive, acting on a specific delegation from the Board – supports ACC to deliver review services in an effective and efficient manner. The contract documents FairWay’s roles and authority in relation to these services, and meets the delegation requirements of the Act and the Crown Entities Act (the CE Act).

Ministerial prior approval of a delegation of review services is not required because under the Act, dispute resolution is a “service” provided to claimants, and the Act expressly authorises delegation of services without prior Ministerial approval under section 73(1)(d) of the CE Act.

We acknowledge that our contractual relationship with FairWay may create a perception that reviewers are not independent of ACC. This is a perception, not the reality, and we note that Miriam Dean QC conducted a thorough review of the statutory review process in 2016 and was satisfied that, despite this perception, reviewers do in fact act independently of ACC.

Our Reviewing Monitoring Panel

We monitor the quality of the services provided by FairWay by giving them feedback on a limited number of review decisions that we consider do not meet the standards claimants are entitled to expect. We do this via our Review Monitoring Panel, which meets once a week to make decisions on whether to file, defend, or settle appeals, and to review decisions. The Panel provides monthly feedback to FairWay about adverse decisions where we feel it is warranted. That feedback largely focuses on the weighting given to clinical evidence or legal application of the AC Act.

Our clients’ perspective in the review process is ensured by law: The Accident Compensation Act requires reviewers to comply with the principles of natural justice, and for a hearing to take place; except where a review is withdrawn by the claimant, or everyone involved agrees a hearing isn’t necessary.

Accident Compensation Act 2001

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