What we cover

Our no-fault scheme covers everyone in New Zealand if you're injured in an accident. The scheme covers children, beneficiaries, students, if you’re working, unemployed or retired. It also includes visitors to New Zealand if they're injured while they're here.

If you're injured, make sure you go and see your doctor or health provider first. They can make a claim for you.

What is no-fault cover?

No-fault cover means it doesn't matter what you were doing when you were injured or who was at fault. We'll cover you, as long as the injury falls within our legislation. 

The cover we provide helps pay for costs to get you back on your feet. It includes payment towards medical bills, treatment, help at home and work and help with your income.

Physical injuries we cover

A physical injury is when there is actual damage to your body. This includes:

  • sprains or strains - such as ankle, back, knee or shoulder sprains 
  • wounds - cut, broken or bruised skin
  • burns 
  • fractures 
  • dislocations 
  • dental injuries 
  • hearing loss 
  • loss of consciousness.

We cover most physical injuries if they’re caused by:

  • an accident 
  • sexual violence
  • a condition that comes on gradually because of work. 

We can also cover injuries that are long-term, permanent or that happen at birth.

Injuries caused by treatment 

Sometimes getting treatment can cause an injury. We can cover a treatment injury if: 

  • the treatment directly caused your injury 
  • a registered health professional was treating you
  • it’s not a normal side-effect of your treatment.

We can also cover injuries caused by treatment for an injury we’ve already covered.

Conditions that come on gradually from work

We can cover injuries or conditions that happen over time and are caused by the type of work you do. This could be things like:

  • tendonitis from overusing muscles or heavy lifting
  • deafness caused from noise at work
  • infections or diseases from exposure to certain environments.

Serious injuries and disabilities

We can cover injuries that cause long-term effects and disabilities such as spinal and traumatic brain injuries. Find out more about what we cover and how we can help:

Visit our serious injury and disability website

Mental injuries we cover

We cover some mental injuries if it's a result of a physical injury that we cover. Eg post-traumatic stress disorder after a physical attack.

We can also cover mental injuries if you've experienced, seen or heard a traumatic event at work. This is even if you haven't been physically injured.

Sexual violence

We offer fully-funded and immediate support and treatment if you've experienced sexual violence. This includes support for your family and whānau. It doesn’t matter if it happened recently or a long time ago, there’s support available when you’re ready.

Find Support website

Damage to dentures, prostheses and implants

If you have an accident and your denture or prosthesis (artificial body part) is damaged, we can help to cover replacement costs. This doesn't include damage from wear and tear.

If you're fitted with an implant or prosthesis and it breaks or causes you injury in some way, we may cover this as a treatment injury.  This is for injuries caused by or that happen during treatment from a registered health professional.

Injuries causing death

We give financial help if someone dies as a result of:

  • an accident 
  • a work-related disease or infection 
  • a treatment injury we're covering
  • a self-inflicted injury (in some circumstances).
Last published: 12/10/17