Injuries we cover
Our no-fault scheme covers everyone, including visitors, who are injured in an accident in New Zealand. It includes events that result in mass casualties. The scheme covers children, beneficiaries, students, if you’re working, unemployed, or retired.
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If you're injured in an accident, make sure you go and see your doctor or health provider first. They can make a claim for you. Claims can be made up to 12 months after your injury. We may still consider claims made after this time if there’s a good reason for the claim not being made sooner.
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 the ankle, back, knee or shoulder sprains
- wounds - cut, broken or bruised skin
- dental injuries
- hearing loss
- concussion and loss of consciousness.
We cover most physical injuries if they're caused by:
- an accident
- sexual violence
We can cover injuries or conditions that happen over time and are caused by the type of work you do. This is known as gradual process conditions. We have to establish if your work tasks or workplace environment are causing your condition.
We can also cover injuries that are long-term, permanent or that happened 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 by 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 (TBI).
Find out how we're working to reduce the number, severity, and impact of TBIs:
Mental injuries we cover
If we accept your claim for a physical injury, we can also cover mental injuries resulting from that injury. For example, post-traumatic stress disorder after a physical attack.
We 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.
We provide support for anyone in New Zealand, including visitors to the country, who has experienced sexual violence. We may also be able to help if you're a New Zealand resident and have experienced sexual violence while travelling overseas. It doesn't matter if the event happened recently or a long time ago.
If you've experienced sexual violence, use the Find Support website to see the organisations that have therapists who can support you. This support is fully funded and you can start whenever you're ready. There are also services available for your family and whānau.
If you're having trouble getting in touch with the right therapist, contact us. We'll help you to make an appointment.
We can pay for dental injuries caused by:
- an accident
- sporting injury
- as a result of medical or dental treatment.
We don’t pay for:
- damage to your teeth or dentures due to normal wear and tear, eg chewing or biting
- damage to your teeth due to decay or gum disease
- damage to your dentures while you were not wearing them
- treatment that was done by someone that’s not a registered dentist, eg a dental technician.
Your dentist will help you to make a claim if you have an injury we cover.
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).