GOV-027790 Appendix 1
Prepare and Attend Review Hearing (RH) v19.0
Linked Process
Implement Resolution Outcomes
3.0
Attend review hearing
2.0
Send review submission to all parties
rite review
1.0
W hearing submission
Attend
Linked Process
Prepare and  Case Conference (CC)
Attend ive
Alterna
Linked Process
Prepare and  an  Dispute Resolution (ADR)
Review Specialist
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Prepare and Attend Review Hearing (RH)
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GOV-027790 Appendix 1
Prepare and Attend Review Hearing (RH) v19.0
b If the review is about a decision on a claim, in Eos, use 
Summary
the email tool set to send the submissions document to 
all parties.
Objective
NOTE What is the required timeframe for sending 
To attend a review hearing, on ACC’s behalf, to provide submis-
submissions?
sions pertaining to the matter at review and the reasons for 
ACC has a contractual agreement that the 
ACC’s decision.
submissions will be sent 14 days prior to the 
Background
hearing taking place.
A review hearing will provide ACC and the customer/
NOTE What if you are expecting new information 
representative with an outcome that is binding between the cus-
within 14 days of the hearing (therefore 
tomer and ACC.
potentially changing your submissions)?
Owner
ACC's expectation is that the submission will be 
[Out of 
Scope]
sent 14 day prior to the hearing date. If new 
Expert
[Out of Scope]
information is received after the submissions are 
sent the Review Specialist must provide either 
Procedure
an amendment (if your position has changed) or 
an addendum (if the new information adds to 
ACC previously stated position).
PROCESS
Prepare and Attend an Alternative 
Dispute Resolution (ADR)
Always ensure all new information (including re-
Review Specialist
vised submissions) are sent prior to the hearing 
for the client/representative to consider to mini-
mise the likelihood of an adjournment.
PROCESS
Prepare and Attend Case Confe-
NOTE Who are all parties?
rence (CC)
This includes:
Review Specialist
• the review provider
• the customer/representative
• interested parties
1.0 Write review hearing submission
NOTE Who are interested parties?
Review Specialist
• Employers are interested parties where the 
a Complete the review submissions.
client (employee) has put in a review to chal-
NOTE What information should be included?
lenge the decline of cover for a work related 
PICBA and WRGPDI.
• Background of the issue
• Clients are interested parties where the em-
• Relevant legislation
ployer has lodged a work injury dispute review.
• Relevant case law
• ACC's position
NOTE What if the customer/representative does not 
b
have an email address?
If the review is about a decision on a claim, in Eos, 
upload the submissions and change the document code 
Print the documents and send them to the 
to 'REV - ACC2199 - ACC Submissions - Review Appeal' 
necessary parties.
and the document description to the unique review iden-
tifier.
If you are working from home and this is not 
possible, please communicate with a colleague 
c If the review is about a levy, complete the submissions 
residing in the office or your Resolutions Man-
and save them to the customer folder.
ager to ensure this task can be completed within 
d Use judgement to consider having the written submis-
the required timeframe.
sions peer reviewed by a colleague, senior resolution 
c If the review is about a levy, email the submissions to all 
specialist or a technical specialist.
parties, and save email as an interaction in Juno_CRM.
e Read the review hearings rules policy to help understand 
NOTE What if the customer/representative does not 
more about review hearings.
have an email address?
Review Hearing Rules Policy
Post the submissions to the customer/
representative and save a scanned copy in a 
Juno_CRM interaction.
2.0 Send review submission to all parties
d Ensure any new information (since the last bulk print) 
Review Specialist
relevant to the review has been sent to all parties prior to 
a Check Eos and ensure that the client care indicator has 
the hearing (eg CAP comment, newly obtained medical 
not been activated since the ACC6239 was sent to the 
notes).
review provider.
NOTE What if the client care indicator was already 
3.0 Attend review hearing
active but it hasn't been updated in the last 
Review Specialist
six months?
Contact the decision maker (DM) and their Team 
a Consider who from ACC should attend the hearing.
Manager (TM) using the Client Care Indicator 
Template to update the Care Indicator.
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Prepare and Attend Review Hearing (RH)
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GOV-027790 Appendix 1
NOTE Who from ACC should you consider?
NOTE What if the reviewer requests costs outside 
 
Consider:
of the regulated amount?
• decision maker
This is outside of the Review Specialist dele-
• TAS
gation and must refer to a Senior Review Spe-
• any other ACC expert (eg technical specialist, 
cialist or Resolution Manager for consideration.
medical advisor, etc).
This would most likely be in cases whereby 
Reference Guide for Review Specialists when decid-
travel costs to the hearing are outside of the 
ing whether to refer a task to Technical Accounting 
regulated amounts.
Specialist (TAS)
b
e Complete the [PRC REV Hearing Requested] e-form 
Dial into the tele/video conference or attend in person.
after the hearing is concluded, and close this task.
Arrange Face to Face Client Meeting - Health and 
f Update the task information in the subsequent [PRC REV 
Safety Requirements
Record Review Outcome] to say "Awaiting Outcome" and 
NOTE Where can face to face hearings be held?
note the date of the hearing. Update the target date to 28 
• Whangarei
days after the hearing date and transfer the task to the 
• Auckland
'Hamilton SC - Quality Assurance' queue.
• Hawkes Bay (Hastings/Napier)
• Hamilton
• New Plymouth
PROCESS
Implement Resolution Outcomes
• Wellington
Review Specialist
• Blenheim/Nelson
• Christchurch
• Dunedin.
Zoom Meeting Guide
c Answer any questions asked by the review provider.
NOTE What happens at the hearing?
• The customer/representative will outline their 
case.
• The reviewer will ask clarifying questions of the 
customer/representative.
• ACC will present their case and submissions.
• The reviewer will ask clarifying questions of 
ACC.
• ACC will be offered the opportunity to cross ex-
amine the customer/representative.
• The customer/representative will summarise 
their case and provide submissions.
NOTE What if you want to view the same file that 
was sent to the client/advocate and provider?
A copy of the file that was sent to all parties is 
available for you to view in the CIR Shared 
Portal
Client Info Requests - Shared Portal
NOTE What happens if the reviewer adjourns the 
hearing?
The customer/representative and Resolution 
Services will agree on actions to be taken.
If the review is about a decision on a claim, 
update the Hearing Request task to provide the 
reasons for the adjournment. The review will 
remain allocated to the Review Specialist until 
the hearing is closed.
Adjournments Policy
d Approve costs within the Review Specialist delegation 
when called upon by the Reviewer, using the delegation 
levels in 7.10 Mediation, review and appeal on Te 
Whāriki.
7.10 Mediation, review and appeal (Te Whāriki)
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Prepare and Attend Review Hearing (RH)
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GOV-027790 Appendix 1
Implement Resolution Outcomes v35.0
 
Outputs
Linked Process
Close Review
2.0
Recognise a deemed review
1.0
Action a negotiated resolution agreement
1.1
Instruct a new decision to be issued
1.2
Action a review withdrawal
Linked Process
Conduct Initial Customer Contact
Linked Process
Prepare and Lead an Internal Resolution Consultation (IRC)
Attend
Alternative
Linked Process
Prepare and  an  Dispute Resolution (ADR)
Attend
Linked Process
Prepare and  Review Hearing (RH)
Attend
Linked Process
Prepare and  Case Conference (CC)
Review Specialist
Resolution Coordinator
Review Specialist
Review Specialist
Senior Review Specialist
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Implement Resolution Outcomes
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GOV-027790 Appendix 1
Implement Resolution Outcomes v35.0
 
NOTE When undertaking a risk analysis what factor 
Summary
should be considered?
Consider the following:
Objective
• what the customer wants (and whether a contri-
The objective of this process is to carry out the agreed reso-
bution towards their request is reasonable as op-
lution outcome so that the review can be closed.
posed to full amount).
• what is the value of the amount the customer 
Owner
[Out of 
may be entitled to if ACC had accepted their 
Scope]
entitlement request
Expert
[Out of Scope]
• the ACC regulations
• the possible outcome at review, versus the cus-
Procedure
tomer experience
• whether the customer has shown a pattern of 
PROCESS
Prepare and Attend Case Confe-
seeking monetary resolution without a reason-
able basis
rence (CC)
• whether the issue has been previously disputed
Review Specialist
• whether the customer has a tendency to resort 
to legal proceedings to resolve disputes where 
no reasonable basis exists
PROCESS
Prepare and Attend Review Hearing 
• that the potential resolution agreement is not 
(RH)
detrimental to a customer's entitlements
Review Specialist
• any ongoing impact for levy years not part of 
the original decision
• whether the client has a legal representative/
PROCESS
Prepare and Attend an Alternative 
advocate that ACC would be hesitant to create 
Dispute Resolution (ADR)
an expectation that ACC 'will settle anything 
Review Specialist
under $2k'
• whether a resolution offer is appropriate for a 
client who is emotionally aggrieved.
PROCESS
Prepare and Lead an Internal Reso-
Once completed consult with a Senior Reso-
lution Consultation (IRC)
lution Specialist to ensure the rational for offering 
Review Specialist
a resolution agreement is robust.
NOTE What pre-work is required prior to offering a 
PROCESS
Conduct Initial Customer Contact
resolution agreement?
Review Specialist
All resolution agreements should met the below 
criteria:
• Should be quantifiable
1.0 Action a negotiated resolution agreement
• Be fair and reasonable
• Have gone through a risk analysis to ensure 
Review Specialist
that the rational is robust
a Contact the decision maker and have a conversation 
• Have evaluated the possible outcome versus 
about your recommendation to offer a resolution agree-
the customer experience.
ment. Document the conversation between parties to 
show that all practicable efforts have been made to 
NOTE What if a potential settlement is over $2000 in 
achieve an agreed decision.
value?
Email a Senior Review Specialist or Resolution 
NOTE What if the decision maker does not agree 
Manager to seek prior approval. Confirmation 
with your rational for offering a resolution 
that a Senior Resolution Specialist or Resolution 
agreement?
Manager has approved the settlement offer must 
The final decision rests with the Review Spe-
be noted in EOS in the 'Review Outcome Com-
cialist/Senior Review Specialist and there should 
ments' e-form with the Resolution Rationale.
be clear documentation of that persons rational.
Resolution Services Delegation
Please note that seeking Manager approval does 
not negate the need to consult with your Senior 
b Send the REV043 settlement letter if the customer/
Resolution Specialist on whether to offer the 
representative has agreed to a resolution agreement.
Resolution Agreement.
REV043 Resolution Agreement
NOTE Should the payment always be made directly 
to the client?
Payment of an agreed monetary resolution shall 
be made only to the client or, where suitable au-
thority exists, to their representative.
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Implement Resolution Outcomes
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GOV-027790 Appendix 1
c • If the agreed resolution is about a decision on a claim, 
 
in Eos upload the letter to the claim including the team 
1.1 Instruct a new decision to be issued
manager authorisation for amounts exceeding dele-
Review Specialist
gations.
a
• If the agreed resolution is about a levy decision, in 
In consultation with the decision maker discuss your 
Juno_CRM, upload the letter to the account, and if appli-
recommendation to revoke the existing decision in dis-
cable include the team manager authorisation of amounts 
pute and replace it with a new decision using the Rev45 -
exceeding delegations.
Revoke Decision letter.
d Notify the decision maker of the resolution agreement.
REV45 - Revoke Decision Letter
• If the review is about a decision on a claim, notify the 
NOTE Who holds the delegation to decide a deci-
decision maker.
sion will be revoked and replaced?
• If the review is about a levy decision, send the notifi-
"In consultation with" means there must be docu-
cation to [email address].
mented consultation between the final decision 
NOTE What information do you need to include in 
making authority (Review Specialist) and the 
the email notification to the levy classi-
other described party (Decision Maker). All prac-
fication team?
ticable efforts should be made to achieve an 
The email subject should read "Resolution Ser-
agreed decision. In the event agreement cannot 
vices Instruction". The email is to include:
be reached, the final decision rests with the deci-
• Review number
sion-making authority and there should be clear 
• Customer/representative name (if applicable)
documentation of that person’s rationale.
• ACC number
• Instruction or action required
For more detail on the delegate please read the 
'Delegations Framework'.
The responsible Levy staff member will reply by 
NOTE What if the claim has been handed back from 
email to the Review Specialist advising the 
an Accredited Employer?
instruction has been actioned.
You must contact a Risk Sharing Specialist to 
e Add an interaction bullet pointing the review outcome, if 
discuss your rationale for wanting to overturn the 
the review is about a levy decision, in Juno_CRM.
decision. The Risk Sharing Specialist will consult 
with the Accredited Employer before issuing a 
f Contact the customer/representative requesting they 
new decision, as required in the Accredited Em-
withdraw their review application in writing (e.g. email/
ployer agreements.
text/ letter/ACC34).
Case and Claims Management Features Dele-
Accepting withdrawals
gations
ACC034 Request to withdraw a review application
NOTE What if the original decision was issued by 
NOTE What if CIT are part way through checking 
the Elective Services Centre (surgery team)?
the relevant documents/full file?
1. Create a Complete Internal Referral task
Email the DSCCIT inbox to advise them the 
2. Write overturn rationale in that task using 
review application has been withdrawn and that 
heading 'POTENTIAL REVISION OF DECI-
they can cease reading the relevant documents/
SION'. if further space is needed, can be entered 
full file.
in the ‘Add info’ section of task which populates 
into E-form).
g Proceed to 'Close Review' to record the rational for offer-
3. Transfer the COMPLETE INTERNAL REFER-
ing a 'resolution agreement' and close the review cog.
RAL TASK to the ESC management queue
NOTE What date should you use when closing 
4. Update your working task with current action 
down a review?
and next steps for follow up of overturn request.
The date for review closure when a review:
NOTE Should Technical Services be consulted if 
they held the original delegation to make the 
- has been withdrawn/overturned/settled is the 
decision?
date the customer withdrew the review.
You must return to the Technical Specialist who 
It is not the date that ICRA/FW confirmed the 
was involved to discuss your rational for wanting 
review closure or the date we sent a new deci-
to revoke and replace the decision. Ensure this 
sion letter overturning the original decision.
conversation is documented on Eos.
- has been to hearing and has a decision from 
reviewer is the date at the bottom of the review 
outcome decision.
- a conciliated agreement where withdrawal has 
been agreed to is the date the customer signs 
the conciliated agreement.
It is not the date that TMR signs the agreement, 
nor the date it is sent to ACC.
- has been verbally withdrawn is the date the 
client confirm verbally.
It is not the date the RS writes to the client con-
firming the withdrawal.
- has been established as deemed is the date 
three months after the review application was re-
ceived.
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Implement Resolution Outcomes
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GOV-027790 Appendix 1
NOTE What if the claim resides in the Assisted 
c If the review is about a levy decision:
 
Recovery Team?
Send an email to [email address]. The sub-
If in Assisted Recovery, contact the Assisted 
ject line should read "Resolution Services Instruction". 
Recovery team extn. 50140 to discuss your 
Attach a copy of the decision document (ie hearing deci-
instruction. Follow-up by creating a 'NGCM -
sion document, case conference minutes, or ADR agree-
General' task assigned to the Recovery Assistant 
ment). The email should include:
that you spoke with detailing your specific 
• Review number
instructions.
• Customer/representative name (if applicable)
• ACC number
The NGCM – GENERAL task should read:
• The instruction or action required on the account
The responsible Levy staff member will reply by email to 
• Review Specialist – Action needed.
the Review Specialist advising the instruction has been 
• (Write specific and clear detail of your request 
actioned.
for the Recovery Team Member to action)
d Contact the customer/representative and tell them that a 
• This new decision is made with the Review 
new decision will be issued, and unless we are issuing a 
Specialist delegation, and does not require addi-
new decision as a result of a hearing outcome request 
tional clinical or technical advice; if you have any 
they withdraw their review application in writing (e.g. 
question, please feel free to contact me.
email/text/letter/ACC34).
If the overturned decision is as a result of a hear-
Accepting withdrawals
ing attached a copy of the reviewers decision to 
NOTE What if CIT are part way through checking 
the task.
the relevant documents/full file?
NOTE What if the claim is assigned to an individual 
Email the DSCCIT inbox to advise them the 
within the Supported or Partnered Recovery 
review application has been withdrawn and that 
Team?
they can cease reading the relevant documents/
Contact the Recovery Coordinator or Recovery 
full file.
Partner by phone directly to discuss your con-
cerns and rationale on why you are looking to 
overturn the decision. Ensure that your rationale 
1.2 Action a review withdrawal
is captured in your Contact note in EOS.
Review Specialist
NOTE: the delegation to overturn sits with the 
a Read the withdrawal review application request and open 
Review Specialist after consultation with a Dele-
the claim, or account as appropriate.
gation holder. This is an important part of work-
Accepting withdrawals
ing together. You do not need to agree but it is 
important that this conversation occurs, so eve-
b If the review withdrawal application is about a decision on 
ryone understands the reasons for the decision.
a claim, in Eos upload the withdrawal request and update 
the document type to 'ACC034 Withdraw review' and 
Please also advise the person you are speaking 
document description with the unique review number.
with, that we do not need them to seek additional 
c If the review withdrawal application is about a levy deci-
clinical or technical comment, as that is consi-
sion add an interaction in Juno_CRM and upload the 
dered as part of our investigation process for the 
ACC034 to the interaction. Send an email of the outcome 
Review.
to [email address]. The subject should read 
'Resolution Services Review Outcome'. The email should 
If the outcome is as a result of a hearing, in Out-
include:
look, email a copy of the review hearing decision 
— Review number
to the decision maker and their Team Manager.
— customer/representative name (if applicable)
NOTE What if the claim is no longer assigned to an 
— ACC number
individual?
— Advice the review has been withdrawn
This instruction includes any claims closed after 
d If the a review hearing date or case conference has been 
sitting with Assisted, Partnered, Supported, 
set down, send confirmation of the withdrawal, to the 
Cover and Treatment Injury.
review provider and say that the customer/representative 
wants to withdraw their application.
Although unassigned, you must always attempt 
NOTE What if CIR are part way through checking 
to contact the person who made the decision via 
the relevant documents/full file?
their DDI. If unavailable for any reason, ring the 
hunt number and speak with another person in 
Email the DSCCIT inbox to advise them the 
the appropriate team who can pick up the task 
review application has been withdrawn and that 
on their behalf.
they can cease reading the relevant documents/
full file.
Team Numbers (Hunt Line)
b Document the detail of your 'Consultation' conversation in 
an Eos contact and label the contact 'Overturn Rationale/
PROCESS
Close Review
Consultation'.
Resolution Coordinator, Review Specialist
2.0 Recognise a deemed review
Review Specialist, Senior Review Specialist
a Advise the Senior Review Specialist of the suspected 
deemed review.
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Implement Resolution Outcomes
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GOV-027790 Appendix 1
NOTE What actions should the Senior Resolution 
 
Specialist take?
If the review is confirmed as deemed, the Senior 
Resolution Specialist should refer the case to 
Review Monitoring Panel to consider if ACC 
should appeal the deemed review.
b Refer to Legal Services to confirm that the review is 
considered to be deemed, and to request clarification on 
the impact and effect of the deemed review.
c Generate, in Eos, the 'Rev44 - Deemed Review Letter' if 
the review has been confirmed as deemed by Legal Ser-
vices.
Deemed Review Letter
d Contact the client and explain the following:
- What a deemed review means?
- How this will impact the review at hand?
- What impact this will have on cover and entitlements?
NOTE Would we then ask the client to withdraw the 
review?
The client is not require to withdraw the review 
as the outcome of the review is decided by the 
application of Section 146 of the AC Act 2001. If 
the customer disagrees, they would need to 
appeal the decision as opposed to review the 
decision.
e Contact the review provider, if the file has already been 
transferred, to inform them of the deemed review. The 
review provider will then provide confirmation of the out-
come in a formalised letter.
f Advise the Resolution Manager of the deemed review.
NOTE What actions should the Resolution Manager 
take?
The Resolution Manager should advise the Man-
ager, Resolution Services of the deemed review 
and what actions have been taken.
g Close the review in EOS using the code 'quashed' and 
complete the 'View Review Outcome' e-form, explaining 
how the review became deemed and the effect of the 
deemed review.
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Implement Resolution Outcomes
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GOV-027790 Appendix 1
Conduct Initial Customer Contact v18.0
 
Attend
Linked Process
Prepare and  Case Conference (CC)
Attend
Alternative
Linked Process
Prepare and  an  Dispute Resolution (ADR)
Task
Linked Process
Create Bulk Print and Send CIR 
0
6
Discuss and agree on the documents relevant to the review
Linked Process
Prepare and Lead an Internal Resolution Consultation (IRC)
Linked Process
Implement Resolution Outcomes
0
5
Discuss resolution options with custom er/representative
0
4
Re-evaluate potential resolution options
0
3
Seek new/relevant supporting information
ACC
0
2
Explain the  decision
0
alidate customer
1
V understanding of decision
Linked Process
Complete Background Review
Review Specialist
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Conduct Initial Customer Contact
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GOV-027790 Appendix 1
Conduct Initial Customer Contact v18.0
 
NOTE What is the authorisation process for levy 
Summary
decisions?
Follow the Perform Authorisation Check - Busi-
Objective
ness Customer process
The objective of this process is to discuss the review application 
PROCESS Perform Authorisation Check -
with the customer, or their representative, check their under-
Business Customer
standing of the review matter, and of ACC’s decision so that we 
can begin to resolve the matter or continue towards a review 
NOTE What if you need to update an authorised 
hearing.
business customer?
Follow Add or Update Business Customer Autho-
Background
rised Party.
After completing the background review the customer/
PROCESS Add or Update Business Cus-
representative must be contacted by phone to discuss the 
tomer Authorised Party
review application, any new information and the process moving 
forward.
c Confirm ACC has the correct customer/representatives 
contact details. Include both the telephone number and 
Owner
[Out of 
email address.
Scope]
Expert
[Out of Scope]
NOTE What if the email address has not been veri-
fied?
Procedure
If the email address has been added to Eos but 
not yet verified - ask the applicant to check their 
emails and return the verification as soon as 
PROCESS
Complete Background Review
possible.
Review Specialist
If the email address has NOT been added to 
Eos, follow the steps outlined in the 'Update 
1.0 Validate customer understanding of decision
Client's Party Record' policy.
Review Specialist
PROCESS Update Client Party Records
a If intending to call a representative, check if there is a 
d Tell the customer/representative:
current Authority to Act (ATA).
• the reason for the call
NOTE What if there is no current ATA on file?
• what will be discussed during the phone call
• the review process, including the focus for ACC on 
By phone, contact the representative and re-
seeking resolution
quest the form is returned.
• the role of the Review Specialist.
NOTE What if the ATA is never returned?
e Ask the customer/representative, in their own words, to 
No details can be discussed with the repre-
explain:
sentative. Proceed to Prepare and Attend Case 
• their understanding of the disputed decision
Conference.
• why they believe ACC decision is incorrect
PROCESS Prepare and Attend Case 
• what they are hoping to achieve through the review 
Conference (CC)
process.
b By phone, contact the customer/representative within 7 
NOTE What is the expected outcome of the conver-
days of the receipt of the review application. Use the 
sation?
appropriate authorisation process to confirm you are 
The outcome of this conversation is to under-
speaking to the right person.
stand the customer's point of contention or griev-
NOTE Best practice is to contact the customer by 
ance, and help the Review Specialist determine 
phone within 48 hours of the review allo-
whether conciliation or a resolution offer may be 
cation.
appropriate.
NOTE What if a translator is required to speak with 
2.0 Explain the ACC decision
the client?
Review Specialist
Use ACC's policy to obtain guidance on engag-
ing with an interpreter.
a Explain why ACC made its decision. This may include an 
explanation of the legislation and/or medical reports that 
When to use an Interpreter Policy
were instrumental to the decision.
Advocate Communications Policy
NOTE What is the authorisation policy for decisions 
3.0 Seek new/relevant supporting information
on claims?
Review Specialist
Read the Advocates and Holders of Authority 
Policy to Act policy.
a Discuss any information that was received after the deci-
PROCESS Advocates and holders of au-
sion date and included with the written application for 
thority to act Policy
review.
b Ask the customer/representative if they have any new 
information that was not included in the written appli-
cation to support the review application.
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Conduct Initial Customer Contact
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GOV-027790 Appendix 1
NOTE What if the customer/representative has new 
NOTE What if the matter at review relates to an Indi-
 
information?
vidual Rehabilitation Plan (IRP)?
• Then ask the customer/representative to ex-
First and foremost consider an Internal Reso-
plain what the new information is and how they 
lution Consultation (IRC) with the decision 
believe it is relevant.
maker. If the relationship is strained it might be 
• If possible, ask them to send the information via 
more useful to attend Conciliation (under the 
email directly to the Review Specialist and 
Alternative Dispute Resolution process) with the 
advise they will be contacted again once the 
decision maker as an alternative to an IRC. 
information has been considered.
Please note there must be a sound reason for 
proceeding straight to review as these can often 
be resolved.
4.0 Re-evaluate potential resolution options
Review Specialist
a If new information has been provided by the client/
5.0 Discuss resolution options with customer/
representative, check if further advice is needed to iden-
representative
tify or re-evaluate potential resolution options to discuss 
Review Specialist
with the customer/representative.
a Discuss with the customer the possible pathway and pro-
NOTE What type of advice would be useful?
ceed as appropriate:
• Comments from Medical or Psychology Advi-
• on a resolution option, or
sors
• a withdrawal and review closure (based on your expla-
• Advice from the Clinical Advice Panel
nation of the decision), or
• Additional information from the customer/
• whether to proceed to an internal resolution consul-
representative
tation.
• Additional information from the treating spe-
b Add a contact in Eos, or interaction in Juno_CRM, as 
cialist
appropriate, to record the main points from the conver-
• A Medical Case Review
sation.
• Comments from a radiologist
c
• Comments from Technical Services
Proceed to Step 6.0, if the above pathways (listed under 
• Comments from Technical Accounting Services
'a') are agreed to be unsuitable.
• Advice from Levy Classification
NOTE What if advice or guidance is needed from 
PROCESS
Implement Resolution Outcomes
Clinical Services?
Review Specialist
To obtain instruction on how to seek the required 
clinical advice/guidance Refer to Clinical Referral 
Instructions
PROCESS
Prepare and Lead an Internal Reso-
Clinical Referral Instructions
lution Consultation (IRC)
Reference Guide for Review Specialists when decid-
Review Specialist
ing whether to refer a task to Technical Accounting 
Specialist (TAS)
6.0 Discuss and agree on the documents relevant 
NOTE Should permission be sought from the client 
to the review
prior to seeking further external clinical com-
Review Specialist
ments or notes?
Yes - you must have a conversation with the 
a Identify and agree the relevant documents with the cus-
client/ATA on what you are wanting to do and 
tomer/representative.
why (e.g. releasing and seeking medical infor-
NOTE What if the client wants the full file?
mation with a view of reconsidering ACC position 
Explain to the client that ACC has made a move 
on the matter at review). This is to ensure there 
to providing relevant document as a preference 
is no objection. Once you have obtained a verbal 
to the full file. This ensures the reviewer doesn't 
permission make a note in your Eos contact 
receive large amounts of information that has no 
reflecting the conversation.
relevance to the disputed decision. If the client 
NOTE Who's role is it to conduct further inves-
has any doubts about the correct information 
tigation when required?
being provided then the Case Conference serves 
When a client has an active review, a Review 
as an opportunity for this to be discussed and 
Specialist can request medical notes and clinical 
corrected if necessary.
specialist reports including/not limited to Medical 
Case Reviews. Review Specialists can request 
If the client still wants the full file - then relevant 
these directly from the Clinic, DHB or Specialist 
documents must be correctly selected. Note in 
unless a collaborative approach or specific input 
the initial customer contact on Eos the clients re-
is required from a Recovery team member or 
quest for the full file.
Specialist Cover assessor.
Relevant Document Guidelines
b Check that the potential resolution options identified in 
the background review are still relevant.
NOTE What if the potential resolution option has 
changed from the background review?
In Eos, update the PRC REV: Complete Admin 
Review 'Additional information' box.
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Conduct Initial Customer Contact
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GOV-027790 Appendix 1
NOTE What if an employer is an interested party?
NOTE What if the employer is the applicant?
 
• Firstly, we should check if the employer is inter-
• The easiest way to tackle any issues with files 
ested in attending the review or requires a copy 
is to contact the customer, explain that the em-
of relevant documents. If they aren’t interested in 
ployer is entitled to information about ACC’s 
being involved in the review, then you do not 
decision. Discuss the relevant documents with 
need to send the employer any documents.
the customer and ask if the customer is happy 
for us to send a full copy of these documents to 
• If the employer does want a copy of the docu-
the employer and reviewer. It is important that 
ments as an interested party, the most straight-
there is discussion with the customer about the 
forward way to tackle any issues with files is to 
information contained in their file and if possible, 
contact the customer, explain that the employer 
a copy of the file should be sent to customer to 
is entitled to information about ACC’s decision. 
check before releasing to the employer. If the 
Discuss the relevant documents with the cus-
customer provides permission for ACC to do this, 
tomer and ask if the customer is happy for us to 
then information will not need to be redacted.
send a full copy of these documents to the em-
ployer.
• If the customer is not happy for us to send the 
full unredacted documents, then we will need to 
• If the customer is not happy for the full file to 
follow the process for collating information for an 
go, we should discuss with the employer what 
employer file and organise information that is not 
information they require. If they are happy with 
relevant to the review be redacted. Ideally, we 
the ACC45 and ACC33 Review Application, 
will send the file to the customer to check they 
these can be easily sent by email with some 
are happy with it before releasing it to the em-
information about the customer redacted. If there 
ployer.
is other information that the employer believes 
that they require, redactions must be made in 
• The customer may advise ACC that they do not 
line with the redaction process.
want any of their information to go to the em-
ployer or Reviewer. In these situations, we would 
• If we can’t contact the customer to discuss the 
advise the customer that the employer and Re-
review documents or the customer is not wanting 
viewer are entitled to receive certain information 
any information to be provided to the employer, 
about the claim (such as information relating to 
follow the instructions as if the employer is the 
the accident itself and causal link between the 
applicant.
accident and the personal injury) because it has 
been lodged as a work-related personal injury. 
We can reassure the customer that personal 
information not relating to whether the injury oc-
curred at work will be removed from the file and 
still give them the opportunity to review the infor-
mation before proceeding.
• If we are unable to contact the customer to dis-
cuss the provision of documents, we must still 
provide relevant documents to the employer and 
Reviewer with careful redaction. We must give 
the customer adequate opportunity to commu-
nicate with ACC by making multiple attempts to 
contact them including sending them a letter if 
possible.
b Discuss with the customer/representative the methods of 
delivery for the relevant documents. Then go to 'Create 
Bulk Print and Send CIR task' to arrange the preparation 
and release of these documents.
NOTE What are the delivery options?
• Electronic documents:
- By email (ACC's preferred method)
- By USB
- By CD
• Paper documents:
- By courier to home address - read client the 
ACC6181
- By courier to rural delivery address (requires 
pre alert) - read client the ACC6181
- By courier to local ACC branch
ACC6181 Receiving personal information by courier
c Proceed to one of the following processes:
• Prepare for Alternative Dispute Resolution (ADR)
• Prepare and Attend Case Conference as agreed with 
the customer/representative.
PROCESS
Create Bulk Print and Send CIR 
Task
Review Specialist
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Conduct Initial Customer Contact
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GOV-027790 Appendix 1
  PROCESS
Prepare and Attend an Alternative 
Dispute Resolution (ADR)
Review Specialist
PROCESS
Prepare and Attend Case Confe-
rence (CC)
Review Specialist
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Conduct Initial Customer Contact
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GOV-027790 Appendix 1
 
ACC8026  
Alternative Dispute Resolution (ADR) 
coversheet 
For Providers: 
We have agreed with the customer to engage in Alternative Dispute Resolution.  We’ve booked a 
time and date through your website.  Please find relevant documents attached. 
 
1.  Alternative Dispute Resolution booking details 
Date:            
Time:            
Issue, or dispute, to be discussed:            
Primary contact:     Customer 
        Representative/Advocate 
            Employer 
  
Customer will be attending:    by phone 
        video conference 
            in person 
  
ACC will be attending:     by phone  
        video conference 
            in person 
   
For in person attendance:  Location:                       Onsite contact person:            
 
2.  Review details (complete if review application has been lodged) 
Review number 
Review category 
Lodgement date 
Decision date 
[insert review 
[insert review category] 
[dd month yy]  
[dd month yy]  
number] 
[insert review 
[insert review category] 
[dd month yy]  
[dd month yy]  
number] 
 
3.  Customer details 
Claim/ACC number:            
Preferred contact method:            
Customer name:            
Telephone number:            
Email address:            
Postal address:            
Care indicator:  
 Yes                                                      
 No                                              
Care indicator information:            
 
4.  Advocate/Representative details  
Name:            
Preferred contact method:            
Organisation:            
Telephone number:            
Email address:            
Postal address:            
Authority to Act included with documents:  
 Yes   
 
5.  Employer details  
Name:            
Preferred contact method:            
Organisation name:            
Telephone number:            
Email address:            
Postal address:            
 
 
 
ACC8026 
April 2020 
Page 1 of 8 

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GOV-027790 Appendix 1
 
ACC8026 Alternative Dispute Resolution (ADR) coversheet 
 
6.  ACC staff details 
ACC staff member:            
Contact email address:             
Contact phone:            
 
When we collect, use and store information, we comply with the Privacy Act 1993 and the Health Information Privacy 
Code 1994. For further details see ACC’s privacy policy, available at www.acc.co.nz. We use the information collected on 
this form to fulfil the requirements of the Accident Compensation Act 2001. 
 
 
 
ACC8026 
April 2020 
Page 2 of 8 

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GOV-027790 Appendix 1
 
ACC8026 Alternative Dispute Resolution (ADR) coversheet 
 
 
 
 
Agreement to Conciliate 
 
This agreement is between 
[Claimant Name] 
AND 
ACC 
AND 
Talk – Meet – Resolve’s Conciliator  
(The Conciliator) 
 
ACC and [Claimant Name] (referred to below as “we” and “us”) agree to enter into 
conciliation.  
 
1.  Appointment of Conciliator 
We agree that the Talk – Meet – Resolve Conciliator has been appointed to conciliate our dispute. 
This agreement sets out the process and conduct of the conciliation. 
 
2.  Good faith and cooperation 
We agree to conciliate in good faith.  We agree to cooperate with the Conciliator and to be honest 
with each other and the Conciliator. We agree that the following can be placed on ACC’s file: 
 
 
(a) 
This signed “Agreement to Conciliate”.  
 
(b) 
Any signed “Resolution Agreement”. 
(c)  
Any information referred to in the Resolution Agreement  
(d)  
Any information provided to the Conciliator that we agree can be placed on ACC’s 
file  
(e) 
Any other information that we agree can be recorded on ACC’s file.  
 
We agree that subject to relevant privacy and confidentiality rules, Talk – Meet – Resolve can 
collect, hold and use information about dispute resolution processes and outcomes to support 
transparency, accountability and system improvement. 
 
 
ACC8026 
April 2020 
Page 3 of 8 

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GOV-027790 Appendix 1
 
ACC8026 Alternative Dispute Resolution (ADR) coversheet 
 
 
 
 
 
3.  Confidentiality of the process 
We agree that the remainder of the conciliation will be entirely confidential. Any information or 
documentation disclosed during the conciliation, including during the preliminary steps, individual 
or joint meetings, by any party or the conciliator, will remain confidential except in the 
circumstances  noted in (a), (b) and (c) below. In summary, this means the people who are part of 
conciliation will not tell others outside of conciliation about what was said during the process.  
The exceptions to confidentiality are: 
(a)  
If the Conciliator has reason to believe that any person is in danger of physical 
harm. 
(b)  
For the purpose of obtaining privileged legal advice. 
(c)  
If disclosure is required by order of a court or by law.  
 
We agree that each of us will not take, and will not permit any other person to take, photographs or 
make any audio-visual recording of the conciliation process or its participants (whether in person or 
online). We understand that the venues where we meet in person may have CCTV cameras in 
operation for safety and security purposes only. 
 
4.  Role of conciliator 
We accept that the Conciliator will be neutral and impartial. She or he will listen to each of us and 
will assist us to explore options to resolve the issues between us. The Conciliator will help us to: 
•  Explain to each other what is important to us. 
•  Work out where we agree on things and/or where we see things differently (the things in 
dispute).  
•  Help us to think about different options to resolve the things in dispute.  
•  Reach an agreed resolution on how to resolve the things in dispute.  
We agree that the Conciliator is an independent expert and can: 
•  use her or his expertise to help us identify the issues in dispute.  
•  if we agree, make suggestions on how to resolve the things in dispute. 
We agree that we can each decide if we make use of the Conciliator’s independent expertise or 
suggestions and that these are not binding on us.   
We understand that the Conciliator can not:   
•  provide legal advice, or 
•  make a decision for us, or  
•  impose a solution on us.  
We agree that each of us can talk privately or meet separately with the Conciliator and that any 
such discussions will remain confidential unless we give authorisation to disclose any information.  
Either of us can request a private meeting at any time. The Conciliator can also suggest this at any 
time.  
 
ACC8026 
April 2020 
Page 4 of 8 

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GOV-027790 Appendix 1
 
ACC8026 Alternative Dispute Resolution (ADR) coversheet 
 
 
 
 
5.  Authority to settle and representation at conciliation 
We agree that we have the legal authority to reach agreement on the meeting day or if not, to 
arrange for someone that has such authority to be available on the meeting day.  
We agree that we can bring someone (including a lawyer) to support, assist and/or advise us 
during the Conciliation. We agree that such people will first need to agree to and sign clause 10 of 
the Agreement to Conciliate before they can participate in the process. If we want someone to 
attend in person, by videoconference or teleconference we will tell the Conciliator who that person 
is prior to the meeting and the Conciliator will then discuss this with us.  
 
6.  Withdrawing from the Conciliation  
Conciliation is voluntary. We agree we will attend the conciliation meeting with the intention of 
trying to resolve our dispute.  
Either of us can withdraw from the conciliation process at any time. Before we do, we agree we will 
first talk to the Conciliator.  
The Conciliator can also end the conciliation process if, after consultation with us, the Conciliator 
considers she or he is unable to achieve a resolution of the dispute.  
 
7.  Writing and signing a Resolution Agreement  
If we reach an agreement the Conciliator will help us record that agreement in writing (the 
“Resolution Agreement”). Once the Resolution Agreement is signed by each of us we wil  be bound 
by that agreement. This means we will think carefully about it before we sign any Resolution 
Agreement. If we do not sign the Resolution Agreement then the terms of the draft Resolution 
Agreement will remain confidential and non-binding until it is signed by each of us.  
 
8.  We will not take action against the Conciliator or each other arising from the conciliation 
process 
We will not take any legal action against the Conciliator in relation to anything to do with the 
Conciliation process. We agree that, subject to any written agreement to the contrary, if one of us 
does take legal action against the Conciliator in relation to anything to do with the conciliation 
process, that person wil  pay the Conciliator’s legal costs.  
We agree that neither of us will claim defamation against each other about anything said or 
referred to during the conciliation process. 
The Conciliator will not act as a decision maker (e.g. a Reviewer) in any dispute which has been to 
conciliation but was not resolved through that conciliation process.  
 
 
 
 
 
ACC8026 
April 2020 
Page 5 of 8 

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GOV-027790 Appendix 1
 
ACC8026 Alternative Dispute Resolution (ADR) coversheet 
 
 
9.  Transparency Accountability and System Improvement 
We agree that subject to relevant privacy and confidentiality rules, Talk – Meet – Resolve can 
collect, hold and use information about dispute resolution processes and outcomes to support 
transparency, accountability and system improvement. 
 
 
10. Without prejudice  
We agree that this process is “without prejudice” to each other’s rights. This means that by entering 
in to this Conciliation process we are not agreeing to give up our rights, including the right to 
request a review hearing. 
 
We have read, understood and agree to the conditions of this agreement: 
 
 
 
 
 
_______________________________ 
 
 
 
____________ 
      
        
/ Claimant (signature)  
 
 
 
 
(date) 
 
 
 
 
 
 
_______________________________ 
 
 
 
____________ 
                    
/ACC (signature) 
 
 
 
 
 
(date) 
 
 
 
 
 
_______________________________ 
_____________ 
                  / Conciliator (signature)   
 
 
 
 
(date) 
 
 
ACC8026 
April 2020 
Page 6 of 8 

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GOV-027790 Appendix 1
 
ACC8026 Alternative Dispute Resolution (ADR) coversheet 
 
 
ACC8026 
April 2020 
Page 7 of 8 

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GOV-027790 Appendix 1
 
ACC8026 Alternative Dispute Resolution (ADR) coversheet 
 
11. Support people/Advocates and other conciliation participants 
We agree that unless authorised by the claimant/customer or the information is otherwise able to be 
disclosed in accordance with clause 2 or 3, we will keep confidential any information or 
documentation disclosed during the conciliation, including during the preliminary steps, individual or 
joint meetings, by any party or the conciliator. In summary, this means as people who are part of 
conciliation we will not tell others outside of conciliation about what was said during this process.  
 
 
 
 
 
_______________________________ 
 
 
 
_______________ 
/ Claimant Representative (signature)  
 
 
 
(date) 
 
 
 
 
_______________________________ 
 
 
 
_______________ 
/ Support person (signature)   
 
 
 
          (date) 
 
 
 
 
 
 
_______________________________ 
 
 
 
_______________ 
/ ACC staff member (signature)  
 
 
 
(date) 
 
 
 
 
 
 
_______________________________ 
 
 
 
_______________ 
 
 
ACC8026 
April 2020 
Page 8 of 8 

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GOV-027790 Appendix 1
 
ACC6239  
Instruction for Review Provider 
For Review Providers: 
We have received a review application from the following customer.  We have arranged a case conference to 
discuss the review application and have attached relevant documents. Please allocate a reviewer. 
1.  Initial case conference details 
Provider Name:            
Date:            
Time:              
Date and time agreed by Customer?  
 Yes          
 No 
Complex Review?  
 Yes          
 No 
Primary contact:  
 Customer         
 Representative/Advocate            
 Employer  
If proceeding to hearing, the customers’ preferred attendance is:  
 Phone            
 Video conference            
 In person 
Additional information:  
[e.g. ADR request; cultural/language requirements; female/male reviewer requested; unsuccessful ADR;  
linked reviews; disability support] 
 
2.  Review details 
Review number 
Review category 
Lodgement date 
Decision date 
[insert review 
[insert review category] 
[dd month yy]  
[dd month yy]  
number] 
[insert review 
[insert review category] 
[dd month yy]  
[dd month yy]  
number] 
Late Review Application?  
 Accepted        
 Declined        
 No decision yet        
 Not Applicable 
 
3.  Customer details 
Claim/ACC number:            
Preferred contact method:            
Customer Name:            
Telephone number:            
Relationship to Review:  
 Interested Party      
 Applicant        
E     
ma   
il  
 address:            
Postal address:            
Care indicator:  
 Yes        
 No 
Care indicator information:              
 
4.  Advocate/Representative details  
Name:            
Preferred contact method:            
Organisation:            
Telephone number:            
Email address:            
Postal address:            
Authority to Act included with documents:  
 Yes 
Care indicator:  
 Yes        
 No 
Care indicator information:              
 
 
 
ACC6239 
April 2020 
Page 1 of 2 

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GOV-027790 Appendix 1
 
ACC6239 Instruction for Review Provider 
 
5.  Employer details  
Name:            
Preferred contact method:            
Organisation name:            
Telephone number:            
Relationship to Review:  
 Interested Party      
 Applicant        
E     
ma   
il  
 address:            
Postal address:            
 
6.  ACC Review Specialist details 
ACC Staff member:            
Email address: [email address] 
Contact telephone number:            
When we collect, use and store information, we comply with the Privacy Act 2020 and the Health Information Privacy 
Code 2020. For further details see ACC’s privacy policy, available at www.acc.co.nz. We use the information collected on 
this form to fulfil the requirements of the Accident Compensation Act 2001. 
 
ACC6239 
April 2020 
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GOV-027790 Appendix 1
Receive, Log and Allocate Review Application v29.0
 
Application
6.0
Allocate the Review  to a Review Specialist
Linked Process
Complete Background Review
5.0
Check for Privacy Act request
Application
4.0
Acknowledge the Review 
levy
-
-
-
3.0
Log review application  decision on a claim
3.1
Log review application  decision
3.2
Log review application  vehicle registration decision
riggers & Inputs
T
1.0
Send review application to Resolution Services
2.0
Check the Review Application
ACC Staff Member
Resolution Coordinator
Review Specialist
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Receive, Log and Allocate Review Application
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GOV-027790 Appendix 1
Receive, Log and Allocate Review Application v29.0
 
NOTE What if the email is not an application review 
Summary
for review?
• If the email has information about an existing 
Objective
review, forward the email to the allocated Reso-
To record and acknowledge the receipt of the review application 
lution Specialist.
to the applicant, acknowledge the receipt of the review appli-
cation and to allocate it to a Review Specialist so that the ACC 
— If the email relates to a decision about claim, 
decision can be reviewed.
file it in Eos, and send to the Decision Maker for 
action and copy in the Decision Maker's Team 
Background
Manager to ensure the correspondence is ad-
Customers or their representatives can seek an independent 
dressed.
review of a decision ACC has made. The review application 
— If the email relates to a decision about a levy, 
must be in writing and received within 3 months of the decision.
in Juno_CRM, create an interaction on the cus-
tomer's account and attach the email to the inte-
Owner
[Out of 
raction.
Scope]
Expert
[Out of Scope]
• If the email is from an Accredited Employer 
(AEP) or Third Party Administrator (TPA) 
Procedure
acknowledging the receipt of a review application 
1.0 Send review application to Resolution Services
then file the email into the AEP/TPA folder in 
Outlook, and file away in Eos.
ACC Staff Member
a Forward the application for review to 
• If the email is about a complaint, then forward 
[email address] within 24 hours of re-
the email to [email address].
ceipt.
NOTE What if it is review that needs to be reopened 
NOTE What constitutes a review application?
as a result of a settled appeal or court deci-
A application for review must be:
sion?
1) in writing (e.g. via letter, email, e-text or 
The original review will be closed so a new 
ACC33)
review cog needs to be generated in Eos. There 
2) identify the decision or decisions in respect of 
will be no new 'review application' per se, so the 
which it is made (e.g. by stating the date or sub-
original review application will be need to be 
ject)
used as the ACC33 to 're-log' it. There should be 
the ‘settlement’ letter from Legal Services to the 
If there is uncertainty as to what the client is re-
client, and the client’s acceptance of the settle-
viewing (or whether it is in fact a valid review 
ment, and preferably the District Court confir-
application) it is important to clarify with the 
mation that the appeal has been withdrawn.
client/advocate in the first instance (and confirm 
the decision they are challenging) - and then for-
NOTE What if the review is about a fatal claim on 
ward it to [email address] 
behalf of the estate?
inbox . This will mitigate the risk of the review 
If the application concerns a fatal claim on behalf 
becoming deemed.
of the estate, an additional process needs to be 
carried out before a review can be made/
proceed. Note that the review relates to a fatal 
2.0 Check the Review Application
claim on behalf of the estate in the allocation 
task.
Resolution Coordinator
a
NOTE What is a fatal claim on behalf of the estate?
Open the accreviewapplication.co.nz inbox and review 
each unread email to determine if a new review appli-
These claims include:
cation has been received.
1. Cover issues concerning the deceased.
2. Entitlements that the claimant was eligible for 
before death such as permanent injury compen-
sation or treatment.
3. Entitlements, such as the funeral grant, that 
explicitly state the estate is the recipient.
Claims where a party is requesting entitlements 
for themselves, such as spousal grant or child-
care, are not fatal claims on behalf of the estate.
b Ensure the information in the review application is legible 
and complete.
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Receive, Log and Allocate Review Application
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GOV-027790 Appendix 1
NOTE What if there is an issue with the application?
NOTE What if the application is for a claim with an 
 
If the review application form is:
active AEP or TPA?
Then forward the review application to the cor-
• Illegible: return the application to the sender 
rect AEP or TPA and request they acknowledge 
with a note highlighting which part cannot be 
that they have received the application. Gen-
read.
erate a general task on the relevant claim as a 
reminder to await an acknowledgement from the 
• Unsigned: Carry on with the process. Unsigned 
AE and follow up at two day intervals. This 
application are acceptable.
process ends.
f Ensure there is a current Authority to Act (ATA) on the 
• Unclear on what decision the client wants to 
claim or account if required.
review (eg the dates to not match): Proceed to 
lodge the application and note on the task for the 
NOTE What if there is no current ATA?
RS to follow up with the client requesting clari-
• If the review is a decision about a claim then 
fication.
send the customer/representative the ACC5937 
to complete and request it is returned to 
• Unclear that the customer wants to apply for a 
[email address].
review: Contact the customer and clarify their 
• If the review is about a levy decision then send 
intention. If they do not want a formal review, 
the customer/representative the ACC1766 to 
contact the decision maker so they can work on 
complete and request it is returned to 
the applicant’s request. If the applicant cannot be 
[email address].
contacted, or does not respond to a request for 
further information within 24 hours continue with 
ACC5937 Authority to act - Client
this process.
ACC1766 Giving Access Levy Information
NOTE What if the customer/representative is 
g Check whether there is a Review Provider listed as a 
submitting an application which they had 
claim participant. If there is a Review provider listed and 
previously withdrawn?
no active review – remove the Review provider as a 
Refer to Managing Withdrawn and then Re-
claim participant.
submitted Review Applications Policy.
h Ensure there is only one decision per review application.
Managing Withdrawn and then Re-submitted Review 
Applications Policy
NOTE What if there is a levy decision which covers 
multiple years?
c Establish who submitted the review application to under-
Log the application. Only one application is re-
stand how to proceed as some applications cannot be 
quired in this circumstance.
considered.
NOTE What if there are multiple decisions con-
NOTE What types of applications cannot be consi-
tained within one decision letter?
dered?
Log each decision as a separate review.
• Review applications from employers about 
work related personal injury entitlements cannot 
The exception to this however is where ACC has 
be considered. In these cases, lodge the appli-
issued a decision declining cover AND surgery. 
cation and instruct the allocated review specialist 
In these cases one review is logged for the cover 
to speak with the application about the matter 
decision and the Review Specialist must explain 
being jurisdictional.
to the client that if cover is overturned then ACC 
will revisit the application for surgery.
• Review applications received from registered 
health professionals about a patient's cover and/
NOTE What if the decision letter has only one deci-
or support cannot be considered. In these cases 
sion, but the review application seeks two 
- lodge the application, and instruct the allocated 
different outcomes?
review specialist to contact the client directly to 
Proceed to lodge the application and note on the 
ask whether it was their intention to go down the 
task for the RS to follow up with the client 
review channel and that they authorise the pro-
requesting clarification on whether a second 
vider to lodge the review on their behalf.
review is required.
d Ensure that the claim or ACC number is correct.
i Ensure any documents supporting the review application 
are for the customer’s review.
NOTE What if the claim or ACC number is incor-
rect?
NOTE What if the supporting documents are not for 
• If the application requires a claim number, in 
the customer’s review?
Eos search for the client through the party 
Contact the external party who sent the appli-
record. If this is unsuccessful, contact the client 
cation immediately, let them know their error, and 
or client’s representative and ask them to pro-
destroy the information.
vide the correct number.
j Ensure the application is not a duplicate of another 
• If the application requires an account number, 
review application.
in Juno_PolicyCenter search for the business 
customer.
e Determine whether application is for a claim with an 
active Accredited Employer (AEP) or Third Party Admin-
istrator (TPA).
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Receive, Log and Allocate Review Application
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GOV-027790 Appendix 1
NOTE What if the application is a duplicate?
Use Adobe Pro to add a Watermark
 
• If the application relates to a claim, locate the 
Convert to PDF, combine, split, and email to Eos
claim in Eos, and upload the application and 
update the description to say ‘duplicate review 
d Update any relevant customer and/or advocate infor-
application’. If the review application has any 
mation.
differences to the initial application - send a gen-
NOTE What information needs to be added?
eral task to the RS to draw their attention to the 
newly submitted application that you consider a 
If an ATA is included with the application, add an 
duplicate.
advocate/representative as a participant to the 
claim.
• If the application is for a business customer, in 
If an email address was included with the appli-
Juno_CRM, upload the application and create a 
cation, ensure this is correctly recorded at the 
new interaction to say ‘duplicate review appli-
party record.
cation’.
Go to step 4.0
k Ensure that the Care Indicator has been updated within 
Manage Participants (Eos Online Help)
the previous four months if required.
NOTE What if the Care Indicator has not been up-
3.1 Log review application - levy decision
dated in the previous four months?
Resolution Coordinator
Contact the decision maker (DM) and their Team 
Manager (TM) using the Client Care Indicator 
a In the Levy Spreadsheet, \\ACCfiles\Data\Public
Template to update the Care Indicator.
\Resolution Services Folder\8. Hub Folders\8.3 Wel-
lington\Levy Review Spreadsheet, start the Review 
Email Template - update Client Care Indicator
Process workflow.
Care indicated clients
NOTE What information needs to be included?
l Add a colour category or tick to the email once it has 
• Review Specialist name
been actioned.
• ACC number
• Review number
• Review issue
3.0 Log review application - decision on a claim
• Date of ACC decision
• Date review application received
Resolution Coordinator
a
b In the I:Drive, set up the customer folder in \\ACCfiles
In Eos, start the [Review Process] workflow through the 
\Data\Public\Resolution Services Folder\8. Hub Folders
[PRC REV: Receive & Log Review] task.
\8.3 Wellington\Levy Reviews
NOTE What information needs to be included?
NOTE What should be stored in the folder?
• lodgement date (date ACC received the appli-
• The type of application i.e. Classification Units, 
cation)
CPX. Multiple CU.
• name of applicant
• A sub folder with the Review number, Customer 
• decision category (in the decision letter)
name, ACC number
• code description
• The application for review
• disputed decision date
• business unit responsible or where the decision 
c In Juno_CRM, add a flag to the customer's account. The 
was made.
comment in the flag is 'active review'.
Review Codes.docx
Create a Flag
Create PRC REV task
d In Juno_CRM, create an interaction and upload the appli-
b
cation, ACC1766 Giving access to your ACC Information 
Close the task after the above information has been 
(if applicable), and any other supporting documentation.
populated to generate the next task in the COG.
c Upload the review application, Authority to Act (if appli-
cable) and any other supporting documentation and use 
3.2 Log review application - vehicle registration 
the correct naming conventions.
decision
Resolution Coordinator
a In the Levy Spreadsheet, start the Review Process 
workflow.
NOTE What information needs to be included?
• Review Specialist name
• Vehicle registration number
Naming Conventions.JPG
• Review number
• Review issue
NOTE What needs to happen to the documents so 
• Date of the decision
that they can be uploaded correctly?
• Date review application received
• If an application form (ACC33) was received by 
email, convert the email message to a PDF file, 
b In the I:Drive, set up the customer folder in \\ACCfiles
and attach this to the front of the application. 
\Data\Public\Resolution Services Folder\8. Hub Folders
This will be the official date stamp.
\8.3 Wellington\Levy Reviews
• If an application was received by post and has 
no date stamp, use the Adobe Pro watermark 
feature to add a watermark.
• If an ATA document is attached and combined 
with a review application, these will need to be 
uploaded separately.
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Receive, Log and Allocate Review Application
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GOV-027790 Appendix 1
NOTE What should be stored in the folder?
NOTE What should be recorded on the 'Complete 
 
• The type of application i.e. vehicle registration 
Request for Copy of Clients Information' 
decision.
task?
• A sub folder with the Review number, Customer 
Record 'Privacy Act Request received via (email/
name, Vehicle registration number.
ACC33/client letter) on (insert date).
• The application for review and a copy of the 
letter from the NZTA.
6.0 Allocate the Review Application to a Review 
Specialist
4.0 Acknowledge the Review Application
Resolution Coordinator
Resolution Coordinator
a In the Resolution Coordinator Calculator tool, enter de-
a Check that the application has been received within the 
tails.
three-month timeframe.
Review Allocation Calculator
NOTE What if the application was received outside 
the three-month timeframe?
NOTE What details should be entered?
Generate the Acknowledgement of a review 
• Customer Name
application letter (REV18) to the applicant and 
•The review number that has been generated 
select the option that explains that a review spe-
from Eos, or the Levy Spreadsheet
cialist will be in contact to discuss the reasons 
•The date the review was received
the review application was late.
•Whether this is a privacy act request
•Whether the review was lodged outside the 
NOTE What if it is not clear that the review was 
three-month time frame
lodged within the three-month timeframe?
•Whether the customer has a representative/
• Allocate the review application to the selected 
advocate and a current Authority to Act on file (or 
Review Specialist and notify them in the allo-
is being requested)
cation task that is has not been established 
•Any interested parties – such as an employer
whether the application is late.
b
• Also advise the Review Specialist that they will 
Copy the information generated in the calculator tool and 
need to update and send the Acknowledgement 
paste into the PRC REV: Complete Admin Review task if 
of a review application letter (REV18) once they 
the review is about a decision on a claim in Eos.
have established if the application is late or not.
NOTE What if the review is about a levy decision?
b Generate the REV18 Acknowledgement of a review 
Copy the information generated in the calculator 
application letter to the applicant, and if in Eos leave the 
tool and paste into an email, along with the 
document as incomplete.
review application email and supporting docu-
ments and send to the allocated Review Spe-
REV18 - Acknowledge Review
cialist.
REV50 - Acknowledge review application - Levy 
(Business)
The process ends.
NOTE What if the review is reopened review as a 
c Mark the task as a high priority, change the target date of 
result of a settled appeal or court decision?
the task to ‘todays date’ and transfer to the allocator's 
Tailor the Rev18 'Acknowledge of review appli-
work queue who will allocate the work out to the Review 
cation' to state something similar to:
Specialist.
"Further to the settlement agreement of XX date 
NOTE What if the review relates to a decision made 
- we have now reopened the review and allo-
under the Code of Claimant Rights?
cated the following review number: "
In these cases the review allocation is sent to 
c Check to see whether there is an interested party to the 
Jessica Sharma or Hope Krause from the Ham-
review.
ilton Review Team.
NOTE Who are interested parties?
• Employers are interested parties where the 
PROCESS
Complete Background Review
client (employee) has put in a review to chal-
Review Specialist
lenge the decline of cover for a work related 
PICBA and WRGPDI.
• Clients are interested parties where the em-
ployer has lodged a work injury dispute review.
NOTE What if there is an interested party?
Generate REV021 Acknowledgement to Inter-
ested Party to notify the interested party of the 
application.
REV21 Acknowledge review to interested party
5.0 Check for Privacy Act request
Resolution Coordinator
a Read through the information submitted and identify 
whether the client has requested a full copy file.
b In Eos, complete a 'Complete Request for Copy of 
Clients Information' task if a full copy file was requested.
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Receive, Log and Allocate Review Application
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GOV-027790 Appendix 1
Prepare and Attend Review Hearing (RH) v19.0
 
Linked Process
Implement Resolution Outcomes
3.0
Attend review hearing
2.0
Send review submission to all parties
rite review
1.0
W hearing submission
Attend
Linked Process
Prepare and  Case Conference (CC)
Attend ive
Alterna
Linked Process
Prepare and  an  Dispute Resolution (ADR)
Review Specialist
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Prepare and Attend Review Hearing (RH)
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GOV-027790 Appendix 1
Prepare and Attend Review Hearing (RH) v19.0
 
b If the review is about a decision on a claim, in Eos, use 
Summary
the email tool set to send the submissions document to 
all parties.
Objective
NOTE What is the required timeframe for sending 
To attend a review hearing, on ACC’s behalf, to provide submis-
submissions?
sions pertaining to the matter at review and the reasons for 
ACC has a contractual agreement that the 
ACC’s decision.
submissions will be sent 14 days prior to the 
Background
hearing taking place.
A review hearing will provide ACC and the customer/
NOTE What if you are expecting new information 
representative with an outcome that is binding between the cus-
within 14 days of the hearing (therefore 
tomer and ACC.
potentially changing your submissions)?
Owner
ACC's expectation is that the submission will be 
[Out of 
Scope]
sent 14 day prior to the hearing date. If new 
Expert
[Out of Scope]
information is received after the submissions are 
sent the Review Specialist must provide either 
Procedure
an amendment (if your position has changed) or 
an addendum (if the new information adds to 
ACC previously stated position).
PROCESS
Prepare and Attend an Alternative 
Dispute Resolution (ADR)
Always ensure all new information (including re-
Review Specialist
vised submissions) are sent prior to the hearing 
for the client/representative to consider to mini-
mise the likelihood of an adjournment.
PROCESS
Prepare and Attend Case Confe-
NOTE Who are all parties?
rence (CC)
This includes:
Review Specialist
• the review provider
• the customer/representative
• interested parties
1.0 Write review hearing submission
NOTE Who are interested parties?
Review Specialist
• Employers are interested parties where the 
a Complete the review submissions.
client (employee) has put in a review to chal-
NOTE What information should be included?
lenge the decline of cover for a work related 
PICBA and WRGPDI.
• Background of the issue
• Clients are interested parties where the em-
• Relevant legislation
ployer has lodged a work injury dispute review.
• Relevant case law
• ACC's position
NOTE What if the customer/representative does not 
b
have an email address?
If the review is about a decision on a claim, in Eos, 
upload the submissions and change the document code 
Print the documents and send them to the 
to 'REV - ACC2199 - ACC Submissions - Review Appeal' 
necessary parties.
and the document description to the unique review iden-
tifier.
If you are working from home and this is not 
possible, please communicate with a colleague 
c If the review is about a levy, complete the submissions 
residing in the office or your Resolutions Man-
and save them to the customer folder.
ager to ensure this task can be completed within 
d Use judgement to consider having the written submis-
the required timeframe.
sions peer reviewed by a colleague, senior resolution 
c If the review is about a levy, email the submissions to all 
specialist or a technical specialist.
parties, and save email as an interaction in Juno_CRM.
e Read the review hearings rules policy to help understand 
NOTE What if the customer/representative does not 
more about review hearings.
have an email address?
Review Hearing Rules Policy
Post the submissions to the customer/
representative and save a scanned copy in a 
Juno_CRM interaction.
2.0 Send review submission to all parties
d Ensure any new information (since the last bulk print) 
Review Specialist
relevant to the review has been sent to all parties prior to 
a Check Eos and ensure that the client care indicator has 
the hearing (eg CAP comment, newly obtained medical 
not been activated since the ACC6239 was sent to the 
notes).
review provider.
NOTE What if the client care indicator was already 
3.0 Attend review hearing
active but it hasn't been updated in the last 
Review Specialist
six months?
Contact the decision maker (DM) and their Team 
a Consider who from ACC should attend the hearing.
Manager (TM) using the Client Care Indicator 
Template to update the Care Indicator.
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Prepare and Attend Review Hearing (RH)
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GOV-027790 Appendix 1
NOTE Who from ACC should you consider?
NOTE What if the reviewer requests costs outside 
 
Consider:
of the regulated amount?
• decision maker
This is outside of the Review Specialist dele-
• TAS
gation and must refer to a Senior Review Spe-
• any other ACC expert (eg technical specialist, 
cialist or Resolution Manager for consideration.
medical advisor, etc).
This would most likely be in cases whereby 
Reference Guide for Review Specialists when decid-
travel costs to the hearing are outside of the 
ing whether to refer a task to Technical Accounting 
regulated amounts.
Specialist (TAS)
b
e Complete the [PRC REV Hearing Requested] e-form 
Dial into the tele/video conference or attend in person.
after the hearing is concluded, and close this task.
Arrange Face to Face Client Meeting - Health and 
f Update the task information in the subsequent [PRC REV 
Safety Requirements
Record Review Outcome] to say "Awaiting Outcome" and 
NOTE Where can face to face hearings be held?
note the date of the hearing. Update the target date to 28 
• Whangarei
days after the hearing date and transfer the task to the 
• Auckland
'Hamilton SC - Quality Assurance' queue.
• Hawkes Bay (Hastings/Napier)
• Hamilton
• New Plymouth
PROCESS
Implement Resolution Outcomes
• Wellington
Review Specialist
• Blenheim/Nelson
• Christchurch
• Dunedin.
Zoom Meeting Guide
c Answer any questions asked by the review provider.
NOTE What happens at the hearing?
• The customer/representative will outline their 
case.
• The reviewer will ask clarifying questions of the 
customer/representative.
• ACC will present their case and submissions.
• The reviewer will ask clarifying questions of 
ACC.
• ACC will be offered the opportunity to cross ex-
amine the customer/representative.
• The customer/representative will summarise 
their case and provide submissions.
NOTE What if you want to view the same file that 
was sent to the client/advocate and provider?
A copy of the file that was sent to all parties is 
available for you to view in the CIR Shared 
Portal
Client Info Requests - Shared Portal
NOTE What happens if the reviewer adjourns the 
hearing?
The customer/representative and Resolution 
Services will agree on actions to be taken.
If the review is about a decision on a claim, 
update the Hearing Request task to provide the 
reasons for the adjournment. The review will 
remain allocated to the Review Specialist until 
the hearing is closed.
Adjournments Policy
d Approve costs within the Review Specialist delegation 
when called upon by the Reviewer, using the delegation 
levels in 7.10 Mediation, review and appeal on Te 
Whāriki.
7.10 Mediation, review and appeal (Te Whāriki)
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews  > Prepare and Attend Review Hearing (RH)
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GOV-027790 Appendix 1
Reference Guide 
Proceed to hearing tasks in Eos 
When to use 
Use this reference guide if you have determined by day 4 that the review application needs to proceed to 
a hearing.  
Instructions 
1. From the PRC REV: Complete an Admin Review task, click the Add. Info tab.
2. Click Change.
CMS ID: ts161009 
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1 November 2018 

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GOV-027790 Appendix 1
 
3.  Edit the information, then click OK. 
 
 
 
4.  Click Close Task. 
 
 
 
 
 
 
 
CMS ID: ts161009 
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1 November 2018 

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GOV-027790 Appendix 1
   
5.  Select the next step, Pending Review Hearing, then the reason New Review Process 
Received and then click OK. 
 
 
Result: The following two tasks will generate, the: 
•  PRC REV: Prepare Submissions task  
•  PRC REV: Prepare Documentation task.  
 
6.  Open the PRC REV: Prepare Documentation task.  
 
Using the Calculator tool, enter the correct information for a review that is Proceeding to 
Hearing. (You can save a copy of the calculator tool to your desktop.) 
 
Link to calculator tool folder:  
W:\Public\Resolution Services Folder\8. Hub Folders\Templates and tools 
 
File name: 28-45 Day Task Calculator.xlsx 
 
Update the target date using the date given for 28 days in the calculator tool. Update the 
information for the RC. 
 
CMS ID: ts161009 
Page 3 of 4 
1 November 2018 

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GOV-027790 Appendix 1
   
7.  Transfer the PRC REV: Prepare Documentation task to Client Information Requests.  
 
 
8.  Open the PRC REV: Prepare Submissions task and copy the information from the calculator 
tool to this task.  This will be your working task using the information and dates to ensure you 
meet all timeframes. 
 
 
CMS ID: ts161009 
Page 4 of 4 
1 November 2018 

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Document Outline

• GOV-027790 Appendix.pdf
• ACC review task

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