Code of Conduct 
POLICY 
1.0.0 
NUMBER 
TOPIC 
Code of Conduct 
OWNER 
Deputy Chief Executive - People and Culture 
DATE 
8 September 2022 
APPROVED 
APPROVER 
Board 
DATE OF 
8 September 2025 
NEXT 
REVIEW 
1  Code Statement 
ACC  is  charged  with  the  implementation  of  the  Accident  Compensation  Act  2001.  In  fulfilling  this 
duty, ACC’s vision is to create a unique partnership with every New Zealander, improving their quality 
of life by minimising the incidence and impact of injury.   
As  a  Crown  entity,  ACC  is  part  of  the  Public  Sector  and  contributes  to  building  the  trust  and 
confidence of citizens in the institutions of government. 
All  Public  Sector  organisations  are  expected  to  work  with  a  spirit  of  service  to  the  community,  to 
make our services accessible and effective to those who need them, and to strive to make a positive 
difference to the wellbeing of New Zealanders. 
Everyone who works for ACC has an important role to play in making sure we achieve our vision, 
and in ensuring we maintain our reputation and standing in the perception of the public. Our actions 
and behaviours must be consistent with these expectations at all times. 
2  Objective 
This Code governs the behaviours of all employees of ACC, to enable us to meet the expectations 
placed  upon  us  as  a  Crown  Entity.  These  standards  are  based  on the  standards that  apply to  all 
Public Servants, detailed in the  Te Kawa Mataaho Standards of Integrity and Conduct. 
The Code of Conduct: 
• can be used to provide coaching on appropriate conduct
• enables recognition of those who model the desired standard of conduct
• reflects and reinforces the ACC values and behaviour required
• outlines inappropriate behaviour and its consequences.
Accident Compensation Corporation 
Page 1 of 8 

---

Code of Conduct 
8 September 2022 
3  Scope 
All  ACC  employees  and  contractors  are  expected  to  maintain  the  highest  standards  of  integrity, 
discretion and ethical conduct when performing duties or representing ACC in any way. 
All employees of ACC must read, understand, and follow our Code of Conduct. 
4  Code standards 
You are expected to exercise good judgement to determine what action to take in a given situation. 
Your actions need to be able to withstand scrutiny from internal and external parties. Our behaviour 
and actions must be seen to be fair, impartial, responsible and trustworthy at all times. 
In order to achieve the high standards of behaviour expected of us, as an employee or contractor 
you must: 
Be honest and act with integrity. 
In all aspects of your employment (e.g. in your work with clients and levy payers, with regard to work 
attendance, requests for financial reimbursement, use of sick leave etc). 
Respect the rights of others. 
• Treat others fairly, courteously, equally, and without discrimination or harassment
• Uphold the rights of clients, as specified in the Code of ACC Claimants’ Rights.
• Respect and respond to all cultures, values and beliefs, particularly Māori and minority groups
• Promote the principles of Equal employment opportunity.
Perform your duties to the best of your ability. 
• Prioritise your primary role as an ACC employee over any secondary interests, commitments,
values  or  beliefs  you  hold  personally,  and  declare  any  potential  Conflict  of  interest
immediately.
• Show commitment to a high quality of work.
• Adhere to the ACC Health, Safety and Wellbeing policy in all areas of work.
• Comply with all ACC policies, processes and standards
• Model and demonstrate ACC values and behaviours, which underpin decisions about what
we do, and how we operate and behave
• Comply with the code of any professional body that you are registered or affiliated with, where
this impacts upon your work with ACC
• Show initiative and creativity when resolving problems, seek to maximise productivity, and
identify opportunities for improvement
• Make  decisions  appropriate  to  your  role  and  be  responsible  for  those  decisions  and  the
actions that result from them
• Be  supportive  of  changes  made  by  ACC,  as  change  is  necessary  for  the  organisation’s
success
• Be supportive of your colleagues and accept your responsibilities as a team member
Accident Compensation Corporation 
Page 2 of 8 

---

Code of Conduct 
8 September 2022 
•  Manage your personal and workplace relationships appropriately so they do not adversely 
affect your work. 
Uphold the reputation and standing of ACC. 
•  Act with integrity in any personal dealings you may have with ACC as a client 
•  Obtain  your  manager’s  approval  before  commencing  any  activity,  business  interest  or 
employment that has the potential to conflict with ACC business (e.g. acting as an advocate 
for a client, undertaking secondary employment) 
•  Ensure your behaviour in relation to gifts and gratuities, managing contracts and purchasing, 
and  other  sensitive  expenditure  does  not  compromise  (or  appear  to  compromise)  your 
personal integrity or ACC’s. 
•  Maintain appropriate professional behaviour when travelling on ACC business 
•  Maintain appropriate professional behaviour in any situation where you may be perceived as 
representing ACC. 
•  Have an appropriate standard of dress 
•  Engage with the Media team about any media enquiries you receive. 
•  Ensure that your behaviour will not bring ACC into disrepute. 
•  Advise your manager of any convictions or charges laid against you whilst employed by ACC.  
•  Maintain appropriate boundaries and relationships with clients and any other people you may 
work with. 
Act in a politically neutral manner. 
•  Ensure that your behaviour maintains Ministerial and public confidence in the impartiality of 
advice given and actions taken 
•  Ensure that your comments do not bring ACC or the Minister into disrepute, or compromise 
the perception of ACC as politically neutral (e.g. stating or implying your personal view on an 
issue as ACC’s view) 
•  Ensure that your personal participation in political matters does not conflict with (or appear to 
conflict with) your duty to act in a politically neutral manner. 
Use ACC information and property appropriately. 
•  Be responsible for the security and confidentiality of all information that you deal with during 
your employment with ACC 
•  Use financial and non-financial information gathered by ACC and your knowledge of ACC’s 
systems and processes only to perform ACC’s business 
•  Treat all ACC assets and property with care and respect 
•  Respect  the  privacy  of  ACC’s  clients,  staff,  and  stakeholders  and  keep  their  personal 
information confidential 
•  Take all reasonable steps to protect the privacy of our clients, customers, employees and 
other stakeholders 
•  Only  access  client,  colleague,  and  stakeholder  personal  information  for  ACC  purposes 
related to your role (in particular, do not access information for non-work purposes) 
 
Accident Compensation Corporation 
Page 3 of 8 

---

Code of Conduct 
8 September 2022 
• Report any actual or potential privacy breaches to your manager immediately.
Act within the law. 
• In particular, the Accident Compensation Act 2001, Official Information Act 1982, Privacy Act
2020, Health Information Privacy Code 2020, Human Rights Act 1993, Employment Relations
Act 2000 and any other relevant legislation.
5  Accountabilities 
The Deputy Chief Executive - People and Culture is responsible for ensuring organisational controls 
are in place in support of this policy. 
6  Roles and Responsibilities 
Role: 
Responsibility 
Employees 
• Read, understand and follow this Code of Conduct.
• Undertake training or confirm your understanding of the Code of Conduct when
requested by ACC
• Remain up to date with the current Code of Conduct expectations.
• Discuss any concerns about what may be considered unacceptable behaviour
with your manager.
• Discuss with your manager before you take any course of action that you are
not entirely sure falls within the bounds of acceptable behaviour.
• If you believe someone in ACC is acting unethically, or has been involved in
serious wrongdoing, you should report this confidentially through OK2Say and
receive protection under the Protected Disclosure Act. For more information,
visit Making a protected disclosure.
Contractors 
• Maintain the highest standards of integrity, discretion and ethical conduct when
performing duties or representing ACC in any way.
Managers 
Managers are representatives of ACC both when dealing with external customers 
or stakeholders, and when dealing with internal employees and contractors. 
Managers have a lead role in establishing and promoting our expected standards 
of behaviour and integrity. Managers are expected to conduct their behaviour, 
actions and decisions consistently with their duty to be fair, impartial, trustworthy 
and responsible at all times. 
As a manager you are expected to: 
• establish and promote ACC’s expected standards of behaviour and integrity
• consider your behaviour, actions and decisions in terms of the expectation to be
fair, impartial, trustworthy and responsible at all times
• manage employees in accordance with the Code of Conduct, and any other
ACC policies, processes, standards and systems in place to support you as a
manager (e.g. development programme, performance management processes)
• lead, model and promote the expected standards of behaviour and integrity
within the Code of Conduct and other internal policies and processes
• provide employees with education and coaching on expected standards of
behaviour and integrity where needed
Accident Compensation Corporation 
Page 4 of 8 

---

Code of Conduct 
8 September 2022 
• represent ACC positively when interacting with staff, and deliver our policies,
changes, initiatives or decisions in a manner consistent with ACC’s intentions
• take ultimate responsibility for work quality, actions and decisions of employees
in your team by addressing concerns
• manage within your capabilities and take ownership of your own development,
and that of your team
• manage within the delegated authorities framework as specified in the
Delegations Manual
Deputy Chief 
• Monitor the effectiveness of the Code of Conduct
Executive - 
• Ensure organisational controls are in place in support of this policy
People and 
Culture 
Executive 
• Model the highest standard of behaviours according to this Code of Conduct
• Ensure Code of Conduct behaviours are integrated into all aspects of ACC
business
Board 
• Approve the Code of Conduct and ensure it is consistent with ACC’s strategic
direction.
7  Monitoring and Oversight 
Lines of 
Role 
Monitoring & Oversight 
Assurance: 
1st Line 
Employees 
• Employees are expected to comply with the Code of Conduct.
and 
• Managers make employees aware of the Code of Conduct and
Managers 
monitor compliance.
2nd Line 
People & 
• The People and Culture Group oversees overall compliance with
Culture 
this policy and obtains feedback on its effectiveness.
Group 
• The Employment Relations Team provides oversight of
employment relations issues, including those relating to breaches
of the Code of Conduct to ensure that proper procedures are
followed.
3rd Line 
Assurance 
• Third line functions provide independent information on the overall
effectiveness of the Code of Conduct.
• This includes Assurance Services’ schedule of continuous
assurance activities for People and Culture processes and
assessment of our compliance with obligations.
4th Line 
Executive 
• The Chief Executive and Deputy Chief Executives have overall
responsibility for ensuring compliance with Code of Conduct
policies and processes.
5th Line 
Board 
• The Board approves the Code of Conduct and ensure it is
consistent with ACC’s strategic direction.
Accident Compensation Corporation 
Page 5 of 8 

---

Code of Conduct 
8 September 2022 
8  Breaches of Policy 
Our Code of Conduct requires our people to comply with all our policies. Breaches of this policy may 
result in disciplinary action. 
Behaviour or actions that are investigated and found to be in breach of the Code of Conduct may 
result in disciplinary action. Where breaches are found, ACC’s Disciplinary procedure will be followed 
and the employee will have an opportunity to provide an explanation for their actions or behaviours 
and have the right to representation. 
The action taken will depend on the severity of the breach: 
•  Breaches  of  the  Code  of  Conduct  that  are  deemed  'misconduct'  may  lead  to  disciplinary 
action up to and including a final warning. 
•  Breaches  of  the  Code  of  Conduct  that  are  deemed  'serious  misconduct'  may  lead  to 
disciplinary action up to and including summary dismissal. Summary dismissal is termination 
of employment without notice or prior warnings. 
If any breaches normally considered to be misconduct are very serious or repeated, these may be 
deemed serious misconduct. 
Misconduct 
Misconduct  occurs  when  an  employee  does  something  wrong  (namely,  breaches  this  Code  of 
Conduct or other ACC policy) either by: doing something, omitting to do something, or through their 
behaviour.  
The  lists  below  of  actions  considered  to  be  misconduct  or  serious  misconduct  are  intended  as  a 
guide for employees, and are examples only. They do not constitute an exhaustive list of breaches 
of the Code of Conduct.  
Examples of misconduct include: 
•  Any act of negligence harming ACC 
•  Disobeying a lawful and reasonable instruction from a manager 
•  Failure to meet the standards of performance and behaviour expected of ACC employees 
•  Inappropriate behaviour or relationships 
•  Any action which may in any way damage the relationship of trust and confidence between 
ACC and government, other agencies or the community 
•  Allowing unauthorised access to, or disclosure of, any matter or information in relation to ACC 
business 
•  Misuse of ACC internet and/or email systems 
•  Inappropriate use of purchasing card or expenses 
•  Absence from duty or place of work without proper reason or authorisation 
•  Repeated lateness for work, or repeated absenteeism without just cause 
•  Failure to comply with any ACC policy or procedure 
•  Any behaviour of a similar type. 
 
 
 
Accident Compensation Corporation 
Page 6 of 8 

---

Code of Conduct 
8 September 2022 
Serious misconduct 
Serious misconduct occurs when the misconduct could have the effect of destroying or undermining 
the relationship of trust and confidence between an employee and employer.  
Examples of serious misconduct include: 
• Dishonesty
• Theft
• Fraud
• Handling a claim relating to oneself, a relative, acquaintance or friend without the express
approval of the manager, or taking a role as an advocate for a client without approval
• Corruption – accepting a bribe, inducement, reward or gift, or complying with a request or
threat to use your position  to provide a benefit to any person or third party, which has the
effect  of  allowing  inappropriate  activity  or  compromising  the  impartial  performance  of  your
duties
• Failure  to  declare  any  activity,  business  interest  or  employment  that  has  the  potential  to
conflict with ACC business
• Accessing  ACC  information  relating  to  family,  friends,  acquaintances  or  clients  without
legitimate cause
• Criminal conviction leading to imprisonment or adversely affecting your ability to carry out
your work.
• Misuse  or  unauthorised  possession  or  sharing  of  ACC  property  and/or  information  (e.g.
misuse of financial information or client information)
• Harassment of anyone you work with (e.g. client, employee, contractor)
• Abusive or discriminatory statements or practices
• Assaulting or abusing another person
• Allowing  work  performance  to  be  affected  by  drug,  alcohol  or  substance abuse  (including
abuse during work hours)
• Dangerous or unsafe work practices, including non-compliance with ACC Health and safety
policies, and Health and Safety legislation
• Any act that has the potential to bring ACC into disrepute
• Significant failure to comply with any ACC policy or procedural requirements
• Any behaviour of a similar type.
9  Contacts 
Contact HR Help regarding this policy. 
10  References 
Te Kawa Mataaho Standards of integrity and conduct 
Policies: 
Respectful and Inclusive Workplace 
Conflict of interest 
Accident Compensation Corporation 
Page 7 of 8 

---

Code of Conduct 
8 September 2022 
Protected disclosure 
Equal employment opportunity 
Sensitive expenditure 
Health, Safety and Wellbeing 
Information security 
Use of the Internet 
Email and instant messaging  
Media 
Social media 
Privacy 
Procurement 
Corporate Delegations 
11  Policy review dates 
Last review: 8 September 2022 
Next review: [ ] 
Accident Compensation Corporation 
Page 8 of 8 

---

Manage access to Staff Claims v4.0
Outputs
riggers & Inputs
T
1.0
Assess requirements for access
2.0
Request access
3.0
Review request
Third Party
-
Third Party
-
Advisor 
Team Leader
ACC Staff Member
Business 
Administration
Team Leader 
Administration
ACC > Human Resource Management > Manage Onboarding > Manage access to Staff Claims
Uncontrolled Copy Only : Version 4.0 : Last Edited Thursday, 29 June 2023 9:25 AM : Printed Friday, 22 September 2023 8:44 AM
Page 1 of 2

---

Seek Internal Guidance v127.0
Outputs
5.0
Provide and Review feedback
ritten
4.0
Action Hotline Guidance
4.1
Action W Guidance
ritten
Hotline
W
-
-
Linked Process
Provide Internal Guidance 
Linked Process
Provide Internal Guidance 
ritten
3.0
Request Hotline Guidance
3.1
Request W Guidance
ype
T
2.0
Determine Appropriate  of Guidance
-Service
riggers & Inputs
T
1.0
Complete Self Guidance
Assessor
Assessor
orkflow
Assessor
Assessor
eam Member
eam Member
eam Member
eam Member
Administrator
Assessor
eam Member
eam Member
Advisor
riage and W
Assessor
Assessor
reatment and Support 
reatment and Support 
Cover 
Recovery 
Recovery T
Specialist Cover 
T
Cover 
Recovery T
Specialist Cover 
T
Clinical T
Payments 
Practice Mentor
Privacy 
Technical T
Clinical T
Senior T
Coordinator
Technical T
ACC > Claims Management > Manage Claims > Gather Additional Information or Advice > Seek Internal Guidance
Uncontrolled Copy Only : Version 127.0 : Last Edited Friday, 8 September 2023 12:14 PM : Printed Monday, 25 September 2023 10:42 AM
Page 1 of 8

---

Seek Internal Guidance v127.0
NOTE What if you need additional guidelines, tools 
Summary
and information to support case manage-
ment?
Objective
Refer to the Te Whāriki site to search.
To assist in making decisions by receiving internal specialist 
Te Whāriki Home Page
guidance from a number of different areas:
NOTE What if you need to obtain approval for ser-
• Clinical Services
vices/costs outside of your delegation?
• Technical Services
Refer to the Delegations Framework to deter-
• Practice Mentors
mine whether you can approve. If approval is 
• Payments
needed, refer to Activity 3.1 to Request Written 
• Technical Overpayments
Guidance
• Privacy
Delegations Framework
Background
c Attempt to problem solve the issue with your Team 
Seeking internal guidance is a three tiered process:
Leader prior to seeking guidance, and that you have put 
together a question that is appropriate for clinical or tech-
Tier 1 - Self-Service: Using the information available on Pro-
nical guidance.
mapp and Te Whāriki to make a decision
Tier 2 - Hotline Guidance: Guidance provided by a short (less 
NOTE What kind of query is considered not appro-
than 15 minutes) phone call
priate for clinical or technical services?
Tier 3 - Written Guidance: Comprehensive guidance provided 
Ensure you are not contacting an advisor or spe-
within a written guidance form in Salesforce, which creates a 
cialist asking "What are the next steps on a 
transcript in Eos
claim", or "Whether or not ACC can fund some-
[Out of Scope]
thing", you must attempt to provide more infor-
Owner
mation relevant to the client's injury.
Expert
Procedure
2.0 Determine Appropriate Type of Guidance
Cover Assessor, Recovery Administrator, Recovery 
1.0 Complete Self-Service Guidance
Team Member, Specialist Cover Assessor, Treatment 
Cover Assessor, Recovery Administrator, Recovery 
and Support Assessor
Team Member, Specialist Cover Assessor, Treatment 
a Use the Recovery Support Decision Tree tool linked 
and Support Assessor
below to determine what kind of guidance you need.
a Review the following on the client's claim:
Recovery Support Decision Tree
• claim history and current circumstances
NOTE What if you are still unsure what type of guid-
• read and consider relevant documents
ance is needed?
• check for and review previous guidance
Attempt to run through the decision tree tool 
• check for and review outstanding investigations
alongside your Team Leader. If you are still 
• check for outstanding reports and/or records
unsure, contact a Practice Mentor to discuss 
your issue and the best way forward.
b Refer to Promapp to check if next steps can be identified 
in using one or more of the following:
NOTE What if you need to request guidance on a 
Surgery claim?
• Process pages - having knowledge of the objective, 
If you require guidance on a Surgery claim, there 
background and expected outcome of the range of ser-
are two channels, ensure you use the decision 
vices provided by ACC could help you determine the next 
tree tool to determine which one to use:
steps to progress your client's recovery.
• For invoicing and coding queries that are 
appropriate for hotline guidance, email your 
• Policy pages - having knowledge of legislation, pay-
query to [email address]
ments and legal aspects of the services and supports 
• For written guidance queries:
provided by ACC could help you determine the next steps 
• If you are seeking guidance from a Principal 
to progress your client's recovery.
Clinical Advisor (CAP referral), refer to the CAP 
referral process document under activity 3.1 (a)
• Service pages - having knowledge of the services pro-
• For invoicing and coding queries that are 
vided by contracted Providers could help you determine 
appropriate for written guidance on a Surgery 
the next steps to progress your client's recovery.
claim, use the written guidance request form in 
Salesforce. Once you’ve submitted your guid-
NOTE What if you are trying to make a cover deci-
ance request, update the task description with 
sion?
the code “TACDUN”
Refer to the processes in the Make Cover Deci-
sion group in Promapp or refer to the Cover Traf-
fic Light tool to assist in determining cover for 
particular injuries or injury types.
Make Cover Decision
TOOL - Add or change diagnosis decision traffic light
ACC > Claims Management > Manage Claims > Gather Additional Information or Advice > Seek Internal Guidance
Uncontrolled Copy Only : Version 127.0 : Last Edited Friday, 8 September 2023 12:14 PM : Printed Monday, 25 September 2023 10:42 AM
Page 2 of 8

---

NOTE What if you are working in the Remote Claims 
b If calling from Genesys Cloud, call the 'Recovery Support' 
Unit or requiring guidance on a Staff claim or 
queue.
High Profile claim?
Refer to the knowledge article below on how to 
Otherwise, dial extension 50118 and select one of the fol-
request Hotline and Written Guidance for the 
lowing options:
above scenarios.
• Select option 1 for Clinical Services. You will then be 
For written guidance on a Staff claim, do not 
asked to select from the following options:
raise this in Salesforce, these tasks must be 
1 - for Clinical Advisors
created in Eos. Use the Written guidance tem-
2 - for Psychology Advisors - sensitive claims
plate below and refer to the system steps for 
3 - for Psychology Advisors - physical injuries
creating/sending the task.
4 - for Pharmaceutical Advisors
6 - for Sensitive Claim Medical Advisors
Remote claims, Staff and High Profile claims - Seek 
internal guidance
• Select option 2 for Technical Services. You will then be 
Written guidance template for non-Salesforce 
asked to select from the following options:
users.docx
1 - for Transport for Independence Specialists
2 - for Housing Modifications Specialists
NOTE What if a provider is requesting to speak di-
3 - for Technical Accounting Specialists
rectly with a Psychology Advisor?
4 - for Technical Specialists in relation to a Sensitive 
The following external Psychology hotline num-
Claim
bers can be shared with providers: Sensitive 
5 - for General Technical Specialists
claims: 09 354 8425 Physical injury: 09 354 8426
• Select option 3 for Practice Mentors.
This is for PROVIDERS ONLY and must not be 
released to clients.
• Select option 4 for Payments Assessors. You will then 
b Go to Activity 3.0 to request Hotline Guidance, or Activity 
be asked to select from the following options:
3.1 to request Written Guidance.
1 - Sensitive Claims Payments
2 - Travel
3 - All Other Client Reimbursements
4 - Payments Assessor
3.0 Request Hotline Guidance
Cover Assessor, Recovery Administrator, Recovery 
• Select option 5 for Privacy Advisors
Team Member, Specialist Cover Assessor, Treatment 
and Support Assessor
• Select option 6 for Client Administration Support related 
a Prepare for requesting guidance using ISBAR (Identify, 
to a physical injury
Situation, Background, Accident, Request). Continue to 
refer to the Recovery Support Decision Tree tool for addi-
• Select option 7 for Client Administration Support related 
tional things to remember/consider and tips for best prac-
to a mental injury
tice.
NOTE What if my query is regarding a mental injury 
claim?
Ensure you provide your full name when requesting hot-
line guidance.
All requests for guidance on mental injury claims 
must go to a Psychology Advisor.
NOTE What if the Hotline is not answered?
Keep trying the Hotline. If, after a few more at-
tempts, there is still no answer add a note to the 
task in Eos (or update the description in Sales-
force) and try again at your earliest convenience.
If you are working in Assisted Recovery, update 
the description to say "Attempt to call the Hotline 
again", before putting the task on hold so you 
can pull another one from the queue. Aim to 
complete any on hold tasks by the end of the 
Hotline ISBAR.PNG
day, taking them off hold and returning them to 
Recovery Support Decision Tree
the queue if you're unable to do so.
NOTE What if you need advice from a Practice 
Mentor about a Mental Injury (MI) claim?
Recovery Partners (MI) can book a 1x1 session 
with a Practice Mentor ahead of time using the 
link after this note.
If you need advice from a Practice Mentor right 
away you can call ring Recovery Support, select 
Option 3 and the Practice Mentor will take the 
claim number of the claim you need support on.
This will then be passed on to the Practice 
Mentor with Mental Injury capability to get in con-
tact with you.
Knowledge & Capability Bookings Calendar
c Go to activity 4.0 to action the Hotline Guidance.
ACC > Claims Management > Manage Claims > Gather Additional Information or Advice > Seek Internal Guidance
Uncontrolled Copy Only : Version 127.0 : Last Edited Friday, 8 September 2023 12:14 PM : Printed Monday, 25 September 2023 10:42 AM
Page 3 of 8

---

c In Salesforce, select the 'Recovery Support' tab and 
3.1 Request Written Guidance
'Create Guidance'. Follow the steps and complete the 
Cover Assessor, Recovery Team Member, Specialist 
fields on the written guidance form.
Cover Assessor, Treatment and Support Assessor
a
If there are relevant documents on file you want the ad-
Prepare for requesting guidance using ISBAR (Identify, 
visor/specialist to review, collate them into a document 
Situation, Background, Accident, Request). Refer to the 
group entitled 'Written Guidance document group' in Eos, 
Recovery Support Decision Tree tool for additional things 
and reference the name and date in the 'Documents or 
to remember/consider and tips for best practice.
contacts relating to the request' section. Ensure you also 
note if documents from multiple claims have been added 
The Decision Tree Tool references key medical infor-
to the group.
mation that must be on file prior to submitting a written 
guidance request, ensure you have attempted to request 
If there are relevant contacts on file you want the advisor/
this information. Clinical and Technical staff will not be 
specialist to review, ensure you specify the date and con-
able to provide written guidance if there is insufficient 
tact description in the 'Documents or contacts relating to 
information on file.
the request' section.
Recovery Support Decision Tree
If you need to add any particular information regarding 
NOTE What are the standards needed when seeking 
who the guidance request should go to (i.e. If this needs 
guidance?
to go to a specific specialist discipline), specify this infor-
Refer to the Standards for Seeking Guidance 
mation in the 'Triage Written Guidance' task description. 
and Written Guidance Questions below.
(This is located inside the 'information' heading, ensure 
Standards for Seeking Guidance
you save the change to the description)
Written Guidance Questions
NOTE What if the claim is for maternal birth injury?
Type "#MBI" in the 'information' heading of the 
NOTE What does a quality referral look like?
'Triage written guidance' task description.
Refer to the Written guidance example below.
Recovery Support FAQs.docx
Written guidance example
NOTE What priority should I select for my Written 
NOTE What if you need written guidance from a 
Guidance request?
Principal Clinical Advisor (PCA) for a Surgery 
Check the Written Guidance Priority Categories 
claim?
document to see whether or not your request 
Refer to the CAP referral process (SF) guide 
falls into one of the P1/P2 categories. Speak with 
below.
your Team Leader if you are unsure whether or 
CAP referral process (SF)
not a certain scenario falls into a P1/P2 category.
NOTE What if you need to request written guidance 
Written Guidance requests falling into a P1/P2 
where there is a CAP referral in progress?
category should be submitted as follows:
Call the Surgery team on 83566 to discuss 
• Select 'P1 - High' or 'P2 - Medium' under 
whether additional question(s) can be added to 
'What's the priority for this request?'
the existing CAP referral. Note: CAP will not 
• Select relevant drop down option under 'Why is 
answer questions regarding ongoing incapacity.
the request urgent?'
Principal Clinical Advisor consideration list
If your reason for escalation does not meet the 
Delegations Framework
P1/P2 categories, but your Team Leader agrees 
b Check the necessary supporting documents and infor-
your request should be escalated, then please 
mation is on the claim.
email with your Team Leader approval and 
reason for requesting escalation to:
NOTE What if there are documents and/or infor-
• For Clinical Guidance, [email address]
mation missing on the claim?
• For Technical Guidance, 
Refer to the Request Clinical Records process.
[email address]
PROCESS Request Clinical Records
Written Guidance requests not falling into a P1/
P2 category should be submitted as P3 - Low.
High and Medium Priority Categories for Written 
Guidance Requests
ACC > Claims Management > Manage Claims > Gather Additional Information or Advice > Seek Internal Guidance
Uncontrolled Copy Only : Version 127.0 : Last Edited Friday, 8 September 2023 12:14 PM : Printed Monday, 25 September 2023 10:42 AM
Page 4 of 8

---

NOTE What if you want to cancel, save as a draft, or 
NOTE What if you require written guidance on 
add additional information to your guidance 
disentitlement for a Wilfully Self-inflicted 
request?
(WSI)/suicide claim where evidence to sup-
• To cancel: Go to the guidance request you 
port a decision is unclear or there are tech-
have submitted and select 'Cancel Written Guid-
nical complexities which complicate the deci-
ance,' then provide a reason for cancellation (i.e. 
sion?
if other client information was entered in the re-
Request written guidance from a Psychology ad-
quest, select the reason as 'Cancelled due to 
visor. You need to create and fill out the relevant 
error').
sections on the ACC6178 (Disentitlement for 
Note - the information submitted in the form is 
WSI or suicide claims). Ensure you leave the 
not discoverable by the client until the written 
document as incomplete.
guidance has been accepted and a transcript is 
created in Eos, if you cancel, there will be no 
Complete the written guidance request form as 
record of it on the client's file
per the current process. Select the tick box for 
'Have one of the above ACC documents been 
• Save as draft: At the bottom of the written guid-
completed' and indicate in your summary 'Refer 
ance form select the tick box labelled ‘Save as 
to the ACC6178 document uploaded on XX/YY/
Draft’ then click 'Next', then when you are ready 
ZZZZ'.
to complete your guidance request, go back to 
the written guidance request in salesforce and 
The PA will then arrange a Complex Mental 
select ‘Edit Written Guidance’
Injury Panel (CMIP) comment via Technical Ser-
vices. Once the Psychology Advisor and CMIP 
If you are saving the request as a draft because 
have completed their comments in the ACC6178, 
you are awaiting some additional information:
complete these documents and action the 
recommendations.
For claims assessment staff - create a follow up 
Delegations Framework
task in Eos to revisit the draft guidance request 
once the information has been received
NOTE What if you require written guidance from a 
Technical Accounting Specialist?
For Recovery team members – create a re-
Refer to the following page for more information 
minder action in salesforce to revisit the draft 
on Technical accounting and what information 
guidance request once the information has been 
needs to be included with a written guidance re-
received
quest.
• If you need to add additional information to a 
NB: Due to the complexity of these requests 
Written Guidance request that has been sent to 
there is a 3 day Service Level Agreement for 
Triage or allocated to an advisor – select ‘Addi-
urgent (client is in financial distress) tasks and a 
tional Information to a Guidance request’ on the 
20 day Service Level Agreement for all other re-
guidance request in salesforce
quests.
NOTE What if you are a non-Salesforce user and 
PROCESS Referring to the Technical 
you require written guidance?
Accounting Specialists for 
Ensure you request your guidance via the 'Com-
Advice
plete Internal Referral' task and then transfer the 
NOTE What if you require guidance on a claim 
task into the Regional Clinical Advice - CEN-
where weekly compensation has been paid 
TRAL queue or the Operations Support queue.
for less than six months and you're consi-
dering suspending entitlements, as the cov-
Please use the referral template document 
ered injury has resolved?
below.
Submit written guidance to clinical only (there is 
Written guidance template for non-Salesforce 
no need to tick coordinated guidance). However, 
users.docx
if due to the complexity of the client or their situ-
ation, and technical guidance is still required, 
NOTE What if you require written guidance on a 
then tick the box for coordinated guidance.
claim not migrated to Salesforce?
There is a system error which means Recovery 
NOTE What if you are working on a claim that is in 
Team Members cannot access Salesforce in 
‘Actioned Cases’?
order to make referrals on very old claims.
Written Guidance must be requested on ‘active’ 
claim, you will need to transfer this into the 
For very old claims where you are unable to 
appropriate queue/name.
access Salesforce in order to make a request for 
d Go to Activity 4.1 'Action Written Guidance' once you 
clinical advice, please action the referral using 
have received your guidance.
the NGCM pathway (see below systems steps) 
on EOS and mark the task as “OLDER EOS 
CLAIM, SF unavailable”.
This label will ensure the Triage Team does not 
return the task due to being submitted in the 
wrong queue.
(NGCM) Create Request for Written Guidance
ACC > Claims Management > Manage Claims > Gather Additional Information or Advice > Seek Internal Guidance
Uncontrolled Copy Only : Version 127.0 : Last Edited Friday, 8 September 2023 12:14 PM : Printed Monday, 25 September 2023 10:42 AM
Page 5 of 8

---

NOTE What if you have already submitted your writ-
NOTE What if you want an Advisor, Specialist, or 
ten guidance request, and you need to 
Practice Mentor hotline comment to be re-
update the priority?
moved from file or amended?
If you have received new information that 
The only instances a clinical or technical com-
changes the priority of the request, complete the 
ment should be removed/ deleted is when the 
steps below:
guidance is on the wrong claim. In rare instances 
• Open the claim in Salesforce.
the Advisor may need to amend or add an 
• Click on the ‘Recovery Support’ tab and then 
addendum to the guidance. Only an Advisor’s or 
click on the relevant Guidance Number to open 
Specialist’s manager can delete their own com-
it.
ment, neither a frontline staff member or another 
• Now you should be on the ‘Details’ page. Click 
advisor can delete your comment.
on the ‘Update Guidance Priority’ button to 
change the priority of the request.
If the comment needs to be removed/amended 
• Check the Written Guidance Priority Categories 
ensure you reach out to the advisor or specialist 
document to see which category your request 
who provided the guidance and include their 
meets.
manager in the discussion.
• Select 'P1 - High' or 'P2 - Medium' under 
Receive Written Guidance (Recovery Team Member)
'What's the priority for this request?'
• Select the relevant drop-down P code option 
under 'Why is the request urgent?'
4.1 Action Written Guidance
If your reason for escalation does not meet the 
Cover Assessor, Recovery Team Member, Specialist 
P1/P2 categories, but your Team Leader agrees 
Cover Assessor, Treatment and Support Assessor
your request should be escalated, then please 
a In Salesforce, review the guidance provided on the Writ-
email with your Team Leader approval and 
ten Guidance request by selecting the 'details' tab.
reason for requesting escalation to:
• For Clinical Guidance, [email address]
NOTE What if you are requested to provide clari-
• For Technical Guidance, 
fication on a guidance request?
[email address]
If this is via IM or call, clarify the question directly 
with them.
High and Medium Priority Categories for Written 
Guidance Requests
If this is via Salesforce, open the Guidance Re-
NOTE How do you check the progress of the task?
quest and click 'Provide Clarification on Guid-
Click on the ‘Related’ tab and then click on the 
ance Request', read the clarification question 
open task number:
and provide the clarification. If you need to 
• If the guidance is still with the Triage team, it 
cancel or put the request on hold you can do this 
will be the ‘Triage Written Guidance request’ task 
at this step.
type.
• If it has already been triaged and allocated to 
If you need to request additional information in 
an Advisor queue, it will be the ‘Provide Written 
order to clarify the request, use the Request 
Guidance’ task type.
Clinical Records process. In Salesforce, extend 
the target date of the clarification task to later 
than the due date of the medical notes task. 
PROCESS
Provide Internal Guidance - Hotline
Ensure you update the task description to reflect 
you have requested additional information (if you 
Clinical Team Member, Payments Asses-
are in Assisted Recovery and are returning this 
sor, Practice Mentor, Privacy Advisor, 
to the queue, update the description when you 
Technical Team Member
do this).
NOTE What if the written guidance is on a claim not 
PROCESS
Provide Internal Guidance - Written
migrated to Salesforce?
Clinical Team Member, Senior Triage and 
For very old claims where you are unable to 
Workflow Coordinator, Technical Team 
access Salesforce in order to make a request for 
Member
clinical advice, a written guidance referral would 
have been actioned using the NGCM pathway in 
EOS.
4.0 Action Hotline Guidance
Cover Assessor, Recovery Administrator, Recovery 
- If you decide to accept the written guidance or 
Team Member, Specialist Cover Assessor, Treatment 
to ask for clarification on the written guidance 
and Support Assessor
provided, use the Review Written Guidance 
system steps below.
a Consider the advice documented by the Advisor, Spe-
cialist or Assessor and undertake the next steps.
- If the Advisor had asked for clarification within 
NOTE What if you need to clarify the guidance pro-
the written guidance, use the Respond to Clari-
vided by the Advisor, Specialist or Assessor?
fication Request from Advisor system steps 
Message or call the Advisor, Specialist or Asses-
below.
sor directly to clarify the guidance.
Receive Written Guidance (Recovery Team Member)
Respond to Clarification Request from Advisor 
(Recovery Team Member)
b Accept the guidance provided by selecting 'Accept Guid-
ance', or request clarification if required.
ACC > Claims Management > Manage Claims > Gather Additional Information or Advice > Seek Internal Guidance
Uncontrolled Copy Only : Version 127.0 : Last Edited Friday, 8 September 2023 12:14 PM : Printed Monday, 25 September 2023 10:42 AM
Page 6 of 8

---

NOTE What if the advice is unclear or the questions 
NOTE What if I'm unable to locate my Written Guid-
are unanswered?
ance request?
 
Select 'Clarification Required on Guidance Pro-
The Written Guidance process is a cog process 
vided' and input your clarification question(s).
meaning that when one action is completed it 
creates a new task in the process to be actioned.
NOTE What if you want an Advisor or Specialist's 
written guidance to be removed from file or 
For example: Once the triage process is com-
amended
pleted, the 'Triage Written Guidance' task will be 
Comments within a Written Guidance form 
closed and a 'Provide Written Guidance Task' is 
cannot be deleted or edited once the Advisor or 
automatically created which is then assigned to 
Specialist has submitted their guidance.
the appropriate advisor.
If the wrong client’s information has been in-
The instructional video below provides an over-
cluded, please cancel the guidance in Salesforce 
view of the Recovery Support Written Guidance 
and submit a new request.
process in Salesforce and EOS and support in 
NOTE What if your request for written guidance was 
locating the various tasks in this cog process.
related to transferring weekly compensation 
An overview of the Recovery Support Written Guid-
to a different claim for a further injury?
ance process in Salesforce and EOS
Return to 'Determine Transfer of Weekly 
Compensation to a new claim due to Further 
Injury' and continue the process.
5.0 Provide and Review feedback
PROCESS Determine Transfer of Weekly 
Cover Assessor, Recovery Administrator, Recovery 
Compensation to a new claim 
Team Member, Specialist Cover Assessor, Treatment 
due to Further Injury
and Support Assessor
Add an Eform
a If applicable, provide feedback on the guidance received.
c Once the guidance has been accepted a transcript will be 
NOTE How do you provide feedback on the Hotline 
created in Eos.
guidance you have received?
NOTE What if guidance indicates it's appropriate to 
In Salesforce, navigate to the Recovery Support 
suspend entitlements where weekly compen-
tab and select the ‘Provide Feedback’ option.
sation has been paid for less than six 
On the Provide Feedback form, complete the 
months, as the injury has resolved?
mandatory question and comments sections, 
Copy and complete the decision rationale tem-
and submit your feedback.
plate below and paste this into a NGCM General 
NOTE How do you provide feedback on written 
Task (in Eos). Assign it to a leader from your 
guidance?
hub. Message them to let them know it’s there.
When you accept the written guidance in Sales-
force, you will get the option to provide feedback, 
• Decision type SUSPEND ENTITLEMENTS 
select this option, and complete the mandatory 
DECISION
fields.
• Who was consulted [eg. Recovery Support hot-
line guidance from Practice Mentor received 
b If applicable, review feedback on the guidance request 
10/03/23 and Written guidance from Clinical Ad-
you submitted.
visor received 24/03/23]
NOTE What if you want to review some feedback 
• Rationale for the final decision [(e.g. Suspend 
you have received?
all entitlements as Clinical guidance has con-
firmed the client's covered injury has resolved) or 
You will be notified you have received feedback 
(Suspend all entitlements as Clinical guidance 
by getting an alert notification from the “bell” icon 
has confirmed the client's covered injury has re-
in Salesforce. If you select this you will be able to 
solved and the reason for ongoing incapacity is 
review the feedback.
non-injury related)]
Alternatively, if you select the nine dots in the top 
The leader will review and send the task back to 
left corner of the Salesforce window, and search 
you within 24 hours - with either their support or 
for “Feedback”, you can select this Feedback 
if they wish to discuss further.
option.
From here you can select the drop down arrow 
Once your Team Leader has endorsed the deci-
to show different list views which display feed-
sion, create a new Salesforce contact action and 
back from a range of dates.
copy the body of the NGCM General Task into 
the Outcome Summary of your Salesforce con-
tact. Close the NGCM General Task.
Follow the relevant steps in the below page for 
"Stop Supports".
PROCESS Stop Supports
NOTE What if guidance indicates I have sufficient 
information to issue a decision?
See the below page for "Issue Recovery Deci-
sion"
PROCESS Issue Recovery Decision
ACC > Claims Management > Manage Claims > Gather Additional Information or Advice > Seek Internal Guidance
Uncontrolled Copy Only : Version 127.0 : Last Edited Friday, 8 September 2023 12:14 PM : Printed Monday, 25 September 2023 10:42 AM
Page 7 of 8

---

NOTE What if you are a Team Leader and you want 
to subscribe to a feedback report?
 
Complete the steps below in Salesforce:
• Select 9 dots to the left of “Work Load Manage-
ment”
• Type in “Reports”
• Select “All Folders’ and then “Feedback Re-
ports”
• Open the new report “ My Team’s Feedback –
Last 7 days”
• Click the down arrow at the top right of the 
report and select subscribe
• Schedule when you want the report subscrip-
tion email e.g. 9am on a Monday every week.
Confirm recipient being added and run report as 
= “Me”
• Result will be an email to your inbox at that 
time/day, with a link to the report in Salesforce
• Last step will be to use the Team Leader filter, 
to narrow the results to your team members i.e. 
use the name your Salesforce user is set up with
ACC > Claims Management > Manage Claims > Gather Additional Information or Advice > Seek Internal Guidance
Uncontrolled Copy Only : Version 127.0 : Last Edited Friday, 8 September 2023 12:14 PM : Printed Monday, 25 September 2023 10:42 AM
Page 8 of 8

---

When to save emails in Eos Policy v16.0
 
Summary
Objective
If the client sends an email regarding a specific claim, upload it 
as a 'Contact' to that claim, otherwise upload it to Party level.
Uploading emails to the appropriate Party record:
• enables us to gather information more easily if the client re-
quests a review or appeal
• provides a date and time stamp
• provides context for the email
• helps us manage requests from clients for their personal infor-
mation
• provides greater integrity and accuracy of information
• provides a complete and accurate record of our contact with 
the client or party.
Exceptions - Email in EOS.PNG
Owner
[Out of Scope]
Expert
Policy
1.0 Rules
a You must upload all correspondence to the appropriate 
Party record in Eos, including emails to and from a client, 
provider or employer. This includes:
• general correspondence regarding our processes
• specific information about how we manage claims
• correspondence about the active management of a 
particular claim
• evidence of a decision or activity regarding the file, in-
cluding internal emails where the case is discussed.
Emails saved in Eos must be a complete record of 
correspondence with the client and include:
• the date and time it was sent
• the name of the sender and the receiver.
You must save all appropriate emails into Eos, regardless 
of the number of emails sent and received on a topic.
You must delete emails from Outlook once they have 
been saved into Eos.
You must secure all legally privileged information after 
uploading it to prevent the documents from printing when 
someone asks for a copy of their claim file.
Verify an Existing Provider, Vendor or Facility Email 
Address
File an inbound email (Te Whāriki)
Email and instant messaging policy (Te Pātaka)
2.0 Exceptions
a The attached table shows which email communications 
you are not required to save into Eos. If you're not sure 
whether to save an email into Eos, talk to your team 
manager.
ACC > Claims Management > Manage Client Information > Operational Policies > Communication > Email > When to save emails in Eos Policy
Uncontrolled Copy Only : Version 16.0 : Last Edited Thursday, 30 March 2023 12:59 PM : Printed Monday, 25 September 2023 10:43 AM
Page 1 of 1

---

 
012ÿ145640ÿ7058
9 ÿ
ÿ
 


ÿ

6
  !"

#ÿ
$
ÿ

%$
&
'$

(%ÿ
$
(ÿ
&
'(&
ÿ
$
)

ÿ
(*
ÿ
)ÿ
'(++%
')$

(%ÿ
,
$
ÿ
)%ÿ
-$
&
%)
ÿ
.)&
$
/ÿ
)ÿ
)ÿ
0(%$
)'$
1
0(%$
)'$
ÿ
)&
ÿ
ÿ
$
(ÿ
&
'(&
ÿ
$
)

ÿ
(*
ÿ
'(++%
')$

(%ÿ
,
$
ÿ
-$
&
%)
ÿ
.)&
$

1
ÿ
2
$
3
ÿ

+.(&
$
)%$
ÿ
$
(ÿ
&
'(&
ÿ
'(%$
)'$
ÿ
(ÿ
$
)$
ÿ
($
&
ÿ
$
)*
*
ÿ
++&
ÿ
)&
ÿ
)
ÿ
$
(ÿ
ÿ
)ÿ
(*
ÿ
$
ÿ
'(++%
')$

(%ÿ
&

)$

%4ÿ
$
(ÿ
)ÿ
'
)
+
(&
ÿ
.)&
$
/1
5(ÿ
')%ÿ
)
(ÿ
&
'(&
ÿ
$
)

ÿ
)($
ÿ

%$
&
%)
ÿ

'
(%ÿ
(&
ÿ
+$

%4ÿ
&

)$
ÿ
$
(ÿ
)ÿ
'
)
+ÿ
(&
ÿ
)ÿ
.)&
$
/6
ÿ

%4ÿ
$
ÿ
'(%$
)'$
ÿ
&
)(%ÿ
7
0(%$
)'$
ÿ
,
$
ÿ
2
%$
&
%)
ÿ
)&
$
/7
1
8%ÿ
)
%4ÿ
)ÿ
'(%$
)'$
ÿ
$
(ÿ
)ÿ
'
)
+6
ÿ
$
ÿ
'

%$
ÿ

ÿ
$
ÿ
*
)
$
ÿ
.)&
$
/ÿ
*
(&
ÿ
)ÿ
%,ÿ
'(%$
)'$

7 9ÿ
 :
9 ÿ
ÿ
;
"
<ÿ
= 
>$
.ÿ
?
@.%ÿ
$
ÿ
'
)
+ÿ
(&
ÿ
.)&
$
/ÿ
&
'(&
ÿ
)%ÿ
4(ÿ
$
(ÿ
$
ÿ
= Aÿ
$
)1
ÿ
0

'Bÿ
9 C
ÿ
Dÿ
0(%$
)'$
ÿ
$
&
(4ÿ
)&
$
/ÿ
E'(&
ÿ
F>?GH
9 ÿ
= ÿ
I  !JIÿ
=;
"
Kÿ
L2MNNOPO
>$
.ÿ

Q%$
&
ÿ
$
ÿ
'(%$
)'$
ÿ
$
)

1
>$
.ÿ

>
'$
ÿ
$
ÿ
 <A 6
ÿ
K<I ÿ
R
ÿ
 S
ÿ
! K<ÿ
T
"
R
ÿ
 <U!"
 < V
ÿ
)%ÿ
"
 <"
ÿ
*
&
(+ÿ
$
ÿ
&
(.W(,%ÿ


$
1
Fÿ
X
YZ
[\
][^_ÿ
Y[abÿ
cd_bef
ÿ
&
)(%ÿ
(
ÿ
ÿ

'$
ÿ
(%
/ÿ

*
ÿ
$
&
ÿ

ÿ
)ÿ
g)

ÿ
&
)(%ÿ
*
(&
ÿ
%($
ÿ

'
(
%4ÿ
)ÿ
'(%$
)'$
ÿ
)ÿ
.)&
$
ÿ
(*
ÿ
$
ÿ
.&

%$
ÿ
0
)
+ÿ
h

ÿ
&
.(&
$
6
ÿ
*
(&
ÿ
-)+.
ÿ
,%ÿ
+)%)4
%4ÿ
&

B/ÿ
'

%$
1
>ÿ
0(%$
)'$
ÿ
&
)(%ÿ
)%ÿ
&
'(++%ÿ
ÿ
*
(&
ÿ
+(&
ÿ

%*
(&
+)$

(%1
>$
.ÿ

Q%$
&
ÿ
$
ÿ
)$
ÿ
(&
ÿ
'

'Bÿ
(%ÿ
$
ÿ
')
%)&
ÿ

'(%ÿ
$
(ÿ

'$
ÿ
)ÿ
)$
ÿ
)%ÿ
'

'Bÿ
1iC
ÿ
0

'Bÿ
$
ÿ
)..&
(.&

)$
ÿ
$
)ÿ
*
(&
ÿ
$
ÿ
.)&
$
/ÿ
$
/.ÿ
/(ÿ
)&
ÿ
'(%$
)'$

%4ÿ
)%ÿ
%$
&
ÿ
)&
'ÿ
'&

$
&

)1
ÿ
0

'Bÿ
2< IC
9 ÿ
4 j=;
"
<ÿ
= ÿ
L2MNNkNNÿ
9 ÿ
ÿ
 j;
"
<ÿ
 ÿ
!A"
Jÿ
I<ÿ
A< Iÿ
R
!"

>$
.ÿ
?
@.%ÿ
$
ÿ
'
)
+ÿ
)%ÿ
4(ÿ
$
(ÿ
$
ÿ
= Aÿ
$
)1
ÿ
0

'Bÿ
9 C

---

01
23ÿ
5
67
8
9 ÿ
1
2ÿ
 

ÿ

ÿ

2
9ÿ
8
9
ÿ
21
ÿ
1
ÿ
1
2ÿ
  ÿ
!
8
27
"ÿ
1
ÿ
98
1
2ÿ
1
2ÿ
1
2
ÿ
3
1
#ÿ
$8
1
ÿ
1
2ÿ
91
91
%
 
01
23ÿ
&
67
8
9 ÿ
1
2ÿ
33
3
8
1
2ÿ
1
'ÿ
!

ÿ
1
2ÿ
3
1
#ÿ
1
#32ÿ
#(ÿ

2ÿ
91
91
8
)ÿ
"ÿ
21
2
ÿ
2
9ÿ
9
8
1
2
8
%
ÿ
67
8
9 ÿ
*+ ,-.
/00ÿ
1234

+ ÿ
42  , ÿ
5*677877ÿ
/00ÿ
ÿ
23,

+ ÿ
,2  , ÿ
9
ÿ
 -+ÿ
  
,
:  ÿ

9, 
2
;9
,<ÿ
 +:
=%
ÿ
>32ÿ
97
8
?%
ÿ
Qÿ
1
ÿ
1
2ÿ
YZ[Z\]^
ÿ
1
'
5%
ÿ
027
291
ÿ
1
2ÿ
3
1
#ÿ
!

?ÿ
_]\`a
ba
c][`dÿ

D1
2ÿ
97
8
?ÿ
(?'2

&%
ÿ
67
8
9 ÿ
fa
Zgÿ
_]\`h
R%
ÿ
Qÿ
1
ÿ
ij[`]b`dÿ
1
'%
ÿ
67
8
9 ÿ
kll
P%
ÿ
67
8
9 ÿ
m]n[a
oha
[nÿ
n^
]ddÿ
21
ÿ
1
ÿ
i^
]a
m
K%
ÿ
S1
2
ÿ
97
8
?ÿ
(?'2
ÿ
8
ÿ
i^
]a
mÿ
pqmrZ\skiituÿ
pqmrZ\ÿ
!
8
27
"
v%
ÿ
67
8
9 ÿ
wZ]\bx%
ÿ
X%
ÿ
6?37
21
2ÿ
"21
8
7
ÿ
8
ÿ
kllÿ
ij[`]b`%
ÿ
67
8
9 ÿ
yz
01
23ÿ
=
>32ÿ
97
8
?ÿ
"ÿ
)ÿ
1
ÿ
1
2ÿ
@++ 
ÿ
1
'ÿ
"ÿ
27
291
ÿ
1
2ÿ
33
3
8
1
2ÿ
3
1
#ÿ
!

?ÿ
  
,
:  ÿ
7
8
1
ÿ
A8
2$%
B 2ÿ
ÿ
1
2ÿ
!
ÿ
1
2ÿ
98
1
2"ÿ
97
8
?ÿ
(?'2
%
C""ÿ
DE67
8
21
ÿ
61
91
ÿ
1

()ÿ
F
1
8
98
31
ÿ
8
ÿ
62ÿ
G21
8
7
ÿ
I0=JJKJ&
01
23ÿ
5
67
8
9 ÿ
L
+Mÿ
  ÿ
1
ÿ
"8
37
#ÿ
1
2ÿ
3
1
#ÿ

29
"%
N8
2$ÿ
F
1
#ÿ
O29
"ÿ
I0=JJKJP
01
23ÿ
&
Qÿ
1
ÿ
1
2ÿ
42  , ÿ
1
'ÿ
"ÿ
97
8
9 ÿ
/00.
01
23ÿ
R
67
8
9 ÿ
1
2ÿ
 

ÿ

ÿ

2
9ÿ
8
9
ÿ
21
ÿ
1
ÿ
1
2ÿ
4

ÿ
!
8
27
"ÿ
1
ÿ
"8
37
#ÿ
1
2ÿ
4 +ÿ
*+ ,-ÿ
9
22%
01
23ÿ
P
S1
2
ÿ
1
2ÿ
97
8
?ÿ
(?'2
ÿ
8
ÿ
1
2ÿ
4

ÿ
19T+U/44VWÿ
19T+ÿ
!
8
27
"
C""ÿ
DE67
8
21
ÿ
61
91
ÿ
67
8
?ÿ
02
9ÿ
I0=JJKJX
01
23ÿ
K

---

01
2
34ÿ
6789 ÿ

ÿ
 1

ÿ

ÿ

8
ÿ

2
1
ÿ
2

ÿ

ÿ


 
ÿ
!
 
0 1

ÿ

ÿ

2
1
"ÿ
2
ÿ
#$$ÿ
%&'8 '
ÿ
01
2
34ÿ
()*
#$$ÿ
8ÿ
%&'8 'ÿ
'%ÿ
'7ÿ
+77,
-ÿ
%.7&/8'
%&ÿ
/01ÿ
8/7
 
ÿ
2
3ÿ

ÿ
441
5ÿ
0 "
2
ÿ
"ÿ
3"ÿ

ÿ
"1
3
ÿ
6ÿ
0 
3
ÿ


ÿ

ÿ

 
ÿ
7
0 1

ÿ

ÿ
3 
3
ÿ

2
1
"
ÿ
8

ÿ

ÿ
9

5ÿ
2
"ÿ

ÿ
31
2

ÿ
ÿ
1ÿ


ÿ
2



2
ÿ
2
"ÿ
3 1

:
ÿ
31
2
34ÿ
3;
ÿ
<ÿ
3 
3
ÿ
"ÿ
ÿ
ÿ
ÿ

ÿ

3
ÿ
"
ÿ
3

2
"ÿ
3 
2
ÿ

ÿ
 
ÿ
=
 
ÿ
=
01
2
34ÿ

ÿ
>2

52
>ÿ
>1
""ÿ

ÿ
?2
ÿ
ÿ
1
2
"
ÿ

ÿ


ÿ


2
32

"ÿ


ÿ
3ÿ
ÿ
"1
3

8

ÿ


9

2
32
 
ÿ

2
"ÿ

ÿ
ÿ
1
2
"

"1
3
ÿ

ÿ
9

2
32

ÿ


ÿ

ÿ
1
2
"
ÿ

ÿ
31
2
34ÿ
AB
ÿ
<ÿ
9

5ÿ

2
1
ÿ
2
"ÿ


"1
3
ÿ
#$$*
ÿ
0 1

ÿ

ÿ

2
1
"ÿ
ÿ

ÿ
6ÿ
9

2
32

"ÿ
9>
ÿ
01
2
34ÿ
C
&$ÿ
D89'-*
0 1

ÿ

ÿ

1

ÿ
"
3ÿ
3
2


2
ÿ

ÿ
31
2
34ÿ
6789 *
 
ÿ
1
2
"

 1
3
ÿ
ÿ


2
32

ÿ


ÿ

ÿ
"
3ÿ

"1

"ÿ

ÿ
31
2
34ÿ
()*
ÿ
<ÿ
9

5ÿ
 
3ÿ
"3
ÿ
2
"ÿ
2
"1
5ÿ
ÿ

ÿ


2
32

ÿ
"ÿ
ÿ
ÿ

ÿ


1
2
"
ÿ

ÿ
9

2
32

"
 1
3
ÿ

ÿ
9

2
32

ÿ


ÿ

ÿ
1
2
"
ÿ

ÿ
31
2
34ÿ
()*
ÿ
<ÿ
9

5ÿ

2
1
ÿ
2
"ÿ


 
ÿ
E
0 1

ÿ
5ÿ

2
2
>ÿ
3 
3
ÿ

2
1
"ÿ

ÿ
31
2
34ÿ
()
ÿ
<ÿ
3 
3
ÿ
"ÿ
ÿ
ÿ

ÿ

ÿ
3 
3
"ÿ
ÿ

ÿ
%&'8 '/ÿ


[Out of Scope]
01
2
"
QNXÿ
NJY
V
JLÿ
UISV
W
0 
3
a>2
>ÿ
0 
3
"
Z
J[
IP
\]K
V
IJÿ
U^SL
 5"
ÿ
 
"
_LY
]K
LTÿ
UI
01
2


---

0123
45ÿ
789 ÿ
89ÿ
 
ÿ
1 ÿ
 ÿ
99 ÿ
1 77ÿ
ÿ
77 7
1
[Out  9
of  32ÿ94
4 9 93
7 ÿ 1ÿÿ
 13

3
13
4ÿ
14ÿ
9 1 4ÿ
9ÿ
 !!
Scope]
"#ÿ
%&'ÿ
()*#ÿ
%#'ÿ
+,
&-#..#.ÿ
)%/ÿ
,
#.&0,
-#.ÿ
1
&ÿ
2)3#ÿ
4
1
ÿ
#).4
#,
ÿ
5
&,
ÿ
6
#)/#,
.ÿ
1
&ÿ
,
#70#.1
ÿ
)%/ÿ
8,
)%1
ÿ
)--#..ÿ
1
&ÿ
1
(#ÿ
.9.1
#2.ÿ
1
(#4
,
ÿ
+#&+6
#ÿ
%##/:
;&ÿ
.0++&,
1
ÿ
1
(4
.<
ÿ
'#=
*#ÿ
0+/)1
#/ÿ
&0,
ÿ
>&6
#ÿ
?)++4
%8ÿ
@4
-1
4
&%),
9<
ÿ
+,
&/0-#/ÿ
)ÿ
%#'ÿ
A9.1
#2ÿ
B--#..ÿ
>#+&,
1
ÿ
5
&,
ÿ
1
(#ÿ
C&.ÿ
D
2)%)84
%8ÿ
-6
4
#%1
ÿ
-6
)4
2.E
ÿ
)%/ÿ
?FGÿ
D
?#/4
-)6
ÿ
F##.ÿ
G,
&-#..4
%8E
ÿ
.9.1
#2.<
ÿ
)%/ÿ
#.1
)H6
4
.(#/ÿ
)ÿ
%#'ÿ
I
%1
#,
%)6
ÿ
A9.1
#2.ÿ
A0++&,
1
ÿ
;#)2
D
I
AA;E
ÿ
1
&ÿ
2)%)8#ÿ
)--#..ÿ
1
&ÿ
&0,
ÿ
.9.1
#2.:
Bÿ
%#'ÿ
#J#),
%4
%8ÿ
2&/06
#ÿ
#K+6
)4
%.ÿ
1
(#ÿ
%#'ÿ
+,
&-#..:
LM
NOPNÿ
RSNRTÿ
USNÿ
ORRNPPÿ
UVÿ
WVPÿ
OXYÿ
Z[Lÿ
\V]^ÿ
_NV_M
Nÿ
R]^^NXUM
\ÿ
SO`N
B6ÿ
G#&+6
#ÿ
J#)/#,
.ÿ
()*#ÿ
H##%ÿ
).3#/ÿ
1
&ÿ
-(#-3ÿ
1
(#ÿ
A9.1
#2ÿ
B--#..ÿ
>#+&,
1
ÿ
)8)4
%.1
ÿ
1
(#ÿ
>&6
#ÿ
?)++4
%8ÿ
@4
-1
4
&%),
9<
ÿ
1
&ÿ
2)3#ÿ
.0,
#ÿ
1
(#ÿ
)--#..ÿ
1
(#4
,
ÿ
+#&+6
#ÿ
()*#ÿ
1
&ÿ
1
(#ÿ
C&.ÿ
)%/ÿ
?FGÿ
.9.1
#2.ÿ
4
.ÿ
)++,
&+,
4
)1
#ÿ
5
&,
ÿ
1
(#4
,
ÿ
,
&6
#.:
;&ÿ
/&ÿ
1
(4
.<
ÿ
9&0ÿ
%##/ÿ
1
&ÿ
-&2+6
#1
#ÿ
5
&6&'4
%8a
>#*4
#'ÿ
1
(#ÿ
A9.1
#2ÿ
B--#..ÿ
>#+&,
1
<
ÿ
1
&ÿ
.##ÿ
4
5
ÿ
9&0,
ÿ
+#&+6
#ÿ
()*#ÿ
)--#..ÿ
1
&ÿ
C&.ÿ
)%/b&,
ÿ
?FG:
ÿ
D
c&1
#a
ÿ
;(4
.ÿ
2)9ÿ
()*#ÿ
H##%ÿ
8,
)%1
#/ÿ
5
&,
ÿ
)ÿ
+,
#*4
&0.ÿ
,
&6
#:
E
ÿ
I
5
ÿ
%&ÿ
%)2#.ÿ
)++#),
<
ÿ
%&ÿ
5
0,
1
(#,
ÿ
)-1
4
&%ÿ
4
.ÿ
,
#704
,
#/:
I
5
ÿ
+#&+6
#ÿ
5
,
&2ÿ
9&0,
ÿ
1
#)2ÿ
),
#ÿ
6
4
.1
#/ÿ
4
%ÿ
1
(#ÿ
A9.1
#2ÿ
B--#..ÿ
>#+&,
1
<
ÿ
+6
#).#ÿ
-(#-3ÿ
1
(#ÿ
>&6
#ÿ
?)++4
%8ÿ
@4
-1
4
&%),
9ÿ
1
&ÿ
-&%5
4
,
2ÿ
1
()1
ÿ
1
(4
.ÿ
)--#..ÿ
4
.ÿ
)++,
&+,
4
)1
#:
I
5
ÿ
1
(#ÿ
4
%5
&,
2)1
4
&%ÿ
2)1
-(#.ÿ
)%/ÿ
1
(4
.ÿ
ORRNPPÿ
e
Pÿ
O__^V_^e
OUN<
ÿ
%&ÿ
5
0,
1
(#,
ÿ
)-1
4
&%ÿ
4
.ÿ
,
#704
,
#/:
I
5
ÿ
9&0ÿ
),
#ÿ
XVUÿ
P]^Nÿ
e
fÿ
ORRNPPÿ
e
Pÿ
O__^V_^e
OUNg
ÿ
0.#ÿ
1
(4
.ÿ
+,
&-#..ÿ
>#70#.1
ÿ
B--#..ÿ
1
&ÿ
C&.ÿ
)%/ÿ
?FGÿ
D
A1
#+ÿ
hE
ÿ
&,
ÿ
-(#-3ÿ
1
(#ÿ
>&6
#ÿ
?)++4
%8ÿ
@4
-1
4
&%),
9ÿ
)8)4
%ÿ
&%-#ÿ
4
1
ÿ
().ÿ
H##%ÿ
0+/)1
#/ÿ
4
%ÿ
F#H,
0),
9ÿ
ijih:
k
I
5
ÿ
9&0ÿ
H#6
4
#*#ÿ
ORRNPPÿ
e
Pÿ
XVUÿ
O__^V_^e
OUN<
ÿ
0.#ÿ
1
(4
.ÿ
+,
&-#..ÿ
>#70#.1
ÿ
B--#..ÿ
1
&ÿ
C&.ÿ
)%/ÿ
?FGÿ
D
A1
#+ÿ
lE
ÿ
1
&ÿ
5
&6&'ÿ
1
(#ÿ
A9.1
#2ÿ
A1
#+.ÿ
m
>#70#.1
ÿ
n+/)1
#/ÿ
C&.ÿ
oÿ
?FGÿ
B--#..ÿ
5
&,
ÿ
)%ÿ
CK4
.1
4
%8ÿ
n.#,
=
:
k?&.1
ÿ
,
&6
#.ÿ
,
#704
,
4
%8ÿ
)--#..ÿ
1
&ÿ
C&.ÿ
)%/ÿ
?FGÿ
()*#ÿ
H##%ÿ
)//#/ÿ
1
&ÿ
1
(#ÿ
>&6
#ÿ
?)++4
%8ÿ
@4
-1
4
&%),
9<
ÿ
)%/ÿ
'#ÿ
#K+#-1
ÿ
1
(#ÿ
,
#2)4
%4
%8ÿ
,
&6
#.ÿ
1
&ÿ
H#ÿ
*)6
4
/)1
#/ÿ
H9ÿ
F#H,
0),
9ÿ
ijih:
p&4
%8ÿ
5
&,
'),
/<
ÿ
9&0=
6ÿ
H#ÿ
+,
&2+1
#/ÿ
1
&ÿ
-(#-3ÿ
1
(#ÿ
A9.1
#2ÿ
B--#..ÿ
>#+&,
1
ÿ
)%/ÿ
>&6
#ÿ
?)++4
%8ÿ
@4
-1
4
&%),
9ÿ
'(#%#*#,
ÿ
.&2#&%#ÿ
q
&4
%.ÿ
9&0,
ÿ
1
#)2ÿ
D
#4
1
(#,
ÿ
%#'ÿ
1
&ÿ
Brrÿ
&,
ÿ
2&*4
%8ÿ
5
,
&2ÿ
)%&1
(#,
ÿ
1
#)2E
:
ÿ
G6
#).#ÿ
)6&'ÿ
)1
ÿ
6
#).1
ÿ
5
4
*#ÿ
/)9.ÿ
'(#%ÿ
,
#70#.1
4
%8
)--#..ÿ
1
&ÿ
C&.ÿ
)%/b&,
ÿ
?FG<
ÿ
)%/ÿ
)6
')9.ÿ
,
#5
#,
ÿ
1
&ÿ
1
(#ÿ
6
)1
#.1
ÿ
*#,
.4
&%ÿ
&5
ÿ
1
(#ÿ
>&6
#ÿ
?)++4
%8ÿ
@4
-1
4
&%),
9ÿ
1
&ÿ
)*&4
/ÿ
/#6
)9.:
ÿ
ÿ
s0,
ÿ
'&,
3ÿ
1
&ÿ
/#*#6
&+ÿ
&0,
ÿ
,
&6
#ÿ
2)+.ÿ
)%/ÿ
4
2+,
&*#ÿ
(&'ÿ
'#ÿ
2)%)8#ÿ
)--#..ÿ
1
&ÿ
C&.ÿ
)%/ÿ
?FGÿ
4
.ÿ
)%&1
(#,
ÿ
&5
ÿ
1
(#ÿ
4
%4
1
4
)1
4
*#.ÿ
1
()1
ÿ
'4
6ÿ
.1
,
#%81
(#%ÿ
&0,
ÿ
)++,
&)-(ÿ
1
&ÿ
+,
4
*)-9ÿ
)%/ÿ
(&'ÿ
'#ÿ
2)%)8#ÿ
&0,
ÿ
)--#..ÿ
1
&ÿ
)%/ÿ
0.#ÿ
&5
ÿ
+#,
.&%)6
ÿ
4
%5
&,
2)1
4
&%:
ÿ
;(4
.
2)(4
ÿ
'4
6ÿ
(#6
+ÿ
0.ÿ
1
&ÿ
)-1
ÿ
).ÿ
3)4
1
4
)34
ÿ
&,
ÿ
80),
/4
)%.ÿ
&5
ÿ
1
(#ÿ
+#,
.&%)6
ÿ
4
%5
&,
2)1
4
&%ÿ
1
()1
ÿ
4
.ÿ
#%1
,
0.1
#/ÿ
1
&ÿ
0.:

---

Conduct Claims Access Monitoring Check v4.0
 
Outputs
Access
4.0
Perform  Monitoring Check
Access
riggers & Inputs
T
1.0
Select teams ready for  Monitoring Check
2.0
Notify team that they have been selected for an Access Monitoring
3.0
Prepare for Access Monitoring Check
orkforce Planner
Technical Manager
W
Team Leader
ACC > Risk Management > Risk and Control Processes  > Conduct Claims Access Monitoring Check
Uncontrolled Copy Only : Version 4.0 : Last Edited Friday, 10 February 2023 1:04 PM : Printed Monday, 25 September 2023 10:51 AM
Page 1 of 3

---

Conduct Claims Access Monitoring Check v4.0
 
NOTE How far in advance do selected teams need 
Summary
to be notified?
Teams must be notified two weeks prior to the 
Objective
beginning of month in which they are required to 
Perform an Access Monitoring Check as part of ACC's commit-
perform the checks.
ment to ensuring client personal information is only accessed 
for appropriate reasons.
3.0 Prepare for Access Monitoring Check
Background
We consider ourselves to be kaitiaki (guardians) of any personal 
Team Leader
information we receive. It is our responsibility to treat personal 
a Review the Client Information Access Review Tool to 
information as a taonga – to care for and use it only for its in-
ensure it includes all team members in the team, and that 
tended purposes. Respecting the personal information and pri-
their access information is recorded in the tool.
vacy of ACC’s clients, staff, and stakeholders is a core value 
Client Information Access Review Tool
and behaviour required of all ACC people.
Leader Instructions for Access Monitoring Tools
To ensure we meet these responsibilities for our clients, we 
NOTE What if you have a team member who does 
regularly monitor how our people are accessing client’s per-
not have any access information in the Client 
sonal information through our claims management systems. 
Information Access Review Tool?
This will provide assurance that staff behaviour in managing 
personal information is meeting our high expectations and any 
These team members can be excluded from the 
instances of concern are followed up on.
checks.
b Schedule a suitable time with each team member to com-
[Out of Scope]
plete the Access Monitoring Check together.
Owner
NOTE Can you use an existing coaching time?
Expert
You may want to complete the check as part of 
existing coaching conversations you have in 
Procedure
place with your staff member (ie CXQ conver-
sation).
1.0 Select teams ready for Access Monitoring 
NOTE How long do you need to perform the 
Check
checks?
Technical Manager
The checks should take appropriately 15 minutes 
a In Team Selection tool, refresh data to confirm six team 
to complete per team member but could take 
names for access check.
longer depending on the quantity and complexity 
NOTE Teams are selected at least two weeks prior 
of access information to review.
to the beginning of the month during which 
the checks are to be performed.
4.0 Perform Access Monitoring Check
Team Leader
NOTE What if Workforce Planning determine that 
capacity issues require a reduction in teams 
a Meet with your team member at the scheduled time.
selected for a month?
b Talk your team member through the objective and 
In these scenarios Workforce Planning can 
process of the Access Monitoring Check.
reduce selection down to a minimum of four 
c Review and discuss the information presented for each 
teams.
claim in the Client Information Access Review Tool with 
b Notify the relevant Workforce Planner to notify the se-
your team member, assessing them against the Access 
lected team/s.
Monitoring Criteria.
Access Monitoring Criteria
2.0 Notify team that they have been selected for an 
NOTE What if the reason for access is obvious to 
Access Monitoring Check
you as a Leader?
Workforce Planner
It is important to still have a conversation with 
your Team Member to reinforce our positive pri-
a Copy the Access Monitoring Notification into the 
vacy culture. It is important our people under-
Workplan.
stand that their access of client information is 
Access Monitoring Notification
visible, and why these checks happen. It can be 
an opportunity to celebrate great practice, or to 
b Send to the selected teams that will need to perform 
inform coaching conversations if you see oppor-
Access Monitoring Checks.
tunities for development.
NOTE How are selected Teams notified?
NOTE What if there are multiple actions on a claim 
Access Monitoring Check notifications are deli-
within a session?
vered to teams via their preferred method of deli-
Review all activity as a collective set of actions 
vering workplans and updates to teams.
leading to an outcome. The question needing to 
This may vary across different functions.
be answered in these situations was whether the 
access to the claim was a for valid reason.
ACC > Risk Management > Risk and Control Processes  > Conduct Claims Access Monitoring Check
Uncontrolled Copy Only : Version 4.0 : Last Edited Friday, 10 February 2023 1:04 PM : Printed Monday, 25 September 2023 10:51 AM
Page 2 of 3

---

NOTE What if a claim has been accessed in more 
than one session during the time period cap-
 
tured in the Access Report?
Complete a separate check for each session.
d Record the findings of each claim access using the Client 
Information Access Validation Tool.
Client Information Access Validation Tool
Leader Instructions for Access Monitoring Tools
NOTE When should you record your findings in the 
Client Information Access Validation Tool?
Record your findings in the Client Information 
Access Validation Tool as you are conducting the 
checks with your Team Member. This is more 
efficient than conducting the check and capturing 
your findings at a later date.
NOTE What if you are capturing commentary in the 
Client Information Access Validation Tool?
The commentary you input will be visible and 
likely reviewed by representatives from Perfor-
mance, Privacy, and Integrity Services. The con-
tent you enter should be clear and unders-
tandable. If this is not the case, you will likely be 
contacted to provide clarification.
NOTE What if a check has resulted in a Low Assur-
ance rating?
This does not mean that access to the claim was 
inappropriate, just that we cannot provide clear 
evidence backing up a valid business reason for 
access using our current systems and tools. De-
pending on the reason for assigning a Low 
Assurance rating you may also want to take 
additional steps or actions to work with the Team 
Member to fill knowledge gaps or reinforce best 
practice behaviors.
In the Client Information Access Monitoring Vali-
dation Tool only select Follow Up Required if you 
believe follow up is required with Integrity Ser-
vices or Employment Relations. If you Team 
Member will benefit from some activity, such as 
coaching, then this is not required to be captured 
in this tool.
NOTE What if you have concerns about access to a 
claim?
This does not automatically mean that access to 
the claim was inappropriate, but that the access 
is currently unexplained and requires further vali-
dation due to a concern raised during the check. 
Proceed to 'Assess Claims Access Concerns'
PROCESS Assess Claims Access Con-
cerns
NOTE What if you haven't captured the appropriate 
level of information in the Client Information 
Access Validation Tool?
The Performance team who monitor submissions 
in the Client Information Access Validation Tool 
may seek clarification from you directly, or this 
may be picked up as part of a conversation with 
your Client Service Leader.
ACC > Risk Management > Risk and Control Processes  > Conduct Claims Access Monitoring Check
Uncontrolled Copy Only : Version 4.0 : Last Edited Friday, 10 February 2023 1:04 PM : Printed Monday, 25 September 2023 10:51 AM
Page 3 of 3

---

Assess Claims Access Concerns v2.0
 
Outputs
4.0
Action Outcome of Referral
3.0
Refer to Integrity Services
3.1
Refer to Employment Relations
2.0
Determine where to direct referral
1.0
Assess access concern with the team member
Linked Process
Conduct Claims Access Monitoring Check
Team Leader
ACC > Risk Management > Risk and Control Processes  > Assess Claims Access Concerns
Uncontrolled Copy Only : Version 2.0 : Last Edited Wednesday, 25 January 2023 3:28 PM : Printed Monday, 25 September 2023 10:51 AM
Page 1 of 3

---

Assess Claims Access Concerns v2.0
 
NOTE What if you decide that the reasons provided 
Summary
are valid and so a referral is not required?
You may also want to take action to address 
Objective
knowledge gaps or reinforce best practice.
Assess claims access concerns raised during Access Moni-
toring Checks and determine whether a referral to Integrity Ser-
This process ends.
vices or Employment Relations is required.
NOTE What additional kinds of information could be 
Background
used to help make a determination?
If an Access Monitoring Check finds concerns around access to 
• Access to Integrity Services advice and guid-
a claim there is a need to further assess this access and make 
ance to enable additional self-powered vali-
a determination as to whether a referral to Integrity Services or 
dation.
Employment Relations is required.
• Access to peer reviews by suitably qualified 
practitioners to verify the reasons
Owner
[Out of Scope]
• Request additional footprint reporting to estab-
lish a wider data set that may be indicative of
Expert
access trends.
• Benchmarking against similar roles or functions 
Procedure
to establish normalised access behaviour.
PROCESS
Conduct Claims Access Monitoring 
Check
2.0 Determine where to direct referral
Team Leader
Team Leader
a Discuss your findings with your Line Manager and to-
gether and confirm that a referral is required.
1.0 Assess access concern with the team member
NOTE What if you decide that the reasons provided 
Team Leader
are valid and so a referral is not required?
a Ask the team member to explain why they accessed the 
You may also want to take action to address 
claim in an instance where you have identified a concern.
knowledge gaps or reinforce best practice.
NOTE How should you ask the team member to ex-
plain their reasons for access?
This process ends.
The purpose of this conversation is to under-
b Determine whether the referral should be directed to Inte-
stand the staff members version of events.
grity Services or to Employment Relations.
NOTE When should you direct the referral to Inte-
This must be asked in a non-confrontational and 
grity Services?
non-judgmental way, and should be an explo-
ratory conversation in nature. There are many 
A referral should be made to Integrity Services 
valid reasons why a team member may have ac-
where the access concern identified requires 
cessed a claim, even if it cannot be evidenced 
additional specialised assessment.
with the systems and processes in place.
NOTE When should you direct the referral to 
b Capture your findings in the Client Information Access 
Employment Relations?
Validation Tool.
A referral should be made direct to Employment 
Relations only in situations where there is clear 
Client Information Access Validation Tool
evidence of deliberate inappropriate access by 
Leader Instructions for Access Monitoring Tools
the team member, or where the team member 
has made a direct admission of deliberate 
c Determine if the reasons provided by the team member 
inappropriate access.
are valid or not.
NOTE How do you make this determination?
Refer to Claims Access Criteria.
3.0 Refer to Integrity Services
Team Leader
You must also exercise your judgement if the 
a Draft a referral email to Integrity Services using the sub-
reasons provided are valid or not valid or you 
ject heading 'Access Monitoring IS Support'.
have ongoing concerns about the reasons for 
access.
NOTE What information do you need to include in 
the referral email?
As a Team Leader who has high visibility of the 
• The team members name and role
workloads, work types, relevant processes, 
• Access points that cause concern
experience, expertise, and other attributes of the 
• Details of additional validation steps completed 
team environment, you must make a reasonable 
and the results
and fair assessment based on the explanation 
• Why concerns persist
provided by the staff member, taking into ac-
• Any conflicting or unusual explanations for the 
count the factors listed above or any other evi-
access
dence that is available.
• Details of discussion held with you Line Man-
ager, including rationale for referral.
Access Monitoring Criteria
b Send the referral to Integrity Services via the email ad-
dress [email address].
ACC > Risk Management > Risk and Control Processes  > Assess Claims Access Concerns
Uncontrolled Copy Only : Version 2.0 : Last Edited Wednesday, 25 January 2023 3:28 PM : Printed Monday, 25 September 2023 10:51 AM
Page 2 of 3

---

3.1 Refer to Employment Relations
Team Leader
  a Draft a referral email to HR Help using the subject head-
ing 'ER Support'.
NOTE What information do you need to include in 
the referral email?
• The team members name and role
• Access points that cause concern
• Details of additional validation steps completed 
and the results
• Why concerns persist
• Any conflicting or unusual explanations for the 
access
• Details of discussion held with you Line Man-
ager, including rationale for referral.
b Send the referral to Employment Relations via the email 
address [email address].
4.0 Action Outcome of Referral
Team Leader
a Receive outcome of the assessment from Integrity Ser-
vices or Employment Relations.
b Action any activities as required, including changing the 
Assurance rating assigned in the Client Information 
Access Validation Tool if instructed.
ACC > Risk Management > Risk and Control Processes  > Assess Claims Access Concerns
Uncontrolled Copy Only : Version 2.0 : Last Edited Wednesday, 25 January 2023 3:28 PM : Printed Monday, 25 September 2023 10:51 AM
Page 3 of 3

---

Transition Claim v82.0
 
Linked Process
Conduct Recovery Check-in Conversation
elcome
Linked Process
Conduct W Conversation
Team
ransition claim to
3.0
T a Recovery 
Linked Process
Allocate Claim
2.0
Consider transitioning the claim
Team
1.0
Identify the Recovery 
elcome
Linked Process
Conduct W Conversation
Linked Process
Conduct Recovery Check-in Conversation
rack Recovery
Linked Process
T
Assistant
-time workforce analyst
Recovery 
Recovery Coordinator
Recovery Partner
Real
ACC > Claims Management > Manage Claims > Assign and Allocate Claim > Transition Claim
Uncontrolled Copy Only : Version 82.0 : Last Edited Friday, 22 September 2023 8:50 AM : Printed Monday, 25 September 2023 10:52 AM
Page 1 of 7

---

Transition Claim v82.0
 
NOTE What if the client has another open claim with 
Summary
Escalated Care Pathways?
If the claim is not a musculoskeletal injury then 
Objective
the claim should continue to be managed by a 
To review and consider transitioning a clients to another recov-
Recovery Team Member. If it is for a muscu-
ery team so that they receive the right level of support for their 
loskeletal injury, contact the ECP Team on 77097 
needs, at the right time.
to discuss.
Background
The ECP Team will review with you, and may 
Clients will transition between recovery teams throughout the 
contact the ECP Provider managing the other 
life of their claim. This might happen when:
claim to see if they also need to manage the 
• they progress with their recovery
additional claim. If they are going to do this, they 
• their situation changes
will create a general task in EOS to track the 
• new information becomes available.
progress and outcome. While you are waiting for 
an outcome, you should refrain from transitioning 
Transitioning a client to a new recovery team takes place when 
the claim unless there is an urgent request that 
the current team is no longer the best option for supporting their 
needs assessment by a particular Recovery 
needs. Recovery team members should use their discretion 
Team Member skillset.
when making this decision, drawing on Promapp guidance, pro-
vider feedback, and recovery support as required.
If the ECP Provider needs to manage the addi-
tional claim, the ECP Team will update and trans-
[Out of Scope]
fer the claim to the ECP queue in EOS. If the 
Owner
Provider does not need to manage the additional 
Expert
claim, the ECP Team will update the task 
description to reflect this and close the general 
task. The claim can be transitioned if the ECP 
Procedure
Provider is not going to take on the claim.
NOTE What if you are in Assisted Recovery and 
PROCESS
Track Recovery
need to determine which Assisted Recovery 
Recovery Assistant, Recovery Coor-
cohort should manage the claim?
dinator, Recovery Partner
This is for claim transitions between Assisted 
Recovery cohorts only. For transitions into As-
sisted Recovery, see step 1.0 b.
PROCESS
Conduct Recovery Check-in 
Conversation
b To enable you to make an informed decision on which is 
Recovery Assistant, Recovery Coor-
the correct Recovery Team review GUIDELINES Choos-
dinator, Recovery Partner
ing the Right NG Recovery Team and NG GUIDELINES 
Whole of Person Guidelines and Allocations Rules.
GUIDELINES Choosing the right Recovery Team
PROCESS
Conduct Welcome Conversation
Whole of Person Guidelines
Recovery Assistant, Recovery Coor-
dinator, Recovery Partner
NOTE What if your client is newly injured?
Hold off on considering a transition until more 
information is available, sometimes injuries are 
1.0 Identify the Recovery Team
not as significant as first thought or clients make 
Recovery Assistant, Recovery Coordinator, Recovery 
faster recoveries and may not need to transition 
Partner
to a different recovery team.
a Review the claim for information about a change in the 
client's circumstances and support needs.
NOTE What if the claim is due to be closed within 
the next week?
The claim does not need to be transitioned. This 
process ends.
ACC > Claims Management > Manage Claims > Assign and Allocate Claim > Transition Claim
Uncontrolled Copy Only : Version 82.0 : Last Edited Friday, 22 September 2023 8:50 AM : Printed Monday, 25 September 2023 10:52 AM
Page 2 of 7

---

NOTE What if a treatment injury claim is accepted 
NOTE What if the client has an actively managed 
for cover for a mesh injury?
Physical Injury claim and Complex Mental 
 
• If the Engagement Model Decision results state 
Injury claim in Assisted?
to send to Partnered, this claim will be trans-
• If the client's needs are stable or require mi-
ferred to Te Ara Tika.
nimal support, both claims can be effectively ma-
• If the Engagement Model Decision results state 
naged by Assisted Recovery. The client does not 
to send to Assisted, Enabled or Supported, this 
need to be transitioned. For further information 
claim will be transferred to Supported Recovery.
refer to the Whole of Person Guidelines and Allo-
• For existing clients in Assisted Recovery -
cation Rules.
unless it is determined the client needs a higher 
level of support, these claims can remain in As-
• If the client's mental health deteriorates and 
sisted Recovery. If the client does require 1:1 
their needs change and they require one on one 
support then normal transition guidelines should 
support, this claim could be considered for tran-
be followed.
sition and Whole of Person may apply. Refer to 
• For existing clients in Supported Recovery or 
the Whole of Person Guidelines and Allocation 
Partnered Recovery - if it is determined that the 
Rules below.
client needs some specialised support then the 
NOTE What if the client has an actively managed 
Recovery Team Member can discuss this with 
Complex Mental Injury claim and Complex 
their Team Leader before the claim is transi-
Physical Injury claim?
tioned to:
- if transitioning to Supported Recovery, the 
Both claims need to be managed by the Recov-
claim will be assigned to a Recovery Coordinator 
ery team member managing the Complex Phys-
who has
ical Injury.
been identified to manage mesh injury claims.
NOTE What if the client has multiple claims re-
- if transitioning to Partnered Recovery, the claim 
quiring management?
will go to Te Ara Tika.
All claims need to be managed by the individual 
NOTE What if there are claims managed by Third 
or team that can best support their needs. For 
Party Administrators either through the 
further information refer to the Whole of Person 
Accredited Employer Programme or TPA 
Guidelines and Allocation Rules.
Non-Work Service?
NOTE What if the client is to remain with the same 
ACC should not be proactively offer to manage 
team but has a request related to their Recov-
these alongside other ACC claims:
ery Team member’s location?
For CMI claims: if at any time (including migra-
• For work related injuries managed under the 
tion) the client identifies that they do not wish to 
Accredited Employer Programme, these claims 
be managed by their geographically located 
will continue to be managed by the Accredited 
team record the conversation in a future dated 
Employer or their nominated Third Party Admin-
contact. As this is customer engagement also 
istrator.
record it in the Cultural area of the Recovery 
Plan with the client's preferred method of 
• For non-work related injuries managed by Third 
communication. The client can also be trans-
Party Administrators, these claims will continue 
ferred to their local region if they move and re-
to be managed by the nominated Third Party 
quest local management. Send an email to 
Administrator, however clients can opt out of this 
[email address] requesting a change of Recov-
at any point and ACC can assume management 
ery Team member in addition to completing this 
of the claim if the clients wishes to opt out con-
process.
tact [email address] or DDI 45394 they 
will facilitate the opt out and claim return.
For Physical Claims - These will only be trans-
NOTE What if it is a Work-Related injury and clai-
ferred if it will result in the best possible outcome 
mant is employed by an Accredited Employer
for the client. The decision to transfer a client is 
Go to the Identify and Transfer Work-Related 
based on their need and is made by Recovery 
Injury Claim to Accredited Employer (AE) 
Team Members with team leader approval.
Process.
On the agreement that a claim can be allocated 
locally, rationale is noted on the claim and the 
PROCESS Identify and Transfer Work-
Team Leader should agree on the named Recov-
Related Injury Claim to Accre-
ery Team Member to receive the allocation, they 
dited Employer (AE)
then complete the Submit Claim Movement 
NOTE What if it is a Non-Work-Related injury and 
survey located in the WFM-Supported sharepoint 
the claimant is employed by an Accredited 
this will ensure that claims go via the capability 
Employer
streaming tool.
Go to the Identify and Transfer Non-Work-
NOTE What if the client has an active Care Indi-
Related Injury Claim to Third-Party Administrator 
cator?
(TPA) process.
Recovery Team Member to review the Care Indi-
PROCESS Identify and Transfer Non-Work-
cator prior to transition and discuss with their 
Related Injury Claim to Third-
Team Leader as required to ensure any risks are 
Party Administrator (TPA)
identified and appropriate action taken.
ACC > Claims Management > Manage Claims > Assign and Allocate Claim > Transition Claim
Uncontrolled Copy Only : Version 82.0 : Last Edited Friday, 22 September 2023 8:50 AM : Printed Monday, 25 September 2023 10:52 AM
Page 3 of 7

---

NOTE What if the client has an active Vulnerable 
NOTE What if the client doesn't agree to be transi-
indicator?
tioned?
 
Recovery Team Member to review the Vulner-
• Record your conversation with the client as a 
able indicator and discuss with their Team 
contact on the claim.
Leader as required to ensure any risks are iden-
• Discuss with your leader how to approach the 
tified and appropriate action taken. Clients with 
transition conversation at the next Recovery 
Vulnerable indicators cannot be managed in As-
Check In.
sisted or Enabled.
• Add a note in the description field to the next 
Recovery Check In to remind you to if appro-
NOTE What if you are a Recovery Partner consi-
priate considering revisiting transitioning the 
dering transitioning a client into or out of a 
client.
capability stream?
Transition to the engaging in work team, will 
This process ends.
happen after the Recovery Team member has 
had a conversation with their Team Leader. Tran-
NOTE What if you are a Recovery Coordinator or 
sitions are required to have Team leader agree-
Partner and are unable to contact the client?
ment and this be noted on the claim.
• Attempt a maximum of 2 contacts over 2 full 
See page 10 of GUIDELINES Choosing the right 
working days before leaving a voicemail or send-
Recovery Team for points to be discussed with 
ing a notification to request client contact.
Team Leader.
• If you are unable to reach the client, extend the 
task for additional 2 working days and note in the 
NOTE What if you are a Recovery Partner consi-
task description that this is the 2nd attempt to 
dering transitioning a client into or out of 
contact the client.
Hāpai?
• On the task due date and if there is been no re-
Notify your Team Leader if you believe your 
sponse from the client to the voicemail or notifi-
Māori clients will be best supported in Hāpai.
cation, send the CM04 - Advise client that you 
Your Team Leader will contact the Hāpai Team 
were unable to reach then by phone letter.
leader to discuss capacity and potential tran-
• Extend the task date as appropriate to take into 
sition to a Kaihāpai.
account postal delivery and note in the task 
If a decision is made to transition into Hāpai, See 
description this is the 3rd attempt to contact the 
page Transition a claim into or out of Hāpai for 
client and the CM04 letter has been sent.
more information and ensure that you add the 
• On the task due date and if there is no contact 
Hāpai indicator.
from the client and they are continuing to receive 
Hāpai - Transition Claims
support, discuss with your team leader to deter-
mine next steps. You may also consider seeking 
Add a Hāpai Indicator
internal guidance.
Transition Guidelines Between Assisted Recovery 
• If you're in Partnered and no contact is made 
Cohorts
with the client after three attempts, you must 
contact the provider, GP or other verified contact 
on the claim.
2.0 Consider transitioning the claim
NOTE What if you are a Recovery Assistant and are 
Recovery Assistant, Recovery Coordinator, Recovery 
unable to contact the client?
Partner
Recovery Assistants must make at least one at-
a Contact the client to discuss moving their claim to anoth-
tempt to contact the client to discuss the tran-
er team and understand the clients preference.
sition. If contact is unsuccessful this needs to be 
documented in the reminder action created in the 
For guidance on how to conduct this conversation refer to 
steps 2.0b
NG SUPPORTING INFORMATION Having Recovery 
NOTE What if the client has a Complex Mental 
Team Transition Conversation and NG FAQ Transitioning 
Injury and is being transitioned from Part-
a Client to Another Recovery Team.
nered to Assisted Recovery?
NOTE What if there is another claim being managed 
• Client has an accepted claim
by another team/person?
• The client does not have an active vulnerable 
Consider Whole of Person management and 
indicator
follow the process as set out in the Whole of 
• There are no risks noted in the report or by the 
Person Guidelines.
provider
• The client is actively engaged in their therapy 
Whole of Person Guidelines
and well supported
NG FAQ Transitioning a Client to Another Recovery 
• The client is receiving non complex supports 
Team
and not financial support i.e. weekly compen-
sation
NG SUPPORTING INFORMATION Having Recovery 
• The client is not under 18 years of age
Team Transition Conversations
NOTE What if you are unsure a transition is 
needed?
The decision to transition the claim is done 
Make sure you have a conversation with your 
collaboratively and must be discussed with the 
team leader to clarify if a transition is needed 
client and/or provider prior to transition.
BEFORE you discuss with the client.
b Based on the discussion you have had with the client, 
determine if they should be transitioned to a different 
Recovery Team which can better support their needs.
ACC > Claims Management > Manage Claims > Assign and Allocate Claim > Transition Claim
Uncontrolled Copy Only : Version 82.0 : Last Edited Friday, 22 September 2023 8:50 AM : Printed Monday, 25 September 2023 10:52 AM
Page 4 of 7

---

NOTE What if the client is in Supported or Part-
NOTE What if there is an unmanaged Mental injury 
nered Physical Injury and is 16 years or 
claim that is impacting the current managed 
 
younger?
claim?
Team Leader approval for the transition must be 
If recommendations have be made for support to 
obtained prior to the transition to Assisted 
be provided or considered on a claim with a sen-
Recovery. Email your Team Leader the claim 
sitive indicator, follow the below steps:
number, summary of the client situation and 
rationale for transition, with clear evidence that 
1) The Recovery Team Member managing the 
you have considered:
physical injury claim should contact the client 
and discuss the recommendations.
• The client’s whole situation including ease of 
2) Offer the client an opportunity to speak with a 
communication with parents/guardians, current 
Recovery Partner to discuss what ACC support 
living situation and other indicators described in 
could be considered under the sensitive claim.
Note 1a of Referring children in potentially 
3) If the client agrees to having this conversation 
vulnerable situations.
with the Recovery Partner, create an NGCM call 
• The stability of the current injury must be clear, 
back request task on the client’s party record 
with Clinical Services hotline input if the injury is 
with the follow details
not clearly progressing / resolving Seek Internal 
a. What has prompted this contact request
Guidance.
b. Brief summary of the client’s situation
c. Contact to be made with client to discuss sup-
ports under sensitive claim and re-opening this.
Team Leaders will consider the clinical needs, 
4. Link the claim number to the task and transfer 
social needs and likelihood of a stable and sus-
to the Partnered Recovery Department queue for 
tainable return to independence for the child. 
allocation.
Team Leader will respond by email with Approval 
or Declinature and recommended next steps.
For the Recovery Partner:
5) Contact the client to discuss support and re-
If approved, update Life Areas in Salesforce with 
engaging under the sensitive claim.
the date of the approval noting “Transition to As-
6) If the client agrees to engage in support or 
sisted Recovery Approved”. File the email away 
wishes to continue with agreed next steps under 
to the claim.
the sensitive claim, the Recovery Partner should 
If declined, update the Recovery Plan to include 
then consider whether whole of person conver-
recommended next steps.
sation is appropriate now or once an engage-
ment form has been received.
See Whole of Person Guidelines below.
Referring children in potentially vulnerable situations
7) Ensure the claim is open and assign to you if 
Seek Internal Guidance
the client has agreed to engage in support.
NOTE What if you have determined the doesn't 
need to be transitioned?
If the client does not wish to engage with support 
The client remains with the current Recovery 
under the sensitive claim, advise the Recovery 
Team. This process ends.
Coordinator or Recovery Assistant of this out-
come. Record your contact and close the task. 
Claim can be transfer into Actioned cases.
NOTE What if you consider the claim should trans-
ferred to the Remote Claims Unit (RCU)?
Go to (NGCM) Transition claim into Remote 
Claims Unit (RCU) process.
PROCESS Transition client into Remote 
Claims Unit (RCU)
NOTE What if you consider the claim should be 
transferred to the Wellington Central Branch/
Te Ara Tika team?
Go to (NGCM) Transition Claim to Te Ara Tika.
PROCESS Transition Claim to Te Ara Tika
Whole of Person Guidelines
NOTE What if you have received a 'General' task 
requesting a claim be transferred to Esca-
lated Care Pathway (ECP)?
Close open tasks on the Recovery Plan. Tran-
sition the claim and the 'General' task received 
from ECP to ‘Escalated Care Pathway’ depart-
ment queue for the ECP team to manage using 
the following system steps.
If you need to contact or transfer a call to the 
ECP team you can call 07 848 7097 or email 
[email address]
ACC > Claims Management > Manage Claims > Assign and Allocate Claim > Transition Claim
Uncontrolled Copy Only : Version 82.0 : Last Edited Friday, 22 September 2023 8:50 AM : Printed Monday, 25 September 2023 10:52 AM
Page 5 of 7

---

3.0 Transition claim to a Recovery Team
NOTE What if you are transitioning a claim to Sup-
Recovery Assistant, Recovery Coordinator, Recovery 
ported or Partnered
  Partner
From the Salesforce Recovery Plan, add a Re-
a Prepare the claim for transition. Follow the below appro-
minder Action and set the action due date to 
priate note, these steps must be completed:
today then enter the following information into 
the description field:
NOTE What if you are preparing the claim to tran-
sition to Supported or Partnered?
• Send a notification to the client advising them 
• Check shared inbox and file away any emails 
of your contact details (Management team 
(see system steps below)
change notification).
• Ensure no outstanding emails on the claim
• Provide your rationale for transitioning the 
• Ensure filing away is completed and document 
claim.
list is tidy
• If applicable, state next actions.
• Complete all actions due
• In Eos, transfer the claim to the appropriate 
• Complete all urgent or overdue work required 
department queue. See Transfer a claim system 
(Including referrals and emails)
steps below.
• Life Areas updated
*If the information exceeds the reminder cha-
• Recovery goal updated
racter limit of 1500 characters then record the ra-
• Client is aware of and happy to transition (if not 
tional for the transition in the 'Engagement' life 
successfully able to contact this is noted in the 
area and note this in the reminder action.
task)
If you are transitioning the claim to Partnered 
NOTE What if you are preparing the claim to tran-
Recovery and need to advise if the claim needs 
sition to Assisted?
to be allocated to the Mental Injury or Physical 
• Filling away completed and documents are tidy 
Injury team please email [email address]
(see system steps for filing away below)
• All actions completed.
NOTE What if you are transitioning a claim to As-
• All urgent or overdue work required is complete 
sisted
(including referrals and emails).
• Notify provider/employer (if appropriate) of the 
• Life areas updated.
transition and provide Assisted Recovery's de-
• Recovery goal updated.
tails.
• No tasks overdue or due within 48 hours.
• In Salesforce, in the engagement life area 
• Stakeholders (employer, provider etc) informed 
record the transition rationale.
and information is updated i.e. participants.
• In Eos, transfer the claim to Assisted Recovery.
• Remove any unnecessary Reminder tasks (i.e. 
• Ensure you have provided the client with As-
waiting for report to arrive).
sisted Recovery's contact details either via 
• Client is aware of and happy to transition.
phone, email or text notification.
Transfer a claim (Eos Online Help)
If the client requires no further rehabilitation go to 
the Identify a Client for No Further Rehabilitation 
Create a Notification - System Steps
process.
NOTE What if the client is continuing to receive one 
PROCESS Identify a Client for No Further 
to one management but being transitioned to 
Rehabilitation
a new Recovery Coordinator/Partner?
NGCM Filing Away - System Steps
Prepare the claim for transition as per the above 
preparation note.
NOTE What if the Recovery Plan requires updating?
Go to the Create or Update Recovery Plan 
From the Salesforce Recovery Plan, add a Re-
process
minder Action and set the action due date to 
PROCESS Create or Update Recovery 
today then enter the following information in the 
Plan
description field:
b Complete transition by following the below appropriate 
note:
• Send 'Management team change' notification to 
the client
• Provide your rationale for transitioning the claim
• If applicable, state next actions.
• Email [email address] if there are any allo-
cation requirements (eg. location, gender, cul-
tural capability)
NOTE What if your client is transitioning from Sup-
ported or Partnered Recovery and receives 
Medical Consumables through Community 
Client/Onelink?
Ensure any 'work items' awaiting approval are 
processed prior to transitioning the claim and 
that relevant Providers/Assessors are aware of 
the change of Recovery Team to ensure they 
select the correct approver for future requests.
ACC > Claims Management > Manage Claims > Assign and Allocate Claim > Transition Claim
Uncontrolled Copy Only : Version 82.0 : Last Edited Friday, 22 September 2023 8:50 AM : Printed Monday, 25 September 2023 10:52 AM
Page 6 of 7

---

NOTE What if the client is being transitioned from 
Run or Edit Engagement Model Decision (EMD)
Enabled to Assisted?
 
I am a Recovery Administrator:
PROCESS
Allocate Claim
• In Eos, transfer the claim to the Assisted 
Real-time workforce analyst
Recovery Department queue.
• Send 'Management team change' notification to 
PROCESS
Conduct Welcome Conversation
the client with Assisted's contact details.
Recovery Assistant, Recovery Coor-
dinator, Recovery Partner
• If the claim has been incorrectly put in Enabled 
Recovery and a Welcome Conversation is re-
quired to complete the initial set up, create a 
PROCESS
NGCM Welcome Conversation task in Eos. Note 
Conduct Recovery Check-in 
in the description the reason for the transition.
Conversation
Recovery Assistant, Recovery Coor-
• If the claim needs to be transitioned due to no 
dinator, Recovery Partner
longer meeting Enabled criteria (refer to Choos-
ing the right Recovery Team), create the Recov-
ery Plan in Salesforce. Add a Recovery Check In 
action (see create or update Recovery plan) and 
note in the description the reason for the tran-
sition.
I am a Recovery Assistant:
• In Eos, transfer the claim to the Assisted 
Recovery Department queue.
• Send 'Management team change' notification to 
the client with Assisted's contact details.
• If the claim has been incorrectly put in Enabled 
Recovery and a Welcome Conversation is re-
quired to complete the initial set up, attempt Wel-
come Conversation and set up the Recovery 
Plan accordingly.
• If the claim needs to be transitioned due to no 
longer meeting Enabled criteria (refer to Choos-
ing the right Recovery Team), attempt a full 
Recovery Check in, if the client is an earner col-
lect all Employment information e.g. Job title, job 
tasks and contact details for Manager and 
update the Recovery Plan accordingly.
• If the client is an earner attempt Employer Wel-
come Conversation and update life areas with 
relevant information.
PROCESS Create or Update Recovery 
Plan
NOTE What if the client is being transitioned to 
Enabled?
• In Salesforce, complete all actions on the 
Recovery Plan timeline and mark as 'complete' 
or 'no longer relevant' (it is preferred that there 
are No open tasks for on-going claims manage-
ment for clients with claims in Enabled Recov-
ery).
• In Eos, transfer the claim to Enabled Recovery 
Department queue.
• Send 'Management team change' notification to 
the client.
Transfer a claim (Eos Online Help)
NOTE What if you're transferring a claim from BAU 
to a Recovery Team?
In Eos, transfer the claim.
Move a claim from BAU to NGCM
ACC > Claims Management > Manage Claims > Assign and Allocate Claim > Transition Claim
Uncontrolled Copy Only : Version 82.0 : Last Edited Friday, 22 September 2023 8:50 AM : Printed Monday, 25 September 2023 10:52 AM
Page 7 of 7

---

Document Outline

• Code of Conduct
• GOV-027853 Binder
  • Manage access to Staff Claims
• GOV-027853 Binder 2
• GOV-027853 Binder 3

---