26 January 2016
Lee M
[FYI request #3501 email]
Dear Lee M
Official Information Act Requests
Thank you for your request of 19 December 2015 (at 9.17pm) asking for information under
the Official Information Act 1982 (the Act). Your questions and ACC’s responses are set out
below. Due to the similarity in subject matter and the response given, some answers have
been grouped.
Questions 1-2
1. How many times can the ACC revoke and substitute cover decisions made under the AC
Act and what part/section of the AC Act provides for this? If no part/section of the AC Act
provides for this, please provide me with a copy of the ACC policy, procedure, guideline or
rule that does provide for this.
2. In the case of a claim for cover, does the AC Act provide for the ACC making a primary
decision, then revoking and substituting it with a second decision and later making a third
decision which does not revoke or substitute the second decision but is separate to same? If
so what part/section of the AC Act provides for this. And, if no part/section of the AC Act
provides for this, please provide me with a copy of the ACC policy, procedure, guideline or
rule that does provide for this.
Under section 65 of the Accident Compensation Act 2001 (AC Act) ACC may revise
decisions if it considers a decision has been made in error, whatever the reason for the
error. A revision may amend the original decision, or revoke the original decision and
substitute it with a new decision.
There is no limit on the number of times ACC can revoke and substitute cover decisions
made under the AC Act.
Questions 3-4
3. How long a period of time can the ACC continue to investigate claims for cover and does
the AC Act or the ACC's policies, procedures, guidelines or rules allow the ACC to continue
investigating claims - ad infinitum - beyond the 4 month and 9 month time-limits provided
under Sections 56 and 57 of the AC Act? And if there is no such provision in the AC Act,
please provide me with a copy of the ACC policy, procedure, guideline or rule that does
provide for this.
4. Is a client's agreement required if the ACC wants to continue investigating a claim for
cover beyond the 4 and 9 month time-limits provided in Sections 56 and 57 of the AC Act? If
so, what part/section of the AC Act provides for this? And if there is no such provision in the
AC Act, please provide me with a copy of the ACC policy, procedure, guideline or rule that
does provide for this.
Sections 56 and 57 of the AC Act set out the timeframes for decisions for cover and
complicated claims for cover respectively. Under section 58, when ACC fails to comply
with these legislated timeframes, cover is deemed to be granted to the client. However,
as above, section 65 enables ACC to revise a cover decision if it considers a decision has
been made in error. Where this revision occurs, ACC may not recover any payments
made to the client, unless the client has provided intentionally misleading information to
ACC.
The client’s agreement is not required to investigate a claim for cover beyond the
timeframe, as the ACC45 claim form provides authority for this investigation.
ACC is happy to answer your questions
If you have any questions about the information provided, ACC will be happy to work with
you to answer these. You can contact us
at [email address] or in writing to
Government Services, PO Box 242, Wel ington 6140.
You have the right to complain to the Office of the Ombudsman about our decision to
withhold some of the information. You can call them on 0800 802 602 between 9am and
5pm on weekdays, or write to The Office of the Ombudsman, PO Box 10152, Wellington
6143.
Yours sincerely
Government Services
Government Services
