Request for Official Information on Corporations policy and procedure after a claimant has lodged a claim for cover and entitlements directly under section 48 of the Act with their case manager.

David Lawson made this Official Information request to Accident Compensation Corporation

Response to this request is long overdue. By law Accident Compensation Corporation should have responded by now (details and exceptions). The requester can complain to the Ombudsman.

From: David Lawson

Dear Accident Compensation Corporation,

Under section 48 of the Accident Compensation Act 2001, any person eligible to lodge a claim under Act is legally entitled to lodge a claim for cover/s and entitlement/s on their own accord directly, and independent of a treatment provider, with ACC/the Corporation. Section 48 is quoted below.

48 Person to lodge claim for cover and entitlement
A person who wishes to claim under this Act must lodge a claim with the Corporation for—
(a) cover for his or her personal injury; or
(b) cover, and a specified entitlement, for his or her personal injury; or
(c) a specified entitlement for his or her personal injury, once the Corporation has accepted the person has cover for the personal injury.

I welcome your provision of the Corporation's official written policy and procedure that an ACC claimants/client's case manager is expected to undertake/comply with when the ACC claimant/client lodges formal and written claim/s for cover and entitlements with their case manager at ACC, to enable the client to remain fully informed with respect to the client/claimant receiving from the Corporation;

1. ACC's written acknowledgement of the clients/claimants section 48 lodgment of claim for the cover and entitlements and the specified time frame in days the Corporation have to provide written confirmation to the client/claimant ACC acknowledges the claim has been registered with ACC.

2. All other ongoing written communication that the Corporation is required to provide to keep the person informed of claims progress through to the provision of ACC's decision letter of claim acceptance/declinature to the person and the time frames provided under ACC policy/Procedure/Act.

3. What will occur should the Corporation exceed their permitted time frame for making a decision, or informing a client that a decision has not yet been made under section 56 or 56 of the ACC Act 2001.

I thank you for your assistance and respectfully request that this information is made available to me under urgency within 5 working days, being by the end of business close on the 31 October 2017 for the purposes of preparing information for alternative dispute resolution (5440587).

Under s16(2) of the Official Information Act, my preferred way of receiving a response is by email to the address from which ACC received the original request, not by post.

Yours faithfully,

David Lawson

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From: Government Services
Accident Compensation Corporation

Dear Mr Lawson

 

Official Information Act request

 

Thank you for your email of 23 October 2017 requesting the following
information under the Official Information Act 1982 (the Act).

 

Under section 48 of the Accident Compensation Act 2001, any person
eligible to lodge a claim under Act is legally entitled to lodge a claim
for cover/s and entitlement/s on their own accord directly, and
independent of a treatment provider,  with ACC/the Corporation.  Section
48 is quoted below.

 

48 Person to lodge claim for cover and entitlement A person who wishes to
claim under this Act must lodge a claim with the Corporation for—

(a)  cover for his or her personal injury; or

(b)  cover, and a specified entitlement, for his or her personal injury;
or

(c)  a specified entitlement for his or her personal injury, once the
Corporation has accepted the person has cover for the personal injury.

 

I welcome your provision of the Corporation's official written policy and
procedure that an ACC claimants/client's case manager is expected to
undertake/comply with when the ACC claimant/client lodges formal and
written claim/s for cover and entitlements with their case manager at ACC,
to enable the client to remain fully informed with respect to the
client/claimant receiving from the Corporation;

 

1. ACC's written acknowledgement of the clients/claimants section 48
lodgment of claim for the cover and entitlements and the specified time
frame in days the Corporation have to provide written confirmation to the
client/claimant ACC acknowledges the claim has been registered with ACC.

 

2. All other ongoing written communication that the Corporation is
required to provide to keep the person informed of claims progress through
to the provision of ACC's decision letter of claim acceptance/declinature
to the person and the time frames provided under ACC policy/Procedure/Act.

 

3. What will occur should the Corporation exceed their permitted time
frame for making a decision, or informing a client that a decision has not
yet been made under section 56 or 56 of the ACC Act 2001.

 

We note your request for an urgent reply by close of business today, 31
October. This email is to inform you that we are still working on your
request and we will be in touch with you as soon as possible, and
certainly by 20 November 2017.

 

In the meantime, if you have any questions we will be happy to work with
you to resolve these. We can be contacted by email at
[1][email address].

 

Yours sincerely

Government Engagement and Support

   

 

Disclaimer:

"This message and any attachments may contain confidential and privileged
information. If you believe you have received this email in error, please
advise us immediately by return email or telephone and then delete this
email together with all attachments. If you are not the intended
recipient, you are not authorised to use or copy this message or any
attachments or disclose the contents to any other person."

References

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From: Government Services
Accident Compensation Corporation


Attachment 0050867 RESPONSE.pdf
427K Download View as HTML


Dear Mr Lawson

 

Please find attached our response to your request for information under
the Official Information Act 1982, dated 23 October 2017.

 

Yours sincerely

Government Engagement and Support

 

Disclaimer:

"This message and any attachments may contain confidential and privileged
information. If you believe you have received this email in error, please
advise us immediately by return email or telephone and then delete this
email together with all attachments. If you are not the intended
recipient, you are not authorised to use or copy this message or any
attachments or disclose the contents to any other person."

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Amy S Van Wey Lovatt (Account suspended) left an annotation ()

Dear Mr Lawson,
I was wondering if you challenged the information in the letter from ACC, as the law does not state that claims must also be lodged by physicians. Section 49 provides an alternative route of lodgment, through a physician involved in your care.

Further section 50 states:
Responsibilities of Corporation after claim lodged
(1) On receiving a claim for cover under section 48 from a person, the Corporation must—
(a) decide whether or not it accepts that the person has cover; and (b) if it accepts that the person has cover,—
(i) provide information about the entitlements to which it considers the claimant may be entitled; and
(ii) facilitate the claimant’s access to those entitlements.
(2) If the claim is for cover for a treatment injury, the Corporation must provide the claimant with information on the role of the Health and Disability Commissioner under the Code of Health and Disability Services Consumers’ Rights.

Section 52 states:
Manner of making claim
(1) A person must lodge a claim with the Corporation in a manner specified by the Corporation.
(2) The Corporation must specify a manner that it is reasonable to expect the person to comply with.
(3) The Corporation may impose reasonable requirements on the person, such as, for example, requiring the person to lodge a written claim.

By requiring a claim to be lodged through a physician, ACC would be breaching section 52(2). My personal experience has been that every physician involved in my care refused to lodge treatment injury claim. This would include the failure to diagnose and treat a medical issue which caused damage to my heart, delay in diagnosis and treatment which nearly cost me my life, and missing a bloody brain tumour (three radiologists and a neurologist). In one instance, one provider wrote a letter of support, but that is not the same as lodging the claim.

Please let us know the outcome.
Cheers,
Amy

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