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Accident Compensation Act 2001

Code of ACC Claimants' Rights, and claims - Claims process

57: Steps Corporation takes to action complicated claims for cover

You could also call this:

“What ACC does when you make a tricky claim”

When you make a complicated claim for cover, the Accident Compensation Corporation (ACC) has to follow certain steps. A complicated claim could be for mental injury, work-related gradual injuries, injuries caused by treatment, or claims made after the usual time limit.

ACC needs to look into your claim within 2 months of you making it. They will do this at their own cost and as much as they need to make a decision. After investigating, ACC will either decide on your claim and let you know, or tell you they need more information. If they need more information, they can take up to 2 more months.

If ACC needs more time, they will ask you or someone else for more information. They’ll tell you if they’re asking someone else. After getting the extra information, ACC will make a decision on your claim and let you know.

You and ACC can agree to give them even more time if needed. However, ACC must make a decision within 9 months of you making your claim.

If ACC finds that your claim is actually not complicated, they will treat it as if you just made the claim on the day they realised this.

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View the original legislation for this page at https://legislation.govt.nz/act/public/1986/0120/latest/link.aspx?id=DLM100984.

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Part 3 Code of ACC Claimants' Rights, and claims
Claims process

57Steps Corporation takes to action complicated claims for cover

  1. This section applies to a claim for cover—

  2. for mental injury in the circumstances described in section 21 or 21B:
    1. for personal injury caused by a work-related gradual process, disease, or infection:
      1. for personal injury caused by treatment:
        1. lodged outside the period stated in section 53.

          1. The Corporation must take the following steps as soon as practicable, and no later than 2 months, after the claim is lodged:

          2. investigate the claim—
            1. at its own expense; and
              1. to the extent reasonably necessary to enable it to take the following steps in this subsection; and
              2. either—
                1. make its decision on the claim and give notice of it under section 64; or
                  1. decide that it cannot make its decision on the claim, or any other decision, without additional information, and tell the person of the extension, which must not exceed 2 months, that will be required.

                  2. The Corporation must take the following steps as soon as practicable, and no later than the expiry of the extension:

                  3. make a reasonable request to the person, or decide to make a request to another person, for the additional information; and
                    1. if the Corporation proposes to make a request to another person for the additional information, tell the person making the claim about the making of the request and its nature; and
                      1. make its decision on the claim and give notice of it under section 64.

                        1. The Corporation and the person making the claim may agree to further extensions after the extension referred to in subsection (3), and that subsection applies to any further extension, but the Corporation's decision on the claim must be made within 9 months of the claim being lodged.

                        2. If the Corporation finds that the claim is an uncomplicated claim under section 56, that section applies as if the claim were lodged on the date the Corporation made that finding.

                        Notes
                        • Section 57(1)(a): amended, on , by section 14 of the Injury Prevention, Rehabilitation, and Compensation Amendment Act 2008 (2008 No 46).
                        • Section 57(1)(c): amended, on , by section 17 of the Injury Prevention, Rehabilitation, and Compensation Amendment Act (No 2) 2005 (2005 No 45).