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Accident Compensation Act 2001

Miscellaneous provisions - Situations where previous insurer involved

295: Obligation to provide entitlements where subsequent injury occurs

You could also call this:

“ACC and insurers must work together to help you if you get hurt again”

If you get hurt again while you’re already getting weekly payments for an earlier injury, here’s what happens:

The insurance company and ACC can’t reduce your weekly payments or independence allowance just because of your new injury.

The insurance company must keep helping you get better from your first injury, as long as it’s still possible with your new injury.

ACC will give you any treatment you need for your new injury.

ACC will make sure you get any other help you need, whether it’s for your old injury or your new one.

If your new injury affects the help you get for your old injury, the insurance company and ACC will work together to figure out how to best take care of you. They’ll decide who will manage your care and who will pay for what.

When the insurance company and ACC make a plan, they should try to have one of them take charge of your care. Sometimes, they might share the job if it’s better for you, but only if it doesn’t make things too hard for you.

They will check their plan from time to time to make sure it’s still good for you.

If you want to ask for a review of any decisions about your injuries, both the insurance company and ACC can be there to explain their side.

The insurance company and ACC are allowed to share information about you to help them make the best plan for your care.

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View the original legislation for this page at https://legislation.govt.nz/act/public/1986/0120/latest/link.aspx?id=DLM103429.

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294: Scope and purpose of sections 295 to 297, or

"Rules for when you get hurt more than once and who helps you"

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296: Failure to reach agreement, or

"What happens when ACC and the insurer can't agree on your claim"

Part 9 Miscellaneous provisions
Situations where previous insurer involved

295Obligation to provide entitlements where subsequent injury occurs

  1. If a subsequent injury occurs while the previous injury still gives rise to an entitlement to weekly compensation for the claimant, the following obligations continue or arise:

  2. neither the insurer nor the Corporation may reduce the rate of weekly compensation or independence allowance payable after the subsequent injury solely because of the subsequent injury:
    1. the insurer must continue to provide any rehabilitation (including treatment in respect of the previous injury) that it was providing, unless the occurrence of the subsequent injury makes that impracticable:
      1. the Corporation must provide any treatment in accordance with this Act required as a result of the subsequent injury:
        1. the Corporation must ensure that the claimant receives any other entitlements, whether arising from the subsequent injury or the previous injury:
          1. unless the Corporation is satisfied that the subsequent injury does not have a material impact on entitlements from the previous injury, the insurer and the Corporation must jointly consider the situation arising from the fact that there have been 2 personal injuries to the claimant and seek to reach an agreement on the appropriate mix of obligations they will have in respect of the claimant's entitlements, both in terms of managing the claimant's claims and rehabilitation and in terms of financial responsibility for the claimant's entitlements.

            1. In seeking to reach agreement under subsection (1)(e), the insurer and the Corporation must be guided by the purpose set out in section 294(2).

            2. An agreement under subsection (1)(e)—

            3. either—
              1. must normally include provision for one of the parties to take sole management responsibility for the claims in return for certain payments by the other; or
                1. may include provision for the parties to share management of the claims, but only if it is necessary for the claimant's successful rehabilitation and it does not unreasonably inconvenience the claimant; and
                2. must include provision for the operation of the agreement to be reviewed from time to time to ensure that it continues to properly reflect the best interests of the claimant; and
                  1. must include provision for allocation of costs of any entitlements already provided after the subsequent injury but before the agreement is reached.

                    1. If the claimant wishes to seek review under Part 5 of a decision by the insurer or the Corporation, in relation to either the previous injury or the subsequent injury, both the insurer and the Corporation have the right to be present and be heard at the review.

                    2. Despite the Privacy Act 2020, both the insurer and the Corporation must exchange personal information about the claimant necessary to enable them to reach an appropriate agreement and to provide entitlements.

                    Notes
                    • Section 295(5): amended, on , by section 217 of the Privacy Act 2020 (2020 No 31).