Making a claim

Contributed by Morgan Speight and current to 1 March 2017

Qualifying for a claim

The following flowcharts summarise the process:

• Pregnancy
• Mental injury
• Medical injury
• Heart attack or stroke
• Physical injury
• Death

Applying for a claim

If you are injured you should seek medical assistance by consulting a doctor, nurse, medical professional, or by visiting the Accident and Emergency department. The medical professional that you see will fill out the forms that ACC require, and send them on to ACC.

You may have to pay a part of the costs of the appointment, but ACC will cover the rest by paying the health care provider directly, this means that you do not have to pay the full amount that the medical professional is owed, and will only be billed the additional surcharge that is set by the professional that you visit.

If you are admitted to hospital the application will also be made on your behalf. If you were taken to hospital by an ambulance, you may be able to have the costs of the transport covered.

If you are asked to cover all of your own expenses, you should keep the receipts and paperwork that is involved as ACC may be able to reimburse some of the costs if they accept your claim.

If you will need to take time off from work, you will need to talk to the doctor or nurse that you visit. They will be able to give you a medical certificate if they agree that you will need time off work to recover from your injury.

Once ACC has received the application for cover, you will receive a phone-call or letter to let you know whether or not your claim has been accepted.

A claim can be made for:

• Cover for a personal injury; or
• Cover and an entitlement for a personal injury; or
• A specified entitlement once ACC has accepted the person for cover for a personal injury