My Costs and Claims

What Share of Costs Will I Have to Pay?
You may have to pay part of the fee for common types of treatment. You don't have to pay for acute public hospital admissions and some related services, or for elective surgery if you have prior approval from the ACC. If you choose a private provider who does not have a contract with the ACC, the ACC may pay only part of the cost of the surgery. The fees can vary, so check first how much you may have to pay. If you pay the full fee, keep your receipt and claim back part of that cost from ACC.

How are my Claims Treated?
When an employee suffers a work related injury they must advise you (the employer) and the ACC. As an employer, you have the right to ask the ACC to review whether a particular claim is work related or not. Injured employees receive treatment and services described above and they are also entitled to assistance with costs of medical treatment and rehabilitation, plus compensation for lost earnings if they require time off work.

If your employee requires time off work, the ACC will assign a case manager to the claim and keep in contact with you about the employee's injury.  Also, they will set out a rehabilitation plan to enable the employee to get back to work as soon as possible. If your employee is eligible for weekly compensation for loss of earnings then you (as their employer) will have to pay the first week of the compensation, even if the injuries were work related motor vehicle injuries.

The second and subsequent weeks of compensation are payable by the ACC. You may be required to complete an employee-earning certificate to enable the ACC to make any ongoing compensation payments. Weekly compensation is calculated at 80% of the lost earnings. If your employee works for more than one employer, then the employer in whose employment the injury occurred is responsible for paying the full first week of compensation.

How and When do I Apply?
The date that you apply is important because it can effect when you qualify for compensation. Always ask for an application form from the ACC or write to the ACC outlining the assistance you are applying for as soon as possible after the accident.

What about my Hospital Treatment?
The ACC will help with the cost of the hospital treatment, surgery, prescription or x-rays if you have an accident. Waiting times for non-urgent treatment and surgery are now shorter, whereas in the past people with non-urgent injuries had to wait for many months for treatment. The ACC now has contracts with public and private hospitals to speed things up, so your doctor has a number of choices about how, when and where you can receive treatment.

What about my Private Surgery Conditions?
If you need elective (that is, non-urgent surgery) or dental care for your injury, you need approval from the ACC before you go into hospital for that operation. This applies especially if you decide to have private surgery, even if you have private medical insurance.

What is Lump Sum Compensation?
Lump sum compensation is a one-off payment to compensate you for permanent impairment resulting from your injuries. A lump sum is paid in addition to any other entitlements or assistance you may receive from the ACC. The amount will depend on your level of permanent impairment.