|Part 1: Introduction|| || |
This Code of ACC Claimants’ Rights (this Code) has been established under sections 42 to 44 of the Injury Prevention, Rehabilitation, and Compensation Act 2001 (the Act).
This Code confers rights on claimants and imposes obligations on ACC in relation to how ACC should deal with claimants.
This Code comes into force on 1 February 2003, and a complaint can be made under this Code from that date. A complaint cannot be made under this Code about any dealings ACC had with a claimant prior to 1 February 2003.
The purpose of this Code is outlined in section 40(1) of the Act. The Act states that the purpose of this Code is to meet the reasonable expectations of claimants (including the highest practicable standard of service and fairness) about how ACC should deal with them. This includes—
Section 40(2) of the Act provides that:
This means that claimants’ obligations, responsibilities, and entitlements, as set out in the Act, do not change. In addition, claimants retain their rights and responsibilities under any other enactment or the general law, including that which governs the Health and Disability Commissioner, the Human Rights Commission, the Office of the Ombudsmen, and the Office of the Privacy Commissioner.
In summary, the purpose of this Code is to meet the reasonable expectations of claimants about how ACC should deal with claimants. This Code is not about cover, or the type and level of entitlements that ACC is obligated to provide, as these continue to be prescribed by the Act.
This Code encourages positive relationships between ACC and claimants. For ACC to assist claimants, a partnership based on mutual trust, respect, understanding, and participation is critical. Claimants and ACC need to work together, especially in the rehabilitation process. This Code is about how ACC will work with claimants to make sure they receive the highest practicable standard of service and fairness.
In all its dealings with claimants, ACC must ensure that its actions are consistent with, and uphold, the rights of claimants as provided for in this Code by applying the highest practicable standard of service and fairness.
Accredited employers, and persons acting as agents of ACC or on behalf of ACC, must also comply with this Code in their dealings with claimants.
The provision of treatment services is not covered by this Code, and continues to be covered by the Code of Health and Disability Services Consumers’ Rights. In addition, any treatment and disability services purchased by ACC are covered by the Health and Disability Sector Standards and the Health and Disability Services (Safety) Act 2001.
Complaints about the quality of health and disability services continue to be covered by the Code of Health and Disability Services Consumers’ Rights.
Any disputes about cover and entitlements, including treatment and compensation, are not covered by this Code, and continue to be addressed by the mechanisms under the Act.
In this Code—
ACC means the Corporation as defined in section 39 of the Act, and we and us have a corresponding meaning
Corporation, as defined in section 39 of the Act, includes—
you means a claimant, as defined in the Act, and your has a corresponding meaning.
|Part 2: Rights and obligations of this Code|| |
The 8 rights of claimants, with ACC’s corresponding obligations, are as follows:
|Right 1|| |
You have the right to be treated with dignity and respect.
|Right 2|| |
You have the right to be treated fairly, and to have your views considered.
|Right 3|| |
You have the right to have your culture, values, and beliefs respected.
(a) We will be respectful of, and responsive to, the culture, values, and beliefs of Māori.
(b) We will be respectful of, and responsive to, all cultures, values, and beliefs.
|Right 4|| |
You have the right to a support person or persons.
|Right 5|| |
You have the right to effective communication.
|Right 6|| |
You have the right to be fully informed.
(c) We will provide you with full and correct information about your claim, entitlements, obligations, and responsibilities.
|Right 7|| |
You have the right to have your privacy respected.
|Right 8|| |
You have the right to complain.
|Part 3: Addressing problems and concerns; and lodging and dealing with complaints|| |
This Code sets out a framework for addressing and resolving problems and concerns at the local level, and then a process to be followed for complaints, in the event that any problem or concern cannot be resolved at the local level.
A claimant can either—
A claimant can raise a problem or concern about ACC’s compliance with this Code. The problem or concern should be raised at the local level with the person the claimant is dealing with at ACC, or that person’s manager.
ACC will work with the claimant to address and resolve problems and concerns, and to find a way forward. At this point, ACC will advise the claimant of—
The claimant can decide whether to lodge a complaint.
A complaint concerning this Code should be lodged with the complaints service. The complaints service is part of ACC, and will deal with, and make decisions on, these complaints. The complaints service will act in a fair and impartial manner, taking the evidence, and the claimant’s and ACC’s views into consideration.
A complaint can be lodged with the complaints service at any time, regardless of whether the claimant previously raised a problem or concern with the person the claimant is dealing with at ACC, or that person’s manager.
The claimant may complain orally or in writing.
ACC may decline to investigate where a complaint is correctly dealt with by another agency, such as the Health and Disability Commissioner. In these circumstances, ACC will advise the claimant of appropriate agencies that may be able to assist.
Any dispute about cover and entitlements, including treatment and compensation, is not covered by this Code, and continues to be addressed by mechanisms under the Act.
The complaints service will—
If, in the course of investigating a complaint against ACC, issues of the performance of an employee or employees of ACC arise, these will be dealt with under the normal human resources policy and processes within ACC, having due regard to employment law. These issues will not be dealt with under the auspices of remedies available under this Code.
The complaints service will issue a decision on the complaint. The decision will be in writing and will advise—
(c) if a breach has occurred, what, if any, of the remedies or actions identified in Part 4 are appropriate.
In addition, the decision will specify that the claimant has the right to a review of that decision, as in Part 6.
|Part 4: Remedies available under this Code|| |
Upon a finding that there has been a breach of this Code, the complaints service may, where appropriate, direct ACC to—
In addition, the complaints service may, where appropriate, recommend other remedial actions as required.
|Part 5: Addressing situations|| |
In addition to the remedies in Part 4, ACC will address the wider implications of breaches that arise by—
|Part 6: Claimant’s right of review|| |
If a claimant disagrees with any decision made by ACC under this Code about a complaint, the claimant can apply for a review of that decision. ACC will provide information about the review process to the claimant. The review process is set out in sections 133 to 148 of the Act. The Act includes, among other things,—
|Part 7: An appeal cannot be lodged to the District Court|| |
Under the appeal provisions in the Act, there is no right to appeal a review decision made under this Code because section 149(3) of the Act provides that:
Any rights of review and appeal, in relation to cover and entitlements, continue under the Act.
|Part 8: Status of Code|| |
Section 46 of the Act provides that this Code is a regulation for the purposes of the Regulations (Disallowance) Act 1989. Under section 44 of the Act, this Code must be presented to the House of Representatives.