Accident Compensation Corporation

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Accident Compensation Corporation

Te Kaporeihana Āwhina Hunga Whara
Accnzlogo.jpg
Logo of Accident Compensation Corporation
Agency overview
Jurisdiction Government of New Zealand
Headquarters Vogel Centre, Aitken St, Wellington
41°16′30″S 174°46′40″E / 41.274876°S 174.777701°E / -41.274876; 174.777701
Minister responsible Nikki Kaye, Minister for ACC
Agency executive David May, Chief Executive
Website www.acc.co.nz

The Accident Compensation Corporation (ACC) (Māori: Te Kaporeihana Āwhina Hunga Whara) is a New Zealand Crown entity responsible for administering the country's universal no-fault accidental injury scheme. The scheme provides financial compensation and support to citizens, residents, and temporary visitors who have suffered personal injuries.

The corporation was founded as the Accident Compensation Commission on 1 April 1974 as a result of the Accident Compensation Act 1972. Its principal governing act today is the Accident Compensation Act 2001.[1] As a Crown entity, ACC is responsible to a Cabinet Minister via its Board of Directors. Unlike most other Crown entities, it has its own dedicated ministerial portfolio, which since October 2014 has been held by Nikki Kaye.

Features[edit]

ACC is the sole and compulsory provider of accident insurance for all work and non-work injuries. The ACC Scheme is administered on a no-fault basis, so that anyone regardless of the way in which they incurred an injury, is eligible for coverage under the Scheme. Due to the Scheme's no-fault basis, people who have suffered personal injury do not have the right to sue an at-fault party, except for exemplary damages.[2]

The ACC Scheme provides a range of entitlements to injured people, however 93.5 percent of new claims in 2011-12 were for treatment costs only. Other entitlements include weekly compensation for lost earnings (paid at a rate of 80% of a person's pre-injury earnings) and the cost of home or vehicle modifications for the seriously injured. The entitlements offered by the Scheme are subject to various eligibility criteria.

Initially ACC was not available to veterans, as the scheme was not introduced until 1974 and was not retrospective. However ACC law specialist John Miller claims a 1992 law change did make the scheme retrospective.[3] Full funding of historic claims is due to come into effect in 2014.[4]

History[edit]

ACC is rooted in the 1900 "Worker's Compensation Act", which established a limited compensation scheme for workers who had suffered injuries where there was no directly responsible party. In 1967, a Royal Commission, chaired by High Court judge Owen Woodhouse, recommended that this compensation should be extended to all injuries on a no-fault basis. Following this report, on 1 April 1974 the Accident Compensation Commission was established, to implement the requirements of the 1972 Accident Compensation Act, and the 1973 Amendments. The Act was later replaced by the Injury Prevention, Rehabilitation and Compensation Act 2001, which was renamed the Accident Compensation Act 2001 in 2010. The Annual Report (1989/90) of the Accident Compensation Commission[5] proposed that the distinction between "accidents" (which is covered[6]) and "illness" (which is not) should be dropped. But this proposal was not taken up. In 1992 the Accident Compensation Commission changed its name to the "Accident Compensation Corporation".

From 1 July 1999 the Fourth National government allowed private insurance operators to provide work-related accident insurance, and ACC was briefly exposed to competition. Following the election of the Fifth Labour government in November 1999, this change was repealed, and as of 1 July 2000, ACC was re-instated as the sole provider of accident insurance coverage.

Administration of levies[edit]

ACC is funded through a combination of levies and government contributions. Income collected from each source goes into predetermined account based on the source. Costs relating to an injury are paid from one of these accounts based on the type and cause of the injury.

The four main accounts are: Work, Earners, Non-Earners, and Motor Vehicle. There is also a fifth account, Treatment Injury (formerly Medical Misadventure) that draws on both the Earners and Non-Earners account.[7]

Account Covers Income sources
Work Work-related injuries Levies collected from employers. The amount payable as of April 2012 is on average 1.15% of the business's total payroll, but the exact percentage varies between 0.11% and 6.46% depending on the risks associated with each business's industry.
Earners Non-work injuries by income earners Levies collected in conjunction with tax deductions on income. Paid via the Inland Revenue Department. As of April 2012, the earners levy is 1.70% of non-exempt taxable income up to $113,768 per annum.
Non-earners Non-work injuries by non-income earners
(e.g. children, elderly, unemployed, visitors)
Government contribution from the general taxation pool.
Motor Vehicle Injuries relating to motor vehicles on public roads Levies included in the price of petrol (not diesel or LPG), and through motor vehicle license fees. Levies average $334.52 per year as of April 2012, with motorcycles and heavy vehicles paying more than average due to the increased likelilhood of injury associated with these modes of transport.
Treatment Injury Injuries as a result of medical treatment Funded from the Earners and Non-Earners accounts, depending on the claimants' employment statuses.

Funding[edit]

ACC offices in Palmerston North

ACC initially had a 'pay-as-you-go' funding model which collected "only enough levies during the year to cover the cost of claims for that particular year". In 1999 a 'fully funded' model was adopted whereby sufficient levies were collected to cover the lifetime cost of each injury - which might require compensation over a period of 30 years or more.[7] However getting ACC onto a strong financial footing was not easy and in 2009, ACC posted a $4.8 billion loss - described as the biggest corporate loss in New Zealand's history. This cost escalation is thought to have been due to an increase in the number of claims, a widening of entitlements and increased costs of meeting the claims.[4] Another factor was physiotherapy services being made free at the point of delivery leading to over-servicing of clients.[8] Between 2000 and 2008 this appears to have contributed to an increase in physiotherapy costs of 214%.[9]

The 100% reimbursement scheme for physiotherapist services was ended and ACC levies on wages and motorists were increased.[10] ACC chairman John Judge told the Sunday Star-Times that it was going to take a "hard-nosed" approach to get ACC into a sustainable position. This would require "substantial" levy increases and "legislative change to get people off the scheme and back to work quicker".[4] By 2012, ACC had made good progress towards its 2019 goal (of being fully funded), and was only $4.5 billion short of matching liabilities ($28.5b) with its assets ($24b).[11]

Towards the end of 2012, Judith Collins announced that Government would not cut ACC levies for the 2013-2014 year. While the ACC Board and Ministry of Business Innovation and Employment had recommended reducing the levies by between 12 and 17 percent, Collins stated that the government's decision was motivated by the uncertain economic conditions and a desire to ensure that reductions to the levy were sustainable. Andrew Little, the Labour Party's ACC spokesman, criticised this decision, claiming that it was driven by the government's attempt to bring the budget into surplus and reducing the levy would provide a boost to the economy.[12] In the 2013 budget, Collins announced a $1.3 billion cut in ACC levies over the next two years. Ms Collins said the Earners and Workers accounts were now fully funded after the Corporation reduced the number of long term ACC claimants from 14,000 to less than 11,000.[13]

In 2012, ACC Minister Judith Collins stated that measures for incentive payments for ACC case managers includes targets for moving long term claimants off ACC support.[14] That year there were 10,400 long-term claimants registered with ACC - down by over 1,000.[15] Green Party MP Kevin Hague said performance pay increased the risk that "we end up with decisions about whether or not someone is entitled to compensation being driven by the financial interests of the case managers and their managers rather than the clinical needs of the claimants."

Notable events[edit]

Violence against staff[edit]

In some cases ACC clients have threatened or attempted to harm ACC staff members. In 2010 ACC logos were removed from company vehicles after several staff were "rammed or driven off the road by other drivers". The following year a threat against former chief executive Ralph Stewart led to a decision for security staff to be posted outside his home. There have been at least two threats to blow up a car bomb outside ACC offices and police have had to be called on several other occasions. In 2012, there were a total of 134 recorded threats made against staff - the majority against case managers "making difficult decisions" on clients' cases.[16]

Client fraud[edit]

In 2013, it was reported that 64 people have been convicted of defrauding ACC of more than $10 million over the past four years. This includes clients claiming they were "injured" but who kept working while receiving ACC benefits and medical practitioners who billed ACC for more treatment than they actually provided. Another category of ACC fraudster includes widows who continued claiming payments after their (injured) partners had subsequently died. Sometimes these payments went on for nearly 30 years before the fraud came to light - with one woman receiving nearly $150,000 after her husband had died.[17]

Staff fraud[edit]

There have been a number of cases where ACC staff have defrauded the corporation. Jeffrey Chapman, former ACC chief executive from 1985 to 1992, was imprisoned for defrauding ACC and another government agencies; Gavin Robbins, his successor from 1993 to 1997, was also charged with fraud but was acquitted.[18] In 2011 a senior manager was convicted of dishonesty offences involving property leased to ACC by private business interests.[19] In late 2012, Dr Jonathan Wright, an ACC-contracted medical assessor, was convicted of dishonestly obtaining over $18,000 in falsified travel expenses from ACC.[20]

Medical misadventure claims[edit]

A New Zealand Herald article in 2000 described ACC as 'sick system' particularly in cases of medical misadventure. It said ACC used to make lump sum payments but stopped in 1992. Also legal aid was abolished for appeals against ACC decisions and judges "raised the bar for proof of wrongdoing". Lawyer Antonia Fisher said: "It surprises me that the vast majority don't realise that if there has been a medical stuff-up there is no redress. Our system is appalling and it leads to appalling injustices".[21]

Mislabelling injuries as degenerative[edit]

In 2010, it was reported that 48-year-old Aucklander Yahaloma Hochman was refused coverage for spinal surgery by ACC after a motor accident. ACC general claims manager Denise Cosgrove tried to blame Mrs Hochman's injuries on "advanced disc degeneration" which was "aggravated by the road traffic accident and not caused by [it]". Wellington lawyer and ACC specialist, John Miller, said hundreds of similar accident victims were wrongly being refused treatment for injuries that were being mislabelled by ACC as "degenerative". This was forcing lawyers to request reviews of ACC's decisions. Mr Miller said his law firm had more than 1000 accidents under review and appeals under way and had had to take on extra staff. "We now have 12 lawyers in our firm working on ACC because it's just grown exponentially from the number of declines they have (made)." Orthopaedic Association president Gary Hooper believes ACC is taking a similar hard line with many older accident victims. "ACC is trying to say everyone over 40 has degeneration," he said.[22] John Miller said this was a deliberate strategy: "ACC are just acting like these rapacious overseas insurance companies, refusing them holus-bolus on the flimsy grounds of degeneration, because we all have degeneration, and hoping like some of these overseas insurance companies that people won't challenge them," he said.[22]

Bronwyn Pullar privacy breach[edit]

ACC has had a number of breaches of privacy relating to claimants. The most significant occurred in 2011 after the release of details of 6700 claimants to an ACC claimant, Bronwyn Pullar. Pullar had been battling ACC since suffering a head injury in 2002—and had 45 separate complaints against the agency—only one of which was about the privacy breaches.[23] In 2011 she and former National Party president Michelle Boag, had a meeting with two senior ACC managers to discuss her concerns. ACC referred the matter to the police claiming Pullar had threatened to go to the media about the privacy breaches if she didn't get what she wanted. The police listened to a tape recording of the meeting and decided there was no case to answer.[24][25]

In March 2012, ACC Minister Dr Nick Smith resigned from Cabinet after it was revealed that that he had written letters on behalf of Ms Pullar, who was a personal friend of his, while he was ACC Minister.[26]

ACC chairman John Judge continued to insist his version of events was correct and as a result ACC Minister Judith Collins did not renew his tenure on the ACC Board. The chief executive of ACC, Ralph Stewart, also resigned the next day.[27] Three other Board members - Murray Hilder, Rob Campbell and John McCliskie - also resigned.[28]

The fallout from the affair continued in May 2012, when Collins sued Labour MPs Trevor Mallard and Andrew Little for defamation over comments they made on Radio New Zealand linking her to the leak of an email from Michelle Boag following the release of the files.[29] The case was settled after a High Court hearing in November 2012.[30]

An independent review of ACC was conducted towards the end of 2012 and found the organisation "lacked a comprehensive strategy for protecting and managing claimants' information" and said ACC had an "almost cavalier" attitude toward its clients. The review showed that the culture within ACC enabled its staff to target clients involved in privacy breaches and complaints rather than demonstrating respect for claimants. In 2013, a training Academy for staff was mooted with an "emphasis on a client-centred approach".[31]

See also[edit]

References[edit]

  1. ^ "Accident Compensation Act 2001 -- New Zealand Legislation". Parliamentary Counsel Office. 
  2. ^ see, Donselaar v. Donselaar [1982] 1 NZLR 97, confirmed by Auckland City Council v. Blundell [1986] 1 NZLR 732
  3. ^ Apology has veterans ready to sue Government
  4. ^ a b c The painful bills about to wallop your wallet
  5. ^ Annual Report (1989/90) of the Accident Compensation Commission, p.5
  6. ^ see Fenton v. Thorley [1903] WN 149 for an old definition
  7. ^ a b "How we're funded - ACC". Retrieved 4 May 2011. 
  8. ^ Physiotherapy claims summary
  9. ^ ACC moves to curtail rise in physiotherapy costs
  10. ^ Armstrong, Grahame (11-10-2009). "The painful bills about to wallop your wallet". The Sunday Star Times. Archived from the original on 13 June 2011. Retrieved 24 May 2011.  Check date values in: |date= (help)
  11. ^ Funding issue brews in ACC's cauldron
  12. ^ Govt ignored ministry call to trim ACC levies by $477m
  13. ^ ACC leads good economic news at National party convention NZ Herald 25 May 2013
  14. ^ ACC bonus pay for claimant cull
  15. ^ Ex-boss defends ACC rehabilitation policy
  16. ^ ACC staff in line of fire
  17. ^ ACC frauds hit $10m over past four years
  18. ^ Don Rennie, "Administering Accident Compensation in the 1980s", (2003) 34 VUWLR 329, 348
  19. ^ Former ACC property boss escapes jail over bribe
  20. ^ ACC fraud doctor named in court
  21. ^ A sick system, NZ Herald 13 February 2000.
  22. ^ a b ACC's 'flimsy refusals', NZ Herald 9 December 2012
  23. ^ Full list of Bronwyn Pullar's complaints against ACC, The Dominion Post
  24. ^ http://www.3news.co.nz/Pullar-did-nothing-criminal---police/tabid/1607/articleID/256751/Default.aspx
  25. ^ Editorial: Time for answers, ACC
  26. ^ Nick Smith bows out as minister
  27. ^ ACC boss resigns amid political pressure The Dominion Post 13 June 2012
  28. ^ Murray Hilder resigns from ACC board
  29. ^ "Mallard served papers by faux-constituent". 28 May 2012. 
  30. ^ Judith Collins defamation case settled, The New Zealand Herald, 14 November 2012
  31. ^ Charm school for ACC staff

External links[edit]