07.03.2015 Views

Accident Compensation Corporation - Statement of Corporate Intent ...

Accident Compensation Corporation - Statement of Corporate Intent ...

Accident Compensation Corporation - Statement of Corporate Intent ...

SHOW MORE
SHOW LESS

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

Output class 3:<br />

Claims management<br />

What is claims management?<br />

ACC’s claims management seeks to rehabilitate injured people covered under the Scheme by<br />

providing appropriate medical treatment, social and vocational rehabilitation services and<br />

compensation to ensure a swift return to work, independence or everyday life.<br />

How does claims management support ACC’s objectives?<br />

The claims management output seeks to support clients to achieve independence (Outcome 2).<br />

Achieving this objective efficiently also supports financial sustainability (Outcome 1) by<br />

delivering client outcomes at the lowest practicable cost.<br />

How does claims management work?<br />

ACC manages claims that range from the relatively minor (requiring some primary health<br />

services such as a one-<strong>of</strong>f visit to a GP) to claims from individuals who suffer serious injuries<br />

requiring life-long services and support.<br />

Operationally, claims are managed by:<br />

• processing and assessing new claims<br />

• providing telephone-based support and management <strong>of</strong> low-complexity claims through<br />

short-term claims centres and inquiry service centres<br />

• providing face-to-face claims management for higher-needs claims through the branch<br />

network<br />

• providing specialist claims management for targeted cohorts <strong>of</strong> claims, e.g. seriously<br />

injured and long-term clients.<br />

In order to rehabilitate clients, ACC must purchase a wide range <strong>of</strong> health and rehabilitation<br />

services. Operationally, this is achieved through:<br />

• identifying the most appropriate and effective services<br />

• procurement and monitoring <strong>of</strong> health providers<br />

• provider relationship management.<br />

What is the scale <strong>of</strong> claims management?<br />

The ACC Scheme is entitlement-based. That means each claim is evaluated to determine<br />

whether it meets the legislative standards. ACC does not have the ability to ration its services<br />

as demand is determined by the number <strong>of</strong> covered injuries that occur and whether those who<br />

are injured seek treatment. Therefore, measures <strong>of</strong> the quantity <strong>of</strong> services delivered are not<br />

meaningful.<br />

47

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!