Accident Compensation Corporation - Statement of Corporate Intent ...
Accident Compensation Corporation - Statement of Corporate Intent ...
Accident Compensation Corporation - Statement of Corporate Intent ...
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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 />
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