ACC updates market on new claims process

ACC updates market on new claims process | Insurance Business

ACC updates market on new claims process

State-owned workplace insurer, the Accident Compensation Corporation (ACC) has published key documents detailing its new claims approval process.

ACC said the new process will identify and almost instantly accept straightforward claims, when it is obvious an injury was caused by an accident. It can only approve claims, it cannot decline them.

The documents also detail how claims data will be used to accept claims.

According to ACC chief operating officer Mike Tully, external expert advice was sought to ensure the new process is accurate and meets the Principles for Safe and Effective Use of Data and Analytics, developed by Statistics New Zealand and the Privacy Commissioner.

“Clients can be confident their data is being used appropriately and for a good purpose: faster claim decisions will put many clients in a better position as they start their recovery,” he noted.

The idea is that the new system will use a statistical model that takes data from 12 million anonymised claims lodged between 2010 and 2016, to determine the probability that a given claim will be accepted. It will also automatically generate text messages to let clients know what’s happening with their claim while they wait for their letter.

“How we make cover decisions for claims remains unchanged,” Tully noted. “All claims will still be assessed against Accident Compensation Act 2001 criteria, as they are now, and less straight-forward claims that don’t meet the criteria for fast-tracking will still be reviewed by a claims assessor.

“This means our people will have more time to focus on higher-value tasks like supporting clients through complex claims, and being there for them during their recovery,” he explained.

The new process will be introduced in mid-September.