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Deemed your injuries revoke cover on the claim for these injuries

#1 User is offline   INTER 

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Posted 03 May 2017 - 05:51 PM

as we are passed the 21 days, We have deemed your injuries as covered.

BUT
this still needs to be investigated and so I have passed on your medical notes and the additional diagnosis requests to our Branch medical advisor to comment on whether we add cover permanently to this claim. If he agrees then yes we can look at what your entitlements would be....Home support, transport support etc. Or if he says that no it should not be added to your claim then we will have to revoke cover on the claim for these two injuries CORRECT OR NOT ??????
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#2 User is offline   Alan Thomas 

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Posted 03 May 2017 - 06:27 PM

Cover is granted.
The Branch medical advisor is NOT a decision maker.
ACC can only seek to challenge the accepted cover if they have a reason. Write to them and ask what their reason for challenge is but in the mean time MUST determine your entitlements.
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#3 User is offline   INTER 

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Posted 03 May 2017 - 07:41 PM

View PostAlan Thomas, on 03 May 2017 - 06:27 PM, said:

Cover is granted.
The Branch medical advisor is NOT a decision maker.
ACC can only seek to challenge the accepted cover if they have a reason. Write to them and ask what their reason for challenge is but in the mean time MUST determine your entitlements.


Cover is granted. Correct , its the But part that has me worried :: as i was under the impression when you have cover granted by deemed :

I thought It meant I win acc lose this time . no interference to be brought into the acquisition
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#4 User is offline   not their victim 

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Posted 04 May 2017 - 07:52 AM

QUITE SIMPLY

ACC CANNOT REVOKE COVER UNLESS


THE INJURY IS NOT AS ITS SAID TO BE

THE MEDICAL EVIDENCE DOES NOT MATCH THE INJURY STATUS

OR

COVER CAN BE PERMANENTLY REVOKED FOR THOSE WHO HAVE DEFRAUDED THE CORPORATION

MUCH LIKE THE CRIMES ACT...

YOU HAVE NO ENTITLEMENT

IF YOUR INJURIES ARE FRAUDULENTLY MISREPRESENTED AND

YOU CLAIM INCAPACITY WHEN IN FACT YOU ARE ABLE TO USE THE INJURED AREA....

:
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#5 User is offline   INTER 

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Posted 04 May 2017 - 10:04 AM

The Question is can Acc REVOKE cover ON When they have deemed your injuries as covered.?

deemed cover was given as 21 days had passed with out acc addressing the acc18 Hence cover by default ?

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#6 User is offline   Alan Thomas 

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Posted 04 May 2017 - 10:54 AM

View Postnot their victim, on 04 May 2017 - 07:52 AM, said:

QUITE SIMPLY

ACC CANNOT REVOKE COVER UNLESS


THE INJURY IS NOT AS ITS SAID TO BE

THE MEDICAL EVIDENCE DOES NOT MATCH THE INJURY STATUS

OR

COVER CAN BE PERMANENTLY REVOKED FOR THOSE WHO HAVE DEFRAUDED THE CORPORATION

MUCH LIKE THE CRIMES ACT...

YOU HAVE NO ENTITLEMENT

IF YOUR INJURIES ARE FRAUDULENTLY MISREPRESENTED AND

YOU CLAIM INCAPACITY WHEN IN FACT YOU ARE ABLE TO USE THE INJURED AREA....

:


Both your grammar and understanding of law is wrong
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#7 User is offline   Alan Thomas 

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Posted 04 May 2017 - 10:57 AM

View PostINTER, on 04 May 2017 - 10:04 AM, said:

The Question is can Acc REVOKE cover ON When they have deemed your injuries as covered.?

deemed cover was given as 21 days had passed with out acc addressing the acc18 Hence cover by default ?



Your cover can not be revoked.
ACC can not seek new information about cover unless it has information to suspect fraud
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#8 User is offline   INTER 

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Posted 04 May 2017 - 12:18 PM

To avoid any confusion regarding my Question's

Acc legislative time frame of 21 days for making a cover decision were Exceeded

and as a result acc have Provided Cover for your updated acc18's.

BUT will continue to investigate your claim. now we have Received your recent medical notes , we will send them to OUR medical Advisor for Comment.

TO SEE if cover is COVER is confirmed - Or to Revoke cover.
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#9 User is offline   Alan Thomas 

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Posted 04 May 2017 - 03:10 PM

View PostINTER, on 04 May 2017 - 12:18 PM, said:

To avoid any confusion regarding my Question's

Acc legislative time frame of 21 days for making a cover decision were Exceeded

and as a result acc have Provided Cover for your updated acc18's.

BUT will continue to investigate your claim. now we have Received your recent medical notes , we will send them to OUR medical Advisor for Comment.

TO SEE if cover is COVER is confirmed - Or to Revoke cover.


What is your question?
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#10 User is offline   tommy 

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Posted 04 May 2017 - 06:12 PM

reports to acc are remarks in relation to ,your acc claim , and are then to be questioned as if a claimant chooses
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#11 User is offline   MINI 

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Posted 05 May 2017 - 12:55 PM

View PostINTER, on 04 May 2017 - 10:04 AM, said:

The Question is can Acc REVOKE cover ON When they have deemed your injuries as covered.?

deemed cover was given as 21 days had passed with out acc addressing the acc18 Hence cover by default ?



Whatever they gave you the cover for, can only be revoked if ACC has good and tight reason. This reason must be explaned to you in full. Get it in writing if you have too.

If you have not had an assessment to say it is no longer incapacitated then they have to go thru the sections 51,70, & 37,65. isn't it. To do with having rehabilitation that have cleared up you need for cover for your problem.

You will have to read thru these sections yourself im afraid as I am very busy with my own stuff at the moment. But if you have not have the 2001 Act you should get it so you may leave thru the relevant pages concerning cover and the revoking of such.

Sorry cant help more. But hopefully this is enough to get you started. Look around for a good advocate as well.

Cheers and good luck

Mini
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#12 User is offline   Battleaxe 

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Posted 05 May 2017 - 01:07 PM

View Postnot their victim, on 04 May 2017 - 07:52 AM, said:

QUITE SIMPLY

ACC CANNOT REVOKE COVER UNLESS


THE INJURY IS NOT AS ITS SAID TO BE

THE MEDICAL EVIDENCE DOES NOT MATCH THE INJURY STATUS

OR

COVER CAN BE PERMANENTLY REVOKED FOR THOSE WHO HAVE DEFRAUDED THE CORPORATION

MUCH LIKE THE CRIMES ACT...

YOU HAVE NO ENTITLEMENT

IF YOUR INJURIES ARE FRAUDULENTLY MISREPRESENTED AND

YOU CLAIM INCAPACITY WHEN IN FACT YOU ARE ABLE TO USE THE INJURED AREA....

:

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#13 User is offline   MINI 

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Posted 06 May 2017 - 12:06 PM

View PostINTER, on 04 May 2017 - 12:18 PM, said:

To avoid any confusion regarding my Question's

Acc legislative time frame of 21 days for making a cover decision were Exceeded

and as a result acc have Provided Cover for your updated acc18's.

BUT will continue to investigate your claim. now we have Received your recent medical notes , we will send them to OUR medical Advisor for Comment.

TO SEE if cover is COVER is confirmed - Or to Revoke cover.


ACC have given you temp cover because of the decision cover was exceeded. HOWEVER, they are investigating your updated acc18's. These updated acc 18's may end up being medical in nature, in which case the temp cover will be withdraw. ACC have the right under a section in the ACt that allows them to revoke, or cancel cover anytime they like. And especially if you updated acc18's have included medical issues.

You of course have full rights to Review and go to Court with anything you do not agree with. If I had a worry about 'medical' or 'injury' I would be getting a second opinion for any covered item the Medical officer should want to revoke cover for.

Don't worry too much until you have the Med Advisors comments back. They could be all covered with no problems.

Good luck

Mini
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#14 User is offline   Battleaxe 

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Posted 06 May 2017 - 12:11 PM

View PostMINI, on 06 May 2017 - 12:06 PM, said:

ACC have given you temp cover because of the decision cover was exceeded. HOWEVER, they are investigating your updated acc18's. These updated acc 18's may end up being medical in nature, in which case the temp cover will be withdraw. ACC have the right under a section in the ACt that allows them to revoke, or cancel cover anytime they like. And especially if you updated acc18's have included medical issues.

You of course have full rights to Review and go to Court with anything you do not agree with. If I had a worry about 'medical' or 'injury' I would be getting a second opinion for any covered item the Medical officer should want to revoke cover for.

Don't worry too much until you have the Med Advisors comments back. They could be all covered with no problems.

Good luck

Mini






Posted Today, 01:06 PM

Posted ImageINTER, on 04 May 2017 - 01:18 PM, said:

To avoid any confusion regarding my Question's

Acc legislative time frame of 21 days for making a cover decision were Exceeded

and as a result acc have Provided Cover for your updated acc18's.

BUT will continue to investigate your claim. now we have Received your recent medical notes , we will send them to OUR medical Advisor for Comment.

TO SEE if cover is COVER is confirmed - Or to Revoke cover.


ACC have given you temp cover because of the decision cover was exceeded. HOWEVER, they are investigating your updated acc18's. These updated acc 18's may end up being medical in nature, in which case the temp cover will be withdraw. ACC have the right under a section in the ACt that allows them to revoke, or cancel cover anytime they like. And especially if you updated acc18's have included medical issues.

You of course have full rights to Review and go to Court with anything you do not agree with. If I had a worry about 'medical' or 'injury' I would be getting a second opinion for any covered item the Medical officer should want to revoke cover for.

Don't worry too much until you have the Med Advisors comments back. They could be all covered with no problems.

Good luck

Mini

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#15 User is offline   MINI 

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Posted 06 May 2017 - 12:15 PM

View PostAlan Thomas, on 04 May 2017 - 10:57 AM, said:

Your cover can not be revoked.
ACC can not seek new information about cover unless it has information to suspect fraud


B/d Thomas

ACC have the right at any time to revoke cover, BUT they have to let you know why they have done it. If cover has been given and the 'injury' turns out to be of a medical nature, they will take cover off you for that. Easy peezy not a problem. Been there, done that. looks like I may have another coming up. Or a fight for it to remain a covered injury at the very least.

you don't know how old this inter is. I do not either, but I do know that some of my bone accidents could at any time at my age turn out to be medical arthritis or anything like that.

It pays to know your rights and what you are not allowed.

Mini
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#16 User is offline   MINI 

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Posted 06 May 2017 - 12:18 PM

View PostAlan Thomas, on 04 May 2017 - 03:10 PM, said:

What is your question?


In this case the Medical officer is the Decider.

Mini
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#17 User is offline   Battleaxe 

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Posted 06 May 2017 - 12:29 PM

View PostMINI, on 06 May 2017 - 12:06 PM, said:

ACC have given you temp cover because of the decision cover was exceeded. HOWEVER, they are investigating your updated acc18's. These updated acc 18's may end up being medical in nature, in which case the temp cover will be withdraw. ACC have the right under a section in the ACt that allows them to revoke, or cancel cover anytime they like. And especially if you updated acc18's have included medical issues.

You of course have full rights to Review and go to Court with anything you do not agree with. If I had a worry about 'medical' or 'injury' I would be getting a second opinion for any covered item the Medical officer should want to revoke cover for.

Don't worry too much until you have the Med Advisors comments back. They could be all covered with no problems.

Good luck

Mini





Inter, ignore what Mini has told you.

Fact - there is NO "temp cover" under the AC Act. This statute provides for the ACC accepting or declining cover. There is no grey area of "temp cover" in between the two.

Fact - the ACC does have a "right under a section in the AC Act that allows them to revoke" but not to "cancel cover anytime they like". Cancelling cover is not a provision of the AC Act and this word is not used in this statute either.


S65(1) of the AC Act provides that if the ACC made a decision IN ERROR (my use of capital letters for emphasis), it may REVISE the original decision at any time, whatever the reason for the error. In other words, making "an error" in reaching the original decision is the determinant factor here, and, this condition HAS TO exist to allow ACC to legally amend its original decision. Therefore if the ACC has not advised you in writing that it made its original decision "in error", then if it revokes or amends that original decision, the new decision will effectively be illegal.

S65(3) of the AC Act also provides that "a revision may --- ( a ) amend the original decision, or ( b ) revoke the original decision AND SUBSTITUTE (IT) WITH A NEW DECISION.

Lastly, S65(4) of the AC Ac further provides that "every amendment to a decision (in other words ( a) above, and every substituted decision (in other words ( b ) above, IS A FRESH DECISION. So this means if you are going to appeal ACC's decision, you need to appeal the FRESH/NEW DECISION.


It does not stop there, however, as S145(2) provides - and legally requires of course - that where the ACC has revised a decision under S65(1) - IN OTHER WORDS WHERE THE ACC HAS CLAIMED ITS ORIGINAL DECISION WAS MADE "IN ERROR", the ACC "MUST ESTABLISH THAT THE ORIGINAL DECISION MADE UNDER THAT SUBSECTION WAS MADE IN ERROR".

So to summarize, where ACC claims it made a decision in error - with S65(1) of the AC Act allowing them to do this - AT REVIEW, THE ACC HAS TO PROVE THAT IT HAS ESTABLISHED THAT THE ORIGINAL DECISION WAS MADE IN ERROR. There is well documented, precedent setting, case law on this subject to be found at www.nzlii.org - District Court ACC decisions.

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#18 User is offline   Battleaxe 

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Posted 06 May 2017 - 12:32 PM

View PostMINI, on 06 May 2017 - 12:18 PM, said:

In this case the Medical officer is the Decider.

Mini



Who is the "Medical Officer" MINI??
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#19 User is offline   Battleaxe 

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Posted 06 May 2017 - 12:33 PM

View PostAlan Thomas, on 04 May 2017 - 03:10 PM, said:

What is your question?




There is no legislative "term" or provision of "21 days" relative to ACC18 forms.
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#20 User is offline   Battleaxe 

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Posted 06 May 2017 - 12:36 PM

View PostMINI, on 06 May 2017 - 12:15 PM, said:

B/d Thomas

ACC have the right at any time to revoke cover, BUT they have to let you know why they have done it. If cover has been given and the 'injury' turns out to be of a medical nature, they will take cover off you for that. Easy peezy not a problem. Been there, done that. looks like I may have another coming up. Or a fight for it to remain a covered injury at the very least.

you don't know how old this inter is. I do not either, but I do know that some of my bone accidents could at any time at my age turn out to be medical arthritis or anything like that.

It pays to know your rights and what you are not allowed.

Mini




At any time yes but the ACC cannot ever "cancel" cover and there is also a strict condition which is a legal provision - see my post to Inter above - that applies to it revising original decisions.



I consider that you are misleading ACC claimants by misinforming them about the law and their rights Mini. Brush up on the AC Act before giving advice in future is my strong suggestion.


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