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Can ACC do this?? ACC accepted a claim.....now have decided not to accept

#1 User is offline   redsquare74ucys 

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Posted 30 July 2008 - 07:17 PM

Put in a claim in Dec 2006. ACC sends a letter accepting the claim. Now just found out today that ACC has decided that there is not enough information to accept the claim !!? Obviously I am appealing via JML - just waiting for a letter from ACC to confirm that (new) decision.

Anyone else had something like this happen??
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#2 User is offline   doppelganger 

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Posted 30 July 2008 - 08:04 PM

the mistake that they made in 2006 was that they did not have enough information in 2006.

this is a case of looking at what section that the claim was accepted under. If it is under section 58 they can not not accept the claim unless they have information that shows that they should never have made the orginial decision.

If they are claiming that they have not got enough information that is not an reason to cancel the claim. Section 58 doesn't allow to use that reason when making a decision under section 65.

if you have had the originial decision to accept the claim under section 58 you have a new decision by the end of week saying that ACC can not reverse the decision when the decision was given because ACC had not obtained all of the necessary information.
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#3 User is offline   MINI 

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Posted 30 July 2008 - 09:35 PM

have you just asked for some treatment for that injury.

That will soon get them busy not allowing it or disallowing the cover belatedly. Have seen it happen before.

What is there excuse?
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#4 User is offline   redsquare74ucys 

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Posted 30 July 2008 - 10:16 PM

Well I don't understand. I did recieve treatment for it - does this mean I have to pay for all that? Besides, they made the original decision Dec 06 and NOW they change their minds. Is there no time frame on there side (like the 3 month appeal timeframe for us)?

No idea why they have done this....the skeptic says its because I made an application for a lump sum (made back in June/July last year).

Don't know what they made the original decision under but I imagine it was the same way all sensitive claims are made. This just gets more and more painful.

I only found out because I phoned them today to ask why the assessment report indicated that that event had not been accepted by ACC. Why couldn't they be more sensitive??

It's just such a shock to hear about it this way.
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#5 User is offline   Sparrow 

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Posted 30 July 2008 - 10:34 PM

You have an accepted claim. ACC cannot suddenly revoke the decision 19 months later without a reason.
They would have to have a medical review of your claim to do this.
SO I suggest you ask the for the reason they have done this in writing and then ask for your file in its entireity.
Then file for MEdiation of Review. Mediation gives you 2 bites at the cherry.
There is no way they can make you pay for your treatment.
They cannot suddenly close a claim, tho they did it to me years ago!!!!! They submitted a DUMMY file to the Branch MO and on those grounds he said close the claim tho medical treatment was still available, the sods!
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#6 User is offline   doppelganger 

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Posted 31 July 2008 - 12:44 PM

View Postredsquare74ucys, on Jul 30 2008, 10:16 PM, said:

I only found out because I phoned them today to ask why the assessment report indicated that that event had not been accepted by ACC. Why couldn't they be more sensitive??

It's just such a shock to hear about it this way.


this is the problem.

ACC gained an assessment which ACC asked the assessor whether the injury, claim and incapacity is covered under the injury, claim, and incapacity reported in the list of injuries to the assessor.

Now Not Waddie, bill burch, has just won a case on a very simular reason.

research shows that ACC does this to 10% of claims that is the ACC do not record an accurate discription of injuries on claims.

If you wern't in the sensitive claims I would ask you to take this further. A result would be the dismissal of the case manager for dishonesty, the Branch manager for Lying to senior staff members. ACC asures me that this is not being carried out.

If it was an lump sum assessment then ACC had not reported all of the injuries to the assessor. Direction from head office through regurlations only perminits ACC to assess the injuries listed by the case manager.
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#7 User is offline   redsquare74ucys 

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Posted 31 July 2008 - 08:07 PM

Cheers DG,

I was told (after the claims had already been accepted) by my GP who spent a while on the phone to ACC to use one claim number that incorporated all claims. So my GP is assured by ACC over the phone that I should (operative word here) be eligible for both a lump sum AND and independance allowance.

For a while I thought that ACC had my best interest at heart. Huh, I even thought people on this board were NEGATIVE!! LOL. I look back at my previous error with dismay.

Even though this is a sensitive claim, I feel it is important to post so that when others are put through this type of crap they can make some sense of it via my posts.
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#8 User is offline   doppelganger 

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Posted 01 August 2008 - 12:47 PM

so ACC are running lots of claim numbers

You have a claimant ID number in which all claims are managed.

If ACC won't change then start and inform ACC that you will be using the claimant ID from now on.everything will be completed under the claimant ID number.

This means that they are going to need to treat you as one person, not two three or four people that all have only one injury.

I though that ACC was there to help and for a period though that the dishonest staff had been removed.

to my surprise they were still there and still carried on administrating the file with out my knowledge.
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#9 User is offline   redsquare74ucys 

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Posted 01 August 2008 - 08:05 PM

I will be seeking legal advice from John Miller Law, so it will be interesting what they say.
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#10 User is offline   doppelganger 

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Posted 02 August 2008 - 01:57 PM

that would be interesting as this has been a problem since the 70's. You would have thought that law firms would have refused to go to court on a claim by claim bases when ACC has to administer the act on a injured person by injuries bases.
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#11 User is offline   redsquare74ucys 

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Posted 04 August 2008 - 10:22 AM

There are so many issues, I don't know where to begin.
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#12 User is offline   doppelganger 

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Posted 04 August 2008 - 01:53 PM

You start with Cover.

Make sure that the ACC have all of the injuries recorded correctly and listed.

Can not obtain entitlements if ACC don't know the full extent of the injuries.
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