ACC is doing my head in!

[Mom]

On the verge of another protest campaign kick off I am battling ACC for cover! Apparently my claim is complicated!

Complicated my Bum!

Either my doctor knowingly prescribed pills that she knew would almost kill me or I took a new perscription knowing that it would almost kill me or I did it to get a BIT of attention for myself, or...

IT WAS A FUCKEN ACCIDENT!

No complications as far as I can see!

They used to call my sort of claim "medical misadventure", now it is called "treatment injury", whatever, ACC have not even responded to a claim that was received by them April 1st (no jokes thanks). I had to ring them today to see if they had received my claim as neither my employer nor me had heard anything from ACC. When I "officially" complained this afternoon as I was not entirely certain that anything was going to happen the call taker had to admit it was not acceptable to not hear anything for that long.

I am amped and pissed off. The young fuck at the call centre I spoke to this morning suggested I contact WINZ to get an invalids benefit as these claims can "take ages" to resolve!

SO, not only am I a pissed off biker, I am a pissed off worker that pays ACC levy via my PAYE who nearly carked it as a result of taking a prescribed medication, who is now battling the cunse for compensation. Actually I would be happy if they would simply cover the cost of 2 trips to hospital in the ambulance and the 24/7 A&E charges I had to pay.

Keep you posted.

EDIT: I did manage a couple of hours of work today, but am far, far from fit for a full return and still have some quite serious ongoing health issues as a result of my auto immune reaction to the allergic reaction I originally suffered. I am actualy a bit worried I wont make a full recovery, and these wankers have me on the ohhhhhhhhhh we will get to that claim in the next few days 2 weeks after the hospital lodged it on my behalf!

[mashman]

That's utterly fucking disgusting.

[Edbear]

When I was battling them there were two definitions, one of Medical Misadventure where the prescribing Dr. was deemed at fault, or Medical Mishap where it was accepted that the GP would not have known sucha reaction would likely occur. I went for medical mishap as I was in no doubt about my GP's qualifications or his intentions which were nothing but in my best interests.

End result was, (despite 4 Neurologist's examining me over the years and not one telling me the medication was at fault), after a review, my case was dismissed on the grounds that there needed to be a less than 1% chance of such a severe reaction occurring and the reviewing specialists said that the chance of such a reaction was a lot greater than 1%!

[Robert Taylor]

On the verge of another protest campaign kick off I am battling ACC for cover! Apparently my claim is complicated!

Complicated my Bum!

Either my doctor knowingly prescribed pills that she knew would almost kill me or I took a new perscription knowing that it would almost kill me or I did it to get a BIT of attention for myself, or...

IT WAS A FUCKEN ACCIDENT!

No complications as far as I can see!

They used to call my sort of claim "medical misadventure", now it is called "treatment injury", whatever, ACC have not even responded to a claim that was received by them April 1st (no jokes thanks). I had to ring them today to see if they had received my claim as neither my employer nor me had heard anything from ACC. When I "officially" complained this afternoon as I was not entirely certain that anything was going to happen the call taker had to admit it was not acceptable to not hear anything for that long.

I am amped and pissed off. The young fuck at the call centre I spoke to this morning suggested I contact WINZ to get an invalids benefit as these claims can "take ages" to resolve!

SO, not only am I a pissed off biker, I am a pissed off worker that pays ACC levy via my PAYE who nearly carked it as a result of taking a prescribed medication, who is now battling the cunse for compensation. Actually I would be happy if they would simply cover the cost of 2 trips to hospital in the ambulance and the 24/7 A&E charges I had to pay.

Keep you posted.

EDIT: I did manage a couple of hours of work today, but am far, far from fit for a full return and still have some quite serious ongoing health issues as a result of my auto immune reaction to the allergic reaction I originally suffered. I am actualy a bit worried I wont make a full recovery, and these wankers have me on the ohhhhhhhhhh we will get to that claim in the next few days 2 weeks after the hospital lodged it on my behalf!

Well thats a serious argument for user pays if ever there was. A private system of insurance would be far more efficient than a Government juggernaut. I think that is what this Government ultimately recognise needs to happen.

[steve_t]

That sux, Mom! Keep at them. As u said, there's no such thing as Medical Misadventure any more. Treatment Injury was a term coined to remove the blame from health professionals :shutup: since ACC is supposed to be a No Fault system.
My advice - stand your ground. They can send your case for review and even though ACC are declining cover left, right, and centre for retarded reasons, you should undoubtedly be covered

[Mom]

End result was..

Well I am at the start of this journey, I am also fairly tenatious :innocent: and am really unlikely to back off. I hope the fact that I made an early "official" complaint will hurry up some decision making.


Well thats a serious argument for user pays if ever there was.

Cool! Thanks for that mate. Wish you could see the thumbs up and crazy grin that accompaines my thanks :weird:

We dont fucken have private insurance as we ARE ALREADY COVERED by ACC. I am appaled that someone like you who is a big defender of the little guy in business can actually be so blase about a little gal (potentially) being done over by ACC!

By all means if we are to lose ACC let me have the fucking right to SUE the doctors and the drug companies and any other bastard me and my attorneys that get paid a % of the return can think of. For now I AM covered by ACC, I pay shitloads of fucken premiums to them and I DEMAND cover that I am entitled to, I also expect common decency in as much as a written acknowledgement of my claim regardless of what it is called, I dont expect to have to ring them 2 weeks after the claim was lodged to discover that Helen will "get to it in the next few days".

[Mom]

That sux, Mom! Keep at them. As u said, there's no such thing as Medical Misadventure any more. Treatment Injury was a term coined to remove the blame from health professionals :shutup: since ACC is supposed to be a No Fault system.
My advice - stand your ground. They can send your case for review and even though ACC are declining cover left, right, and centre for retarded reasons, you should undoubtedly be covered

I am that ticked off that I am happy to lodge a complaint with the Doctors disclipline complaints whatever! Honestly, if this was a simple rash then yeah, tell me to get stuffed. I was one sick gal. I read, that I may never lose the scars from this rash (it covered 100% of my body). The consultant at the hospital said it will reduce in time. Time, cool, define time. I have never been so flat after being sick as I am now. I first saw a doctor for this March 27th, I am still 7 kilos heavier than I was before I got sick, and dont fit any of my clothes, and while I can now walk 60 metres without losing my breath as opposed to 6 when I was in hospital, I used to be able to walk 6 kilometres at pace of an evening no worries.

FUCK EM I SAY!

[Usarka]

ACC are trying every trick in the book to decline claims at the moment.

Bunch of corrupt pricks.

[steve_t]

I am that ticked off that I am happy to lodge a complaint with the Doctors disclipline complaints whatever! Honestly, if this was a simple rash then yeah, tell me to get stuffed. I was one sick gal. I read, that I may never lose the scars from this rash (it covered 100% of my body). The consultant at the hospital said it will reduce in time. Time, cool, define time. I have never been so flat after being sick as I am now. I first saw a doctor for this March 27th, I am still 7 kilos heavier than I was before I got sick, and dont fit any of my clothes, and while I can now walk 60 metres without losing my breath as opposed to 6 when I was in hospital, I used to be able to walk 6 kilometres at pace of an evening no worries.

FUCK EM I SAY!

Oh man, that sux. Hope u recover soon! So what are you thinking of saying to the Health and Disability Commissioner? Did your Dr negligently prescribe you a drug you were known to be allergic to? Hopefully not. If it was your first allergic reaction to this medication, the HDC won't be able to do anything. ACC will come to the party... eventually - I (almost) guarantee it. Get better soon!!

[mashman]

Well thats a serious argument for user pays if ever there was. A private system of insurance would be far more efficient than a Government juggernaut. I think that is what this Government ultimately recognise needs to happen.

And if a Government, publicly owned "insurer" can do it... you can be your arse that a private insurer will do it too... Private insurance is not the way to go.

[pete376403]

Well thats a serious argument for user pays if ever there was. A private system of insurance would be far more efficient than a Government juggernaut. I think that is what this Government ultimately recognise needs to happen.
A private insurance company would use every trick at its disposal to avoid paying out. Just like ACC.

[Hopeful Bastard]

Woot! Go Mom!! You tell them one! If they dont let into your pressure, See if Fair Go will join in on the pressure. Im sure they would be happy to bring down ACC :D

[p.dath]

Oh Mom that is really bad news to hear. I imagine it came like a bolt out of the blue. It certainly sounds unexpected.

I hope you manage to find something to aid you in this medical issue.

[The Stranger]

Does this fall under the definition of an accident (for the purposes of ACC)?
Whilst I realise that no one knowingly has an adverse reaction to a drug etc, neither does anyone knowingly say contract a disease.
Even the haemophiliacs who contracted Hep C from tainted blood didn't get ACC cover.
Would not a medical condition (such as an adverse reaction) fall outside the scope of an accident?
Should hayfever therefore be covered by ACC?

[Mom]

Woot! Go Mom!! You tell them one! If they dont let into your pressure, See if Fair Go will join in on the pressure. Im sure they would be happy to bring down ACC :D

Not so sure about Fair Go really, but ACC actually have a really robust complaints procedure and I am using that at the moment. They have stuffed up, I dont want blood, I want resolution and a decision. I can help drive the process that needs to happen if only they would friggen action the claim and perhaps advise me what is happening. They have not done so, I have complained. My GP is about to feel the warmth of my love tomorow :D

[Bikernereid]

If you are having trouble with ACC I would fight it. It took me nearly four months to get them to respond to my surgeon's request. Firstly they sent a request for more information to Auckland hospital and yet I reside in Chch. Secondly they sent the request for more information to the wrong hospital in Chch hence the delay. I think they may be using delaying tactics with claims (as suggested by others on here) due to funding problems. keep your chin up!!

[Robert Taylor]

Well I am at the start of this journey, I am also fairly tenatious :innocent: and am really unlikely to back off. I hope the fact that I made an early "official" complaint will hurry up some decision making.



Cool! Thanks for that mate. Wish you could see the thumbs up and crazy grin that accompaines my thanks :weird:

We dont fucken have private insurance as we ARE ALREADY COVERED by ACC. I am appaled that someone like you who is a big defender of the little guy in business can actually be so blase about a little gal (potentially) being done over by ACC!

By all means if we are to lose ACC let me have the fucking right to SUE the doctors and the drug companies and any other bastard me and my attorneys that get paid a % of the return can think of. For now I AM covered by ACC, I pay shitloads of fucken premiums to them and I DEMAND cover that I am entitled to, I also expect common decency in as much as a written acknowledgement of my claim regardless of what it is called, I dont expect to have to ring them 2 weeks after the claim was lodged to discover that Helen will "get to it in the next few days".

I do seriously sympathise with your plight but Im saying that the ACC system is a rort and needs some serious dismantling, in part to relieve the burden on taxpayers. If that can go hand in hand with seriuos tax reductions then I say bring on the private system. I personally think the medical system should be a whole load more accountable, not to silly levels of litigation as in the US but not being able to hide behind ACC as they do now. Its clearly not working well for you!

[Toaster]

That's utterly fucking disgusting.

So is a poo sandwich.

ACC were appalling to Mom, me and many many others left to swing in the breeze.

[SixPackBack]

Gotta say I love ACC. The treatment received for my injury was superlative:

2 months of salary payments
Hospital stay in Ascot complete with my own shower tea/coffee etc.
On going rehab.....
My treatment was the reason I neglected to comment on the recent rego hike, and gotta say medical misadventure is hardly an accident!

[Mom]

So is a poo sandwich.

ACC were appalling to Mom, me and many many others left to swing in the breeze.

I will happily post up here when they accept my claim and reimburse me for my ambo trips etc. Interestingly enough these two operate like a tag team Cam. I reckon they PM each other, ones stirs, one reps, pathetic really. At very least, I want the cost of the doctor appointments reimbursed. $140 for a Sunday at Red Beach. Then the Saturday and Monday at Warkworth. 80% of 5/8ths wages is not such a big deal :laugh:

[mashman]

So essentially people are being abandoned by their government, because you can "fall through the cracks"... pretty horrendous thought considering you pay for that cover throughout your life and you are an economically viable asset to the government... why wouldn't they want to help you? looks like bad economic policy to me.

[Usarka]

Does this fall under the definition of an accident (for the purposes of ACC)?
Whilst I realise that no one knowingly has an adverse reaction to a drug etc, neither does anyone knowingly say contract a disease.
Even the haemophiliacs who contracted Hep C from tainted blood didn't get ACC cover.
Would not a medical condition (such as an adverse reaction) fall outside the scope of an accident?
Should hayfever therefore be covered by ACC?

ACC do have a treatment injury budget. If something goes wrong during treatment for an ACC claim then you should be covered.

Caveats etc http://www.acc.co.nz/for-providers/lodge-and-manage-claims/PRV00032

[rainman]

I do seriously sympathise with your plight but Im saying that the ACC system is a rort and needs some serious dismantling, in part to relieve the burden on taxpayers. If that can go hand in hand with seriuos tax reductions then I say bring on the private system. I personally think the medical system should be a whole load more accountable, not to silly levels of litigation as in the US but not being able to hide behind ACC as they do now. Its clearly not working well for you!

Robert, you seem to be trotting out the old "government bad, privatise good, lower taxes..." lines, but how do you see this actually working? Example: I have a buggered back, from a sporting injury. ACC have covered me (sorta) and continue to look after it (increasingly poorly, as National tries to break ACC and public faith therein by cutting everything they can). Let's say your dream comes true, and we privatise ACC. What happens to poor buggers like me? No hope of getting reasonably priced cover for a pre-existing condition, if I can get private cover at all. But I've already paid my premiums through tax. If you privatise I assume you woud not propose handing the private insurers a bunch of taxpayer money? Good luck with that!

If you force the private insurers to cover pre-existing conditions you actually have to regulate that over the lifetime of the population that get grandfathered over, or those dodgy buggers will cut cover as soon as they can. Don't believe that? Have a close look at the US medical insurance systems. So if you do successfully force pre-existing cover, you've gained nothing financially.

If you don't, people like me go either untreated (and end up unable to work, so labour productivity drops further), or on the public health system - remember no private co is insane enough to cover us - so public cost for private gain. And you have to find room for a profit in there somewhere...

And if your claim is that governments are sooooo terrily inefficient that there will be heaps of money saved from privatising, I'll challenge you to prove that with hard data and facts. Good luck with that too.

Sorry, but your way sounds stupid to me. Which is the general problem with neoliberal bullshit generally. It sounds lovely in theory, but doesn't work in practice. Unless you're the private insurer, getting rich(er) at the rest of our expense, of course.

[p.dath]

Scary as it is, I woke up thinking about your case Mom. I woke up thinking about "what is an accident". Could you perhaps go and look at the ACC legislation and post the definition of accident here for us? Legislation can be found here:
http://www.legislation.govt.nz/

The reason I was thinking about this is because I was reflecting on stays I have had in hospital. Two of them have been paid for by my private medical insurance.

And then this led me to wonder if he have a mis-understanding about what ACC is covering us for. My initial reaction was that ACC should be covering you because it was a medical accident (excuse my simple terms). It wasn't a planned event, but perhaps I am also mis-understanding the cover that ACC is providing - and perhaps this is the point where private medical cover takes over.

[Mom]

Scary as it is, I woke up thinking about your case Mom.

You poor bugger :laugh:


http://www.legislation.govt.nz/act/public/2001/0049/latest/DLM100904.html?search=ts_act_Accident_resel&p=1

25 Accident
(1) Accident means any of the following kinds of occurrences:

(a) a specific event or a series of events, other than a gradual process, that—

(i) involves the application of a force (including gravity), or resistance, external to the human body; or

(ii) involves the sudden movement of the body to avoid a force (including gravity), or resistance, external to the body; or

(iii) involves a twisting movement of the body:

(b) the inhalation of any solid, liquid, gas, or foreign object on a specific occasion, which kind of occurrence does not include the inhalation of a virus, bacterium, protozoan, or fungus, unless that inhalation is the result of the criminal act of a person other than the injured person:

(ba) the oral ingestion of any solid, liquid, gas, fungus, or foreign object on a specific occasion, which kind of occurrence does not include the ingestion of a virus, bacterium, or protozoan, unless that ingestion is the result of the criminal act of a person other than the injured person:

(c) a burn, or exposure to radiation or rays of any kind, on a specific occasion, which kind of occurrence does not include a burn or exposure caused by exposure to the elements:

(d) the absorption of any chemical through the skin within a defined period of time not exceeding 1 month:

(e) any exposure to the elements, or to extremes of temperature or environment, within a defined period of time not exceeding 1 month, that,—

(i) for a continuous period exceeding 1 month, results in any restriction or lack of ability that prevents the person from performing an activity in the manner or within the range considered normal for the person; or

(ii) causes death.

(2) However, accident does not include—

(a) any of those kinds of occurrences if the occurrence is treatment given,—

(i) in New Zealand, by or at the direction of a registered health professional; or

(ii) outside New Zealand, by or at the direction of a person who has qualifications that are the same as or equivalent to those of a registered health professional; or

(b) any ecto-parasitic infestation (such as scabies), unless it is work-related; or

(c) the contraction of any disease carried by an arthropod as an active vector (such as malaria that results from a mosquito bite), unless it is work-related.

(3) The fact that a person has suffered a personal injury is not of itself to be construed as an indication or presumption that it was caused by an accident.

Compare: 1998 No 114 s 28

Section 25(1)(a): substituted, on 1 July 2005, by section 10(1) of the Injury Prevention, Rehabilitation, and Compensation Amendment Act (No 2) 2005 (2005 No 45).

Section 25(1)(b): substituted, on 1 July 2005, by section 10(2) of the Injury Prevention, Rehabilitation, and Compensation Amendment Act (No 2) 2005 (2005 No 45).

Section 25(1)(ba): inserted, on 1 July 2005, by section 10(2) of the Injury Prevention, Rehabilitation, and Compensation Amendment Act (No 2) 2005 (2005 No 45

[Mom]

Now this is interesting;

(2) However, accident does not include—

(a) any of those kinds of occurrences if the occurrence is treatment given,—

(i) in New Zealand, by or at the direction of a registered health professional; or

Hmmmmm...


13 New sections 32 to 34 substituted
The principal Act is amended by repealing sections 32 to 34, and substituting the following sections:

“32 Treatment injury
“(1) Treatment injury means personal injury that is—

“(a) suffered by a person—

“(i) seeking treatment from 1 or more registered health professionals; or

“(ii) receiving treatment from, or at the direction of, 1 or more registered health professionals; or

“(iii) referred to in subsection (7); and

“(b) caused by treatment; and

“(c) not a necessary part, or ordinary consequence, of the treatment, taking into account all the circumstances of the treatment, including—

“(i) the person's underlying health condition at the time of the treatment; and

“(ii) the clinical knowledge at the time of the treatment.

“(2) Treatment injury does not include the following kinds of personal injury:

“(a) personal injury that is wholly or substantially caused by a person's underlying health condition:

“(b) personal injury that is solely attributable to a resource allocation decision:

“(c) personal injury that is a result of a person unreasonably withholding or delaying their consent to undergo treatment.

“(3) The fact that the treatment did not achieve a desired result does not, of itself, constitute treatment injury.

“(4) Treatment injury includes personal injury suffered by a person as a result of treatment given as part of a clinical trial, in the circumstances described in subsection (5) or subsection (6).

“(5) One of the circumstances referred to in subsection (4) is where the claimant did not agree, in writing, to participate in the trial.

“(6) The other circumstance referred to in subsection (4) is where—

“(a) an ethics committee—

“(i) approved the trial; and

“(ii) was satisfied that the trial was not to be conducted principally for the benefit of the manufacturer or distributor of the medicine or item being trialled; and

“(b) the ethics committee was approved by the Health Research Council of New Zealand or the Director-General of Health at the time it gave its approval.

“(7) If a person (person A) suffers an infection that is a treatment injury, cover for that personal injury extends to—

“(a) person A's spouse or partner, if person A has passed the infection on directly to the spouse or partner:

“(b) person A's child, if person A has passed the infection on directly to the child:

“(c) any other third party, if person A has passed the infection on directly to that third party:

“(d) person A's child or any other third party, if—

“(i) person A has passed the infection directly to his or her spouse or partner; and

“(ii) person A's spouse or partner has then passed the infection directly to the child or third party.

“33 Treatment
“(1) For the purposes of determining whether a treatment injury has occurred, or when that injury occurred, treatment includes—

“(a) the giving of treatment:

“(b) a diagnosis of a person's medical condition:

“(c) a decision on the treatment to be provided (including a decision not to provide treatment):

“(d) a failure to provide treatment, or to provide treatment in a timely manner:

“(e) obtaining, or failing to obtain, a person's consent to undergo treatment, including any information provided to the person (or other person legally entitled to consent on their behalf if the person does not have legal capacity) to enable the person to make an informed decision on whether to accept treatment:

“(f) the provision of prophylaxis:

“(g) the failure of any equipment, device, or tool used as part of the treatment process, including the failure of any implant or prosthesis (except where the failure of the implant or prosthesis is caused by an intervening act or by fair wear and tear), whether at the time of giving treatment or subsequently:

“(h) the application of any support systems, including policies, processes, practices, and administrative systems, that—

“(i) are used by the organisation or person providing the treatment; and

“(ii) directly support the treatment.

“(2) Subsection (1) does not affect the application of the definition of treatment in section 6(1) for purposes other than those stated in subsection (1).

“(3) Subsection (2) is for the avoidance of doubt.

“34 Cover for personal injury caused by medical misadventure before 1 July 2005
“(1) This section applies to—

“(a) claims for cover for personal injury caused by medical misadventure that were lodged with the Corporation before 1 July 2005, but have not been determined; and

“(b) claims for cover for personal injury caused by medical misadventure that were declined by the Corporation before 1 July 2005, but are lodged again on or after that date as claims for cover for treatment injury (and not lodged as claims referred to in subsection (4)).

“(2) Claims lodged in the circumstances described in subsection (1) must be determined under the relevant provisions in force immediately before 1 July 2005.

“(3) Reviews and appeals must be dealt with under the relevant provisions of Part 5 in force immediately before 1 July 2005, if the decision being reviewed or appealed—

“(a) was made before 1 July 2005; or

“(b) is one to which subsection (2) applies.

“(4) Subsection (1)(b) does not apply in relation to a claimant if,—

“(a) before 1 July 2005, the Corporation declined the claimant's claim for cover for personal injury caused by medical misadventure because there was no personal injury; and

“(b) on or after 1 July 2005, the claimant lodges a claim for cover for treatment injury in respect of a personal injury that—

“(i) occurred after the decision to decline the earlier claim (whether before or after 1 July 2005); and

“(ii) arises out of the circumstances on which the earlier claim was based.”

[p.dath]

Depending on the definition of "injury", it sounds like you should be covered. Not because you had a medical accident, but because you suffered a "treatment injury".

Oh well, at least you know the terms to use now when discussing your complaint with them.

[Genie]

Had some issues when my son was going though some stuff....keep a detailled account of all your convos with them, names are very important...try to speak to the same person all the time and just keep annoying them. they are a bunch of twats, their hands are tied with red tape and they always seem to have the need to "speak with my supervisor about that as I'm not sure".....good luck

[Mom]

I talked to a chick yesterday that broke her Archillies Tendon. She was playing chasey with her kids in the back yard and it just went bang.

ACC did not accept liability for her claim! Was not an accident apparently, she was not playing sport when it happened, it must have been a congenital weakness if you please. Any reason, any excuse. SHe battled them for months and eventually actually gave up as it was affecting her mental health to be battling them on an almost daily basis.

[mashman]

I talked to a chick yesterday that broke her Archillies Tendon. She was playing chasey with her kids in the back yard and it just went bang.

ACC did not accept liability for her claim! Was not an accident apparently, she was not playing sport when it happened, it must have been a congenital weakness if you please. Any reason, any excuse. SHe battled them for months and eventually actually gave up as it was affecting her mental health to be battling them on an almost daily basis.

A colleague of mine tripped over a football (he was warming up, they weren't even playing)... ripped his tendon, broke 2 bones in his leg, ligaments etc... the Doc couldn't believe the cause of the injuries because it was so innocuous... My colleague is stunned himself... he didn't think anything of what he was doing and BANG broken leg... At the moment he IS BEING DEALT WITH BY ACC... ACC where also here in the office last week and he only did his leg 10 days ago... Something wrong somewhere me thinks...

[Usarka]

A colleague of mine tripped over a football (he was warming up, they weren't even playing)... ripped his tendon, broke 2 bones in his leg, ligaments etc... the Doc couldn't believe the cause of the injuries because it was so innocuous... My colleague is stunned himself... he didn't think anything of what he was doing and BANG broken leg... At the moment he IS BEING DEALT WITH BY ACC... ACC where also here in the office last week and he only did his leg 10 days ago... Something wrong somewhere me thinks...

I might have read this wrong but are you saying the accident insurance shouldn't pay up for accidents?

Accident doesn't = sports.

[Robert Taylor]

Robert, you seem to be trotting out the old "government bad, privatise good, lower taxes..." lines, but how do you see this actually working? Example: I have a buggered back, from a sporting injury. ACC have covered me (sorta) and continue to look after it (increasingly poorly, as National tries to break ACC and public faith therein by cutting everything they can). Let's say your dream comes true, and we privatise ACC. What happens to poor buggers like me? No hope of getting reasonably priced cover for a pre-existing condition, if I can get private cover at all. But I've already paid my premiums through tax. If you privatise I assume you woud not propose handing the private insurers a bunch of taxpayer money? Good luck with that!

If you force the private insurers to cover pre-existing conditions you actually have to regulate that over the lifetime of the population that get grandfathered over, or those dodgy buggers will cut cover as soon as they can. Don't believe that? Have a close look at the US medical insurance systems. So if you do successfully force pre-existing cover, you've gained nothing financially.

If you don't, people like me go either untreated (and end up unable to work, so labour productivity drops further), or on the public health system - remember no private co is insane enough to cover us - so public cost for private gain. And you have to find room for a profit in there somewhere...

And if your claim is that governments are sooooo terrily inefficient that there will be heaps of money saved from privatising, I'll challenge you to prove that with hard data and facts. Good luck with that too.

Sorry, but your way sounds stupid to me. Which is the general problem with neoliberal bullshit generally. It sounds lovely in theory, but doesn't work in practice. Unless you're the private insurer, getting rich(er) at the rest of our expense, of course.

You are not going to like me for saying this but Ive always felt that discretional activities such as sporting injuries should not be funded by the taxpayer, but by private insurance. The country is too small for comprehensive taxpayer funded cover. We need a seachange of attitude in this country where the state is not looked to for everyones needs.

[mashman]

I might have read this wrong but are you saying the accident insurance shouldn't pay up for accidents?

Accident doesn't = sports.

Not at all. quite the opposite. There person Mom quoted sounds like she had very similar injuries to my colleague. My colleague is now receiving ACC and for some reason Moms quoted chick didn't. There's no real difference between the 2 in my eyes. Or does it matter that he had a ball at his feet?

One thing I will say though. My colleague has a rather famous uncle... wonder if that has anything to do with it?

[Ixion]

(b) caused by treatment; and “(c) not a necessary part, or ordinary consequence , of the treatment, taking into account all the circumstances of the treatment, including— “(i) the person's underlying health condition at the time of the treatment; and “(ii) the clinical knowledge at the time of the treatment. This is the bit they will get you on. If there is any reference , in the really really fine print on the information leaflet, to "may cause blah blah" then they will claim that it is an 'ordinary consequence'. Albeit a rare one.

Some drugs are known to cause such allergic reactions. In that case they will deem the reaction an 'ordinary consequence'. Not saying that's right, just that's how they will try to shaft you.

[Swoop]

Either my doctor knowingly prescribed pills that she knew would almost kill me
They used to call my sort of claim "medical misadventure"...

Just glad that you are still around.:yes:

The fuckwits at North Shore hospital murdered my grandfather years ago, by prescribing the wrong pills.
I regard it as murder.

[yungatart]

Good luck, Mom, keep at the bastards.
Whether the claim is approved or denied is not actually the issue...the issue is, nobody (ACC) has bothered to communicate with Mom and let her know what is happening with regard to her claim. After this length of time, that is appalling!

[oldrider]

A private insurance company would use every trick at its disposal to avoid paying out. Just like ACC.

Well, at least you would have a "choice and other options", just like we have for bike insurance! (that's the theory anyway)

I prefer ACC "in it's purest form" actually rather than this politically influenced shit that we have got now! :mellow:

[The Pastor]

Can't offer you any help, but beer always helps :D

[MSTRS]

You are not going to like me for saying this but Ive always felt that discretional activities such as sporting injuries should not be funded by the taxpayer, but by private insurance. The country is too small for comprehensive taxpayer funded cover. .

The earner levy (and the govt contribution) covers any and all injuries not occuring at work or a vehicle accident. It is demonstrably UNfair that vehicle type attract different risk ratings, but someone who does not play any sport or risky pastime pays the same rate as someone who does. So to a degree, I agree with what you say EXCEPT what happened to the No Fault thing?

[Mom]

Good luck, Mom, keep at the bastards.
Whether the claim is approved or denied is not actually the issue...the issue is, nobody (ACC) has bothered to communicate with Mom and let her know what is happening with regard to her claim. After this length of time, that is appalling!

Well the complaints department at ACC certainly agreed that it was an unacceptable delay anyway. They have a very robust complaints process, I will have some resolution in 4 working days. Have been back to the doctors today and have a medical certificate till the end of the month. Hopefully by then I will actually feel a bit more back to my old self instead of the absolute train wreck I am now :D

[rainman]

You are not going to like me for saying this but Ive always felt that discretional activities such as sporting injuries should not be funded by the taxpayer, but by private insurance. The country is too small for comprehensive taxpayer funded cover. We need a seachange of attitude in this country where the state is not looked to for everyones needs.

That may be as it may be (it was a foreign concept to me too when I arrived here 15 years ago), but still doesn't answer my question. How does privatising ACC now address the issues, and how do you do it without completely screwing over people like me? Answer: It doesn't, all it does is hand over more of our cash to insurance companies.

BTW, I assume you include motorcycling as a discretionary activity? If so, do you have private accident insurance to cover injuries you might sustain while riding?

[Fatt Max]

I'm sorry but that is just so fecking wrong I cannot find the words......mate, that 'kin sucks.....

What do you have to do these days for fuck sake...!!

So sorry for your trouble here mate

Arrrrgghh....

[Mom]

I'm sorry but that is just so fecking wrong I cannot find the words......mate, that 'kin sucks.....

What do you have to do these days for fuck sake...!!

So sorry for your trouble here mate

Arrrrgghh....

Good speech fodder though ;)

[steve_t]

I talked to a chick yesterday that broke her Archillies Tendon. She was playing chasey with her kids in the back yard and it just went bang.

ACC did not accept liability for her claim! Was not an accident apparently, she was not playing sport when it happened, it must have been a congenital weakness if you please. Any reason, any excuse. SHe battled them for months and eventually actually gave up as it was affecting her mental health to be battling them on an almost daily basis.

I'd heard of someone who was going to be hit by a car so they jumped out of the way into a ditch and broke their ankle. They got refused cover because there was "no external force". Basically, the story was that if the car had hit her and broken her leg, she would have been covered, but as it was ankle vs ground, she was denied cover!!! Retarded!!


You are not going to like me for saying this but Ive always felt that discretional activities such as sporting injuries should not be funded by the taxpayer, but by private insurance. The country is too small for comprehensive taxpayer funded cover. We need a seachange of attitude in this country where the state is not looked to for everyones needs.

I don't mind sports injuries getting covered so long as people playing organised sport with high risk of injury pay levies. Someone said rugby club fees contain an ACC component. I'm not sure if this is true though...

[MSTRS]

Belonging to a sports club does attract a small amount of ACC levy in the club fees. Or in the fee paid to enter a sports event. But where rugby is concerned, that levy nowhere near covers the injury costs. FFS rugby costs only slightly less than m/c accidents, but we don't see their levies at levels like ours.

[Mom]

I don't mind sports injuries getting covered so long as people playing organised sport with high risk of injury pay levies. Someone said rugby club fees contain an ACC component. I'm not sure if this is true though...

Well see this is where my thinking is on this. I work part time on wages. I pay an ACC levy as part of my PAYE, this levy goes into a fund to cover me should I injure myself in a recreational situation. I also have a small business and pay an ACC levy on any profit that business makes which is treated as income to me :yes: This also goes to cover any recreational injury I suffer. The business also pays an ACC levy on the amount of wages paid out, that is to cover any work place accident. I own a couple of vehicles (a car and a van) I pay ACC levy on the registration for both these vehicles and some also when I purchase fuel for them. This for if I make a motorvehicle claim. I also have a motorcycle. I am not currently paying any ACC levy for that as the rego is on hold.

I pay a shed load of levy and I will get cover when I am entitled to it, they have no right to leave a claim sitting on a desk unactioned, particularly when the person claiming is not able to retrun to work and is not getting paid, just bcause the injury is classed as a treatment injury. I am entitled to at least an acknowledgement of my claim and to have my care paid for, and my earnings compensated in a timely manner. That is my beef.

[steve_t]

Agree with you wholeheartedly, Mom

[Mom]

This is the bit they will get you on. If there is any reference , in the really really fine print on the information leaflet, to "may cause blah blah" then they will claim that it is an 'ordinary consequence'. Albeit a rare one.

Some drugs are known to cause such allergic reactions. In that case they will deem the reaction an 'ordinary consequence'. Not saying that's right, just that's how they will try to shaft you.

Yeah I hear you but what actually happened to me was a step removed from a known adverse reaction. I developed something that goes by the name of Erythema Multiforme referred to sometimes as Steven Johnson Syndrome. I did not have any infection that riggered the episode hence the SJS rider on what I had. Whatever, I was one hell sick puppy and will take a long time to recover.

[Usarka]

Be careful with the using the complaints process, you can end up on your case managers "shit list".

[Mom]

Be careful with the using the complaints process, you can end up on your case managers "shit list".

I dont have a case manager, I dont have an anything. I hear you too, and thanks for the heads up.

[Ixion]

Erythema Multiforme

Uh Erythema Multiforme translates literally as 'shit loads of different sorts of big red spots'

[Mom]

Uh Erythema Multiforme translates literally as 'shit loads of different sorts of big red spots'

:lol: Yepper, they were different for sure, and there were lots of them...

I particularly liked the ones on the palms of my hands, mind you I got a bit freaked out when the soles of my feet were involved as well :pinch:

[inlinefour]

On the verge of another protest campaign kick off I am battling ACC for cover! Apparently my claim is complicated!

Complicated my Bum!

Either my doctor knowingly prescribed pills that she knew would almost kill me or I took a new perscription knowing that it would almost kill me or I did it to get a BIT of attention for myself, or...

IT WAS A FUCKEN ACCIDENT!

No complications as far as I can see!

They used to call my sort of claim "medical misadventure", now it is called "treatment injury", whatever, ACC have not even responded to a claim that was received by them April 1st (no jokes thanks). I had to ring them today to see if they had received my claim as neither my employer nor me had heard anything from ACC. When I "officially" complained this afternoon as I was not entirely certain that anything was going to happen the call taker had to admit it was not acceptable to not hear anything for that long.

I am amped and pissed off. The young fuck at the call centre I spoke to this morning suggested I contact WINZ to get an invalids benefit as these claims can "take ages" to resolve!

SO, not only am I a pissed off biker, I am a pissed off worker that pays ACC levy via my PAYE who nearly carked it as a result of taking a prescribed medication, who is now battling the cunse for compensation. Actually I would be happy if they would simply cover the cost of 2 trips to hospital in the ambulance and the 24/7 A&E charges I had to pay.

Keep you posted.

EDIT: I did manage a couple of hours of work today, but am far, far from fit for a full return and still have some quite serious ongoing health issues as a result of my auto immune reaction to the allergic reaction I originally suffered. I am actualy a bit worried I wont make a full recovery, and these wankers have me on the ohhhhhhhhhh we will get to that claim in the next few days 2 weeks after the hospital lodged it on my behalf!

Nah, you fit in with your employer. Who pays for the first week and then ACC take it from there, until your back at work. If your on a benefit, I wouldn't know and I don't like your chances. Other than the invalids benefit, that was originally stated.

I know you wouldn't have taken the med on purpose. Although I can't see a motorcycle rally helping much, but your welcome to try. ACC don't get involved if your in hospital, are given the meds and have an adverse reaction to them. If I had yours though, then I wouldn't be around today.

Sorry to hear whats going on with you. I know how much a disability bites, especially when your used to doing everything yourself.

[Robert Taylor]

That may be as it may be (it was a foreign concept to me too when I arrived here 15 years ago), but still doesn't answer my question. How does privatising ACC now address the issues, and how do you do it without completely screwing over people like me? Answer: It doesn't, all it does is hand over more of our cash to insurance companies.

BTW, I assume you include motorcycling as a discretionary activity? If so, do you have private accident insurance to cover injuries you might sustain while riding?

Yes in fact I do, and what I expend on that I delete off what would otherwise be spent on discretional items. And Im not wealthy by any means, everything Ive got Ive worked bloody hard for.

We have a lot of motorcyclists complaining about the hike in acc levies and I have to agree with a lot of what they are saying. But if anything over the years employers have had a lot more rieason to complain.

[rainman]

Yes in fact I do

Given you are already covered by ACC, and pay levies (premiums) for that, isn't it economically irrational to double insure yourself?

[Robert Taylor]

Given you are already covered by ACC, and pay levies (premiums) for that, isn't it economically irrational to double insure yourself?

Given the experience that some have opined about with ACC clearly not.

[rainman]

Given the experience that some have opined about with ACC clearly not.

Fair enough.

[Swoop]

where rugby is concerned, that levy nowhere near covers the injury costs. FFS rugby costs only slightly less than m/c accidents, but we don't see their levies at levels like ours.
Unfortunately...

I remember seeing the health clinic queue on a monday morning. All those fit thugbyists' who "strangely" injure themselves within the first few hours at work on a Monday morning.
They really should put it down as a thugby injury and stop parasiting off of the employer.

[MSTRS]

Unfortunately...

I remember seeing the health clinic queue on a monday morning. All those fit thugbyists' who "strangely" injure themselves within the first few hours at work on a Monday morning.
They really should put it down as a thugby injury and stop parasiting off of the employer.

$50M spent on rugby injuries. Just one sport code.
$62M spent on m/c injuries. And that will include a high proportion of non-levy paying offroaders (cos m/c injury is what was put on the form).

[steve_t]

Yes in fact I do.....

Mr Taylor, did you receive from ACC the other month a letter advising you that you can select a level of cover by option of different levies? A colleague of mine received one but I don't seem to have had one. I suggested she choose the lowest levy she can since her Income Protection insurance will cover anything that ACC doesn't cover. I thought I'd check and see if that's the right advice

[Owl]

Nah, you fit in with your employer. Who pays for the first week and then ACC take it from there, until your back at work.

I understood your employer was only obliged to pay the first week if it's a workplace accident?

[inlinefour]

I understood your employer was only obliged to pay the first week if it's a workplace accident?

Good point, I forgot about that. Thanks Owl.

[Mom]

I understood your employer was only obliged to pay the first week if it's a workplace accident?

Yeah, they are only obliged if its a work place accident. I have been very lucky so far. My employer paid me 4 days sick pay that I had accrued, and there was one Stat day I was due. That and 8 hours I had actually worked meant I got some pay. From here on in though, nothing till ACC get to my claim. Oh well, at least I am still alive eh :D My hubby is a rich man too after yesterdays windfall :lol:

[Robert Taylor]

Mr Taylor, did you receive from ACC the other month a letter advising you that you can select a level of cover by option of different levies? A colleague of mine received one but I don't seem to have had one. I suggested she choose the lowest levy she can since her Income Protection insurance will cover anything that ACC doesn't cover. I thought I'd check and see if that's the right advice

No I havent seen that but will enquire. ACC levies are of course paid for my employees, but as is well known if you are self employed you are pretty much a leper in the eyes of ACC, despite as an employer paying sizable levies! Thats part or all of my mentality in having private cover.

[Owl]

Get well soon Mom and I hope you get a resolution with Acc quick smart!

I was lucky/unlucky to come to medical grief while on ACC, so I was continually covered. Of course my organs were still working and I looked ok, so we'll call it lucky.:yes:

[Mom]

Well I dont think I will be holding my breath on this one. I received a letter on Thursday acknowledging my claim and some information explaining the process of a treatment injury claim. As requested I rang the number on the letter to give further information. The girl I spoke to said she had passed that on and that Helen (I am beginning to go off her) would get to it in a couple of days.

Yesterday I got my phone call foloowing up on my complaint about the delay in getting anything done. What a joke! ACC received my claim APril 1st and did not even look at it until April 12th (the day I rang them - coincidence anyone?) The resolution of my complaint? ACC apologises for the delay in responding to my claim :D Well that makes all the difference :weird: ANyway, I asked this Team Leader from the treatment injury department what the deal was with Helen and her couple of days attitude to anything that hits her desk, told her I had telephoned the day before etc. The response? We have no record of your call yesterday!

Difficult not to get a little bit ticked off really.

The woman I spoke to told me that these claims could take up to 9 months to get a decision on cover. Meantime I have just received 2 accounts from St John AMbulance for my trips to hospital. $67.50 each. I still have to attend my docotrs and am not earning any money,. Lucky I have a rich hubby eh? Be up shit creek otherwise.

[Mom]

Well, well, well...

I have just spoken with ACC who have advised that they have now accepted my claim for a treatment injury. I will have to complete a form for reimbursement of any expenses I have had in relation to this injury, and they will be contacting my employer to get details of my income so they can pay me some compenation for the time I was not earning. What a mission.

How they could even have thought it was not covered was beyond me. Having to jump through hoops and about beggar yourself in the process of proving they had to cover it is beyond the pale.