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Thread: Wear and tear excuse to decline cover

  1. #1
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    Wear and tear excuse to decline cover

    I recall a post or two on this subject and have had a search to find them. No luck. Does anyone else recall the topic and can point me at the thread?
    Basically, we all know that ACC is declining cover on this basis (eh Maha?) and I would like to see what % of claims it applies to compared with years previously.
    Do you realise how many holes there could be if people would just take the time to take the dirt out of them?

  2. #2
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    Oh, and there was a series of posts about an ACC-appointed doctor in Dunedin dismissing claims too...
    Do you realise how many holes there could be if people would just take the time to take the dirt out of them?

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    i dont know where the posts are, but ive seen threads on trademe relating to people being declined. ive told an older co worker to refuse to carry heavy or awkward boxes upstairs due to this new "policy" as the two of us get used as the muscle.
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  4. #4
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    Nobody?
    The reason I ask is that some ACC flunky has had a letter to ed published, saying that they 'don't use tear and tear as an excuse to decline claims'
    This needs to be countered with facts...
    Do you realise how many holes there could be if people would just take the time to take the dirt out of them?

  5. #5
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    My Dad damaged his shoulder putting scaffolding up and got declined from ACC due to his age. They claim it is wear and tear due to his age and the fact that the older you are the more likely you are to damage yourself due to being brittle.

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    Quote Originally Posted by MSTRS View Post
    Nobody?
    The reason I ask is that some ACC flunky has had a letter to ed published, saying that they 'don't use tear and tear as an excuse to decline claims'
    This needs to be countered with facts...
    Try and make a claim for a joint if you are over 10years old, (ACC) will come up with a negative somewhere..

  7. #7
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    Quote Originally Posted by Stickchick View Post
    My Dad damaged his shoulder putting scaffolding up and got declined from ACC due to his age. They claim it is wear and tear due to his age and the fact that the older you are the more likely you are to damage yourself due to being brittle.
    You will win that if you contest it, it's descrimmination. I'd actually go straight to any media outlet that will listen over that, and they will probably grab that like a dog with a bone. "sorry elderly not entitled to ACC because you are brittle".
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  8. #8
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    Quote Originally Posted by Stickchick View Post
    My Dad damaged his shoulder putting scaffolding up and got declined from ACC due to his age. They claim it is wear and tear due to his age and the fact that the older you are the more likely you are to damage yourself due to being brittle.
    You will win that if you contest it, it's descrimmination. I'd actually go straight to any media outlet that will listen over that, and they will probably grab that like a dog with a bone. "sorry elderly not entitled to ACC because you are brittle".
    Cats land on their feet. Toast lands jamside down.
    A cat glued to some jam toast will hover in quantum indecision


    Curiosity was framed; ignorance killed the cat

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  9. #9
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    Thanks.
    I know there are some 'horror' stories out there. What I'd really like is some figures...
    Say year 2000 % claims denied w+t ... 2009 % claim denied w+t.
    Or similar
    Do you realise how many holes there could be if people would just take the time to take the dirt out of them?

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  11. #11
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    Quote Originally Posted by Sentox View Post
    I love that article. How the hell a 21 year old could have too much wear and tear is ludicrous. In fact, privatising ACC sounds better and better, at least you know you are covered.

    When you think about the amount of ACC levys you pay a year from income, rego etc it's probably the same cost as private except you will be able to squeeze dental cover in there too.
    Cats land on their feet. Toast lands jamside down.
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    Curiosity was framed; ignorance killed the cat

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  12. #12
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    Quote Originally Posted by firefighter View Post
    You will win that if you contest it, it's descrimmination. I'd actually go straight to any media outlet that will listen over that, and they will probably grab that like a dog with a bone. "sorry elderly not entitled to ACC because you are brittle".
    It is not necessary to rely on a vague argument of discrimination.

    There is abundant case law, around the very old legal rule called the "Eggshell Skull Rule". Which , in fine, says that if you negligently bump into an old lady, and she knocks her head, occasioning a blow which to a normal person would be of no consequence; but she happens to have an exceptionally fragile skull and suffers injury; you are liable, her thin skull is no defence.

    Throw some case citations at her :

    Mullins vs Gray 1999
    Smith v. Leech Brain & Co. Ltd. (QB, 1962
    Stephenson v. Waite Tileman Limited (NZ CA, 1973

    Lots of others but those are good ones. The last is a NZ case
    Smith vs Leech Brain covers the case of an injury aggravating an existing precondition.

    But you do need to be aware of the counter, the "Crumbling Skull Rule". This covers the case where an injury brings to light a pre existing condition. And the injured persons condition is in fact due to the underlying condition , not the injury. So the ACC might say "You have indeed suffered injury. And that injury is made worse by a pre existing condition. We are liable for the cost of treating the injury itself, but not for the underlying degenerative condition"

    To take an extreme instance, if I am knocked off my bike, suffering a severe laceration. ACC are liable for the cost of treatment of the laceration. But, in the course of cutting me open to treat the injury they , happenstance, discover that I have an unrelated cancer. ACC will be liable for the cost of treating the injury, but not the cancer (but note Smith vs Leech Brain where the injury CAUSED a cancer- which is covered).
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    Quote Originally Posted by MSTRS View Post
    Thanks.
    I know there are some 'horror' stories out there. What I'd really like is some figures...
    Say year 2000 % claims denied w+t ... 2009 % claim denied w+t.
    Or similar
    Maybe go here and ask those that are involved with the system, rather than asking for figures and others subjective nonsence....http://accforum.org lot of info from real persons on there...

  14. #14
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    Link doesn't work.
    I have 'heaps' of anecdotal evidence regarding individuals. That anecdotal evidence suggests that way more are being turned away. Or forced to take some sort of legal action.
    I'd really like numbers...
    But I don't know where to find them.
    Do you realise how many holes there could be if people would just take the time to take the dirt out of them?

  15. #15
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    Quote Originally Posted by MSTRS View Post
    I'd really like numbers...
    But I don't know where to find them.
    I'm not even sure if the stats are readily available. Stats NZ keeps some ACC-related data, but only addressing the composition of work-related injuries. I couldn't find anything related to denied claims nor their specifics.

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