ACC is not invincible

[Tazz]

Ah, but real commercial insurance doesn't start with the viewpoint that you're trying to commit fraud.

The hell they don't!

Oh wait, maybe it is actually them trying to commit fraud in regards to ridiculously pay outs =P

[Zedder]

Ah, but real commercial insurance doesn't start with the viewpoint that you're trying to commit fraud. They just want to pay you something and close the case quickly.
Recent events have shown me at least, that EQC is just the same as ACC - start with expectations of the worst case clients and try to deny any liability whatsoever.

The term "preexisting condition" is now in both ACC and EQC handbooks as standard terminology.

According to Edbears posts though, it's not a problem dealing with ACC.

However, even having a clear case it took 12 months. Also, you have to do most of the work yourself (analysing MRI and CT scan reports etc) despite having a very experienced case manager and even then it's "taken its toll" he's wrung out and isn't totally finished yet.

[Edbear]

According to Edbears posts though, it's not a problem dealing with ACC.

However, even having a clear case it took 12 months. Also, you have to do most of the work yourself (analysing MRI and CT scan reports etc) despite having a very experienced case manager and even then it's "taken its toll" he's wrung out and isn't totally finished yet.

Yeah. It's been a steep learning curve and knowing what I have learned it would be far easier now. Addressing the lump sum case, will be much more straight forward, now. Most of the stress was due to our financial situation, having no income for 2 years, and not knowing if you are ever going to get anything makes it very hard. I had to work far too hard on my business in an effort to get something we could live on.

Having zero capital to start and relying on my wife's income, we have somehow managed to survive and build a business that is now paying the mortgage and most bills. It has certainly taken a toll on both of us and Mrs. Bear handed her notice in yesterday.

That's why I am happy to share with anyone if they are facing similar issues. ACC needs to go through the same process that IRD went through and be more open and sympathetic.

Even the best case manager is limited to the information they have and there were discrepancies in the Dr's. reports and incomplete evidence that I had to identify and bring to her attention. The whole case came about after a visit with my surgeon where he gave me a contradicting opinion to the Dr. Using the new information l was able go back to ACC and request a late review.

[Zedder]

Yeah. It's been a steep learning curve and knowing what I have learned it would be far easier now. Addressing the lump sum case, will be much more straight forward, now. Most of the stress was due to our financial situation, having no income for 2 years, and not knowing if you are ever going to get anything makes it very hard. I had to work far too hard on my business in an effort to get something we could live on.

Having zero capital to start and relying on my wife's income, we have somehow managed to survive and build a business that is now paying the mortgage and most bills. It has certainly taken a toll on both of us and Mrs. Bear handed her notice in yesterday.

That's why I am happy to share with anyone if they are facing similar issues. ACC needs to go through the same process that IRD went through and be more open and sympathetic.

Even the best case manager is limited to the information they have and there were discrepancies in the Dr's. reports and incomplete evidence that I had to identify and bring to her attention. The whole case came about after a visit with my surgeon where he gave me a contradicting opinion to the Dr. Using the new information l was able go back to ACC and request a late review.

Good on you for wanting to help out.

My point though is about how wrong you were when you stated "NZ's ACC system is the best in the world" and if it's the envy of people in other countries then either they're deluded or bluntly haven't had to put up with the crap the ACC ripoff merchants put a person through.

[avgas]

A key point with ACC is not to ever give up and go away. I made sure they knew I wasn't going to quit and that I had nothing to lose by pursuing it to the end. They were forced to take it seriously, especially when it became clear I knew the legislation and could relate to them on their own terms. Plus having the support of my surgeon, one who is used, and very well respected, by ACC for surgery and clinical assessments.

After pressure from people to get a lawyer, I tried a lawyer who was supposed to be an expert in ACC matters. He stuffed up and caused a two month delay, so I ditched him and did it on my own. Far cheaper and quicker!

Yeah but Ed, we shouldn't have to HACK the system to get treated!
We are not talking about some private health insurance - we are talking about NZ Government Health and Injury Cover. aka ACC.
ACC is the reason why we can't sue, and why everyone is covered.

It shouldn't require lawyers - it should require doctors.
It shouldn't require pursuit - it should require rehabilitation.
People should only have to pay for private medical attention because they don't like public hospitals or they want something that nothing to do with an injury.

This is the equivalent to taking the local library to court.
The system is there to treat the sick and injured...........not mistreat them.

[mashman]

Good on you for wanting to help out.

My point though is about how wrong you were when you stated "NZ's ACC system is the best in the world" and if it's the envy of people in other countries then either they're deluded or bluntly haven't had to put up with the crap the ACC ripoff merchants put a person through.

Meh. I reckon the NHS was better than ACC and the NHS was, erm, fraught with "problems". It's just another system that provides cover to a budget. Fuckin madness. @envy. People need to know for their to be any envy. The Scandanvians probably laugh at ACC etc...

[Zedder]

Meh. I reckon the NHS was better than ACC and the NHS was, erm, fraught with "problems". It's just another system that provides cover to a budget. Fuckin madness. @envy. People need to know for their to be any envy. The Scandanvians probably laugh at ACC etc...

The poor old NHS alright. Yep, going on what I know of the Scandy system it does seem to be at the top in terms of public health.

[Edbear]

If you have an accident and smash your back, ACC is unbeatable! I shudder to think how much my own accident cost and there was no delay in my treatment, no questions about insurance, and nothing was mentioned about costs. I got the absolute best of treatment, nothing was too much.

My surgeon is one of the best in the world and home care was anything I needed or asked for. Especially in the USA were people astonished at the system we have here.

Unfortunately, as with any Publicly funded health system, it's the long term treatment that's the issue.

[Katman]

Unfortunately, as with any Publicly funded health system, it's the long term treatment that's the issue.

Along with the means to rip that system off.

[Zedder]

If you have an accident and smash your back, ACC is unbeatable! I shudder to think how much my own accident cost and there was no delay in my treatment, no questions about insurance, and nothing was mentioned about costs. I got the absolute best of treatment, nothing was too much.

My surgeon is one of the best in the world and home care was anything I needed or asked for. Especially in the USA were people astonished at the system we have here.

Unfortunately, as with any Publicly funded health system, it's the long term treatment that's the issue.

Of course you got the absolute best of treatment, it's funded multiple times. Wake up man!

[Ocean1]

The poor old NHS alright. Yep, going on what I know of the Scandy system it does seem to be at the top in terms of public health.

You're comparing an apple to a complete orange tree.

National health in the UK is free to the end user, don't matter what's wrong or who caused it, they don't fund accident injuries any different to any other health need. Both the Govt and individuals retain the right to sue for damages, which both sometimes do. The exercise merely serves to illustrate the futility of trying to fund accident treatment retrospectively through the courts, it invariably costs more than the damages amount to. Which is exactly the situation with the US's almost exclusively privately owned system: neither work very well at all in paying for accident treatment.

Our health system is only partly publicly funded, when it was first set up the hope was to copy most of the best bits of Europe's better performing public health systems. However, most GP's didn't want to work for the govt, so primary health care remains a collection of privately owned businesses. Publicly subsidised businesses, of course. Which I suspect is where your later comment re multiple payments comes from?

ACC was a later invention, and it remains a funding model the rest of the world indeed tries to copy. For good reason, much as we bleat about it ACC is more cost effective than just about any alternative you can find.

Don't get me wrong, I'm as pissed about ACC's recent lack of honesty and loss of integrity as anyone else. The thing is, most of that is driven not by some catch-up to a fully funded model, it's caused by scope creep, the ever expanding range of services and treatments ACC agree, under the incessant barrage of public (and private) demand to fund. And, of course faced with those extra costs and little extra funding you're faced with a choice: They can limit who they fund, which is untenable in NZ, or they can limit access to the whole range. Which is what you're seeing now.

[Zedder]

You're comparing an apple to a complete orange tree.

National health in the UK is free to the end user, don't matter what's wrong or who caused it, they don't fund accident injuries any different to any other health need. Both the Govt and individuals retain the right to sue for damages, which both sometimes do. The exercise merely serves to illustrate the futility of trying to fund accident treatment retrospectively through the courts, it invariably costs more than the damages amount to. Which is exactly the situation with the US's almost exclusively privately owned system: neither work very well at all in paying for accident treatment.

Our health system is only partly publicly funded, when it was first set up the hope was to copy most of the best bits of Europe's better performing public health systems. However, most GP's didn't want to work for the govt, so primary health care remains a collection of privately owned businesses. Publicly subsidised businesses, of course. Which I suspect is where your later comment re multiple payments comes from?

ACC was a later invention, and it remains a funding model the rest of the world indeed tries to copy. For good reason, much as we bleat about it ACC is more cost effective than just about any alternative you can find.

Don't get me wrong, I'm as pissed about ACC's recent lack of honesty and loss of integrity as anyone else. The thing is, most of that is driven not by some catch-up to a fully funded model, it's caused by scope creep, the ever expanding range of services and treatments ACC agree, under the incessant barrage of public (and private) demand to fund. And, of course faced with those extra costs and little extra funding you're faced with a choice: They can limit who they fund, which is untenable in NZ, or they can limit access to the whole range. Which is what you're seeing now.

Yep, I was indeed comparing apples to orange trees. I was agreeing with mashman about the NHS which always seems to bumble along unlike the Scandy countries which are very sorted out. ACC though is a whole different kettle of fish indeed.

[jasonu]

Especially in the USA were people astonished at the system we have here.
.

Not quite. When you tell the yanks about the 'free' public healthcare system they are astonished. They are less astonished when you explain where the funding for the 'free' system comes from ie acc levies on your vehicle rego, employer levies etc. Free to you when you are getting the care but a good proportion of us UnZedders are paying for it indirectly.

[mashman]

Yep, I was indeed comparing apples to orange trees. I was agreeing with mashman about the NHS which always seems to bumble along unlike the Scandy countries which are very sorted out. ACC though is a whole different kettle of fish indeed.

NHS, ACC, Private, Private/Public etc... all "different" models that can supposedly work. To an extent, they all do exactly the same thing. The only things that are really different are the parameters of cover and funding models. They all churn out fixed people after all. The parameters of cover and funding models are becoming the core of the business, not the fixing of people... which means that people are going to get fucked over, because that's how it translates innit. We all have story's. Something is broken.

[Edbear]

od reason, much as we bleat about it ACC is more cost effective than just about any alternative you can find.

Don't get me wrong, I'm as pissed about ACC's recent lack of honesty and loss of integrity as anyone else. The thing is, most of that is driven not by some catch-up to a fully funded model, it's caused by scope creep, the ever expanding range of services and treatments ACC agree, under the incessant barrage of public (and private) demand to fund. And, of course faced with those extra costs and little extra funding you're faced with a choice: They can limit who they fund, which is untenable in NZ, or they can limit access to the whole range. Which is what you're seeing now.

Not quite. When you tell the yanks about the 'free' public healthcare system they are astonished. They are less astonished when you explain where the funding for the 'free' system comes from ie acc levies on your vehicle rego, employer levies etc. Free to you when you are getting the care but a good proportion of us UnZedders are paying for it indirectly.

NHS, ACC, Private, Private/Public etc... all "different" models that can supposedly work. To an extent, they all do exactly the same thing. The only things that are really different are the parameters of cover and funding models. They all churn out fixed people after all. The parameters of cover and funding models are becoming the core of the business, not the fixing of people... which means that people are going to get fucked over, because that's how it translates innit. We all have story's. Something is broken.

However it's funded, it's funded by taxes, either from the general taxes or specific taxes. The public fund the service. As Ocean1 points out, everyone wants everything for free, provided by a mysterious Government fund that gets money from trees.

Reality is that NZ has a shrinking tax base along with greatly increasing costs. Without immigration and overseas investment we are going to go backwards very quickly. Scandinavia is having funding issues as well. England is practically broke and too feudally fragmented to get its act together. The USA is an absolute shambles, financially, and Australia is having issues despite the far larger tax base.

There are things that need addressing here for sure, but I challenge anyone to seriously look into the issues of Government funding and make workable suggestions. Levies on users is open to examination at least and most think it's a fairer way of funding.