ACC speeds up claims approval

WEDNESDAY, JULY 4, 2018

Many ACC claims will soon be accepted as they are lodged, thanks to a new system that will reduce the time it takes for clients to find out what’s happening with their claim.

ACC Chief Operating Officer Mike Tully says the new system, to be introduced later this year, will fast-track simple claims that meet specific criteria. This will free up time for staff to focus on more complex and sensitive claims, which would continue to be reviewed manually, in the same way they are now.

The new system uses a statistical model that uses data from 12 million anonymised claims lodged between 2010 and 2016, to determine the probability that a given claim will be accepted. No claim will ever be automatically declined. This will support ACC to operate more efficiently and effectively, while providing greater certainty to injured New Zealanders.

The statistical model is being rigorously tested and independently validated by experts to ensure it is accurate and meets good practice guidelines for use of personal data.

“Currently we approve 96 per cent of the two million claims we receive each year. Our new system is looking to fast-track as many simple claims as possible, where it is fairly obvious that the injury was caused by an accident. For example, someone making a trip to the emergency clinic to have a cut stitched, would have their claim fast-tracked.” says Mike Tully.

“Less straight-forward claims – such as sensitive claims and treatment injury claims that wouldn’t meet the criteria for fast-tracked processing – will be reviewed in person by an ACC staff member, as all claims are now.

“This time-saving technology is widely used by New Zealand and global organisations, so we’re excited to be using it here at ACC.

“We’re planning to notify clients by text or email, possibly while they are still with their doctor. We could indicate that the claim has been already accepted, or that it has been received and we are working on it. Either way, they won’t have to wait days for a letter. This could give clients confidence that their initial treatment costs are covered and save them worrying about having to fund their initial treatment themselves.” says Mike Tully.

ACC is looking at other technology-driven improvements for clients, including a self-service website where clients can view information about their claim and request further support.

The Minister for ACC, the Privacy Commissioner and the Human Rights Commission are being kept up to date with the model as it is developing.

ACC will publish information about the statistical model on their website later this year.

Additional information about the new claims approval system is available at: https://www.acc.co.nz/assets/general/Lodgement-Technical-summary.pdf

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