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Apply for a review (ACC33)

Applying for a Review

Completing this form with the required information and submitting it to us means that you are applying for an independent review.  

Once you apply for a review, if we are unable to agree on a resolution early in the process, then we will need to involve a reviewer that is independent from ACC who will organise a review hearing.

At a review hearing, the independent reviewer will consider all the information available to them, including information about your case, ACC legislation, and written submissions from both you and ACC.

After the review hearing, the reviewer will make a decision about your review application. They can decide in your favour, or in ACC’s favour.

If applying for a review doesn’t sound right for you, you can look at our other options for resolving issues:

Alternative Dispute Resolution

Talk to us or make a complaint

 

Important information about completing this form

You will need to complete this form for each review application you are wanting to submit.

It should take around 10 minutes to complete this form, depending on how much information you would like to provide us about your situation.

All sections of this online form are mandatory, unless specified. You are unable to save your progress so we recommend having all of the information ready to go before starting. 

You need to apply for a review within three months from the date of our decision letter. In some circumstances we can accept late applications, such as if events outside your control prevent you from applying in time.

You can provide us with the reason for the late review in the application form. We are unable to extend the time for levy reviews or where the applicant is an employer.

If you need any help with this online form, please contact the person at ACC who has been helping you with your claim or levies, or contact us on 0800 101 996.

Primary contact details

Preferred contact method:

Complete an Authority to Act form and upload it

Authority to Act

Please email this completed form to accreviewapplication@acc.co.nz

Who is the review application about?

What is the decision about?
At least one option must be checked
You can find the date of the decision letter in the top left corner of your letter from ACC.
If your decision was more than three months ago, please tell us why you were unable to apply earlier. You need to apply for a review within three months from the date of our decision letter. In some circumstances we can accept late applications, such as i
Please explain why you would like to review our decision and what your ideal outcome is. Include any information that supports your application.

Cultural support services

You have the right to have your culture, values, and beliefs respected. If you would like cultural support with your review, please let us know how we can best support you: 

  • whānau, kaumātua or family support to be present
  • interpreters, if required, for you or your support person or people
  • have your review hearing at an appropriate community venue, if possible

Alternative dispute resolution

Alternative Dispute Resolution provides us and customers with an opportunity to engage in meaningful conversations with an independent party to find a way forward or resolution without the need for a formal review hearing.

ACC engages two suppliers to provide Independent Reviewer Administration and Dispute Resolution services. Please let us know if you have a preference of supplier:

Declaration

To collect this information and use it, as well as share it, according to ACC rules for reviewing your case and ACC privacy policy

·       Medical and other records which are or may be relevant to my claim 

·       Details of my accident 

·       Tax records, employment details and history which are or may be relevant to my claim

·       The holders of such information to provide it to ACC

  •   ACC to provide my claim file to an independent reviewer or conciliator and to external ACC advisors (such as lawyers or medical experts).