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    ACC Assistance

We offer an advocacy service to our members who may have been incorrectly declined cover by ACC in relation to a personal injury caused by an accident, medical treatment injury or gradual workplace injury. There is no charge for this service. Please respond to the following questions to get help.


 

By completing this form, you consent to us contacting the injured person or the person authorised to speak on behalf of the injured person.

Please select Please select ACC claim has been accepted ACC claim has been declined Need assistance with my claim
Please select Please select Making a new claim for personal injury caused by accident Making a new claim for treatment injury Making a new claim for work-related gradual process injury Something else
Please select Please select Yes No I don't know
Please select Please select Yes No
Please select Please select Yes No I don't know

Supporting documents

Please attach your acceptance letter and any other relevant documents.

Accepted file types: DOC, DOCX, PDF, JPEG, JPG or PNG (Max file size 2MB).


Supporting documents

Please attach any documents that could help us resolve your issue with ACC, such as:

  • Your ACC decline letter
  • Case conference or review hearing notices
  • Any clinical or legal information ACC has obtained to support their decision
  • Any other information that might be helpful

Accepted file types: DOC, DOCX, PDF, JPEG, JPG or PNG (Max file size 2MB).


Enter your personal details

These details help us verify who you are so we can deal with your enquiry as quickly as possible.


Optional Optional Mr Mrs Miss Ms Mx None
 

By submitting this form, you acknowledge and agree that personal and health information provided to us (including any supporting documents) will be collected, stored, used and disclosed in accordance with the terms of our Member Privacy Statement.