|
|
|
 |
 |
 |
 |
|
 |
 |
|
|
LAWS OF NEW ZEALAND
BACK Commenced: ANALYSIS Analysis 5 Status of this Part 6 How this Act is arranged 7 General nature of scheme 8 Establishment of entitlements 9 Competitive delivery of elements of scheme 10 Government delivery of other elements of scheme 11 Accident Compensation Corporation 12 Transitional issues 14 ``Acute treatment'' and ``public health acute service'' 15 ``Capacity for work'' 16 ``Cover'' 17 ``Earnings as an employee'': what it means 18 ``Earnings as an employee'': payments to spouse 19 ``Earnings as an employee'': what it does not include 20 ``Earnings as a self-employed person'' 21 ``Earnings as a shareholder-employee'' 22 ``Insured'' 23 ``New Zealand'' 24 ``Ordinarily resident in New Zealand'' 25 ``Spouse'', in relation to deceased insured 28 ``Accident'' 29 ``Personal injury'' 30 ``Mental injury'' 32 ``Work-related personal injury'' 33 ``Personal injury caused by a work-related gradual process, disease, or infection'' 35 ``Personal injury caused by medical misadventure'': defined in this section and in section 357 36 ``Medical error'' 37 ``Medical mishap'' 40 Cover for mental injury caused by certain criminal acts 41 Cover for personal injury suffered outside New Zealand (except mental injury caused by certain criminal acts) 42 Cover for personal injury suffered by persons not ordinarily resident in New Zealand: exclusions while travelling to, around, and from New Zealand 43 Cover for personal injury caused by a work-related gradual process, disease, or infection: exclusion for events occurring outside New Zealand before 1 April 1974 45 Date on which insured suffers personal injury caused by a work-related gradual process, disease, or infection 46 Date on which insured suffers personal injury caused by medical misadventure 48 ``Managing insurer'' 49 ``Receiving insurer'' 50 Relationship between contributing insurers, managing insurers, and receiving insurers 51 Receiving insurer's initial liability 52 Receiving insurer to identify, and transfer claim to, managing insurer 53 Responsibilities of managing insurer 55 Insurer with which to lodge claim involving cover 56 Insurer with which to lodge claim for entitlement 57 Treatment provider lodging claim on behalf of insured 58 When claim lodged and received 59 ``Insurer'' in sections 60 to 73 60 Manner of making claim 61 Time for making claim 62 Responsibility of insurer to make reasonable decisions 63 Responsibilities of insured to assist in establishment of cover and entitlements 64 Steps insurer takes to action claims 65 Steps insurer takes to action complicated claims 66 Failure to meet time limits, or to decide, is decision to accept 68 Decision on claim for ILO schedule injury 69 Decision on claim for deafness as personal injury caused by a work-related gradual process 70 Decision on claim for personal injury caused by medical misadventure 71 Insurer must tell insured about review and appeal rights 72 Insurer must give notice of decisions 73 Insurer may revise decisions 74 Managing insurer must keep claims files 77 Employer's duty to pay first week compensation 78 First week compensation is salary or wages for certain purposes 81 Limits on treatment providers in decisions on acute treatment 83 Procedures for determining incapacity for employment and capacity for work 85 Insurer to determine incapacity of insured who, at time of incapacity, was earner 86 Effect of determination under section 85 on entitlement to weekly compensation 87 Insurer to determine incapacity of insured who, at time of incapacity, had ceased to be an employee, was a potential earner, or had made election under section 286 88 Effect of determination under section 87 on entitlement to weekly compensation 90 How determination that insured has capacity for work is to be regarded 91 Insured with capacity for work loses entitlement to weekly compensation 92 Insured who no longer has capacity for work regains entitlement to weekly compensation 94 Conduct of assessment of capacity for work 95 Occupational assessor 96 Conduct of occupational assessment 97 Report on occupational assessment 98 Medical assessor 99 Conduct of medical assessment 100 Report on medical assessment 106 Managing insurer not entitled to contributions 108 Managing insurer entitled to contributions 110 Managing insurer entitled to contributions on duration basis when Residual Claims Account involved 111 Managing insurer entitled to contributions on contribution to injury basis when Residual Claims Account not involved 113 Managing insurer entitled to contributions 114 Insured's cover and entitlements not affected by sections 104 to 113 118 Disentitlement for misrepresentation: personal injury caused by a work-related gradual process, disease, or infection 119 Disentitlement because proceedings brought: personal injury caused by a work-related gradual process, disease, or infection 120 Disentitlement for wilfully self-inflicted personal injuries and suicide 121 Disentitlement for conviction for murder 122 Disentitlement during imprisonment 123 Court may deny statutory entitlements to previously imprisoned offender 125 Statutory entitlements to be provided to insured only 126 Insurer to pay amount for child to caregiver or financially responsible person 127 Insurer to pay amount to insured's estate 128 Payment of weekly compensation or independence allowance to insured outside New Zealand 129 Payment for treatment or rehabilitation to insured outside New Zealand 130 Payment for attendant care to insured outside New Zealand 131 Payment of survivor's grant to insured outside New Zealand 132 Payment to insured outside New Zealand may be in New Zealand dollars to New Zealand bank account 134 Effect of review or appeal on decisions 136 How to apply for review 137 Insurer to acknowledge receipt of review application 138 Insurer to engage and allocate reviewers 139 ``Accepted interests'' 140 Reviewer's duty to act independently 141 Reviewer must disclose interests and previous involvement 142 Insurer's duties to secure independence of reviewer 143 Conduct of review: general principles 144 Conduct of review: hearing to be held 145 Persons entitled to be present and heard at hearing 146 Record of hearing 147 Review decisions: formalities 148 Review decisions: substance 149 Deemed review decisions 150 Effect of review decisions 151 Costs on review 153 District Courts Rules 1992 and this Act apply to appeal 154 Manner of bringing appeal 155 Insurer to provide names of persons entitled to be heard 156 Notice of hearing date 157 Insurer's duty to make record available 158 Hearing of appeal 159 Evidence at appeal 160 Appointment of assessor 161 Involvement of assessor 162 Court may make order as to persons who may be present 163 Court may make order prohibiting publication 164 Decisions on appeal 166 Appeal to Court of Appeal on question of law 170 Implied terms of employer accident insurance contracts 171 Employers must disclose terms of accident insurance contract to employees 172 Employers must not require contributions from employees 173 Employees of insurer 174 Termination of accident insurance contract by employer 175 Employer to notify employees of proposed termination of accident insurance contract 177 Rules for self-employed entering accident insurance contracts 178 Implied terms of self-employed accident insurance contracts 179 Termination of accident insurance contract by self-employed person 181 Implied terms of private domestic worker accident insurance contracts 182 Rules for private domestic workers entering accident insurance contracts 183 Termination of accident insurance contract by private domestic worker 187 Obligations relating to contracts 188 Information relating to statutory entitlements must be set out in top-up or bundled contracts 189 Termination of accident insurance contract by insurer 190 Accident insurance contracts not avoided for misrepresentation or non-disclosure 191 Damages for non-disclosure 192 Other rights to cancel or amend 193 Retrospective accident insurance contracts 195 Regulator must pass on information about work-related injuries 196 Position of employees of foreign representatives 198 Functions of Regulator 200 Application for registration 203 Inspection of register 205 Cancellation of registration 206 Voluntary removal from register 207 Suspension of obligation to enter new insurance contracts 209 Conflict of interest 210 Duties of prudential supervisors 211 Liability of prudential supervisors 212 Termination of appointment as prudential supervisor 213 Saving of liability under general law 215 Special provisions relating to charge 216 Registration of trust deeds 217 Amendment of registered trust deed 219 Protection of actuaries and auditors 220 Regulator to provide insurance numbers to employers 221 Manager to provide insurance numbers to others 222 Regulator's powers of verification 224 Regulator's entry to premises restricted 225 Powers conferred by warrant 226 Warrant to be produced 227 Other duties of person who executes a warrant 228 Duty to assist 229 Power to inspect and take copies of documents, etc, obtained under warrant 230 Disposal of things seized 231 Exercise of powers under warrant not affected by application to court 232 Offences 233 False or misleading statements to Regulator 234 Restriction on disclosure by authorised persons 238 Primary responsibility in relation to insolvent insurer 239 Role of Regulator in respect of insolvent insurer 240 Role of administrator of insolvent insurer 241 Insolvent Insurers Fund 242 Money payable into Insolvent Insurers Fund 243 Initial Crown advance 244 Regulator must estimate amount of initial Crown advance to Insolvent Insurers Fund 245 Further Crown advances 246 One-off contribution to Insolvent Insurers Fund by employers, etc 247 Annual insurers' contributions to Insolvent Insurers Fund 248 Payment of contributions by employers and insurers 249 Refunds of Crown advance 250 Refunds of insurers' contributions 251 Refunds of other contributions 252 Payments out of Insolvent Insurers Fund 253 Administrator to provide information to Regulator 254 Regulator may contract out management or liabilities of Insolvent Insurers Fund 255 Transfer of liabilities 256 Provisions relating to contracting out 257 Regulator may assume rights and obligations 258 Regulator as insurer 259 Regulator may intervene in certain legal proceedings 260 Regulator may recover proceeds of realisation of insolvent insurer's assets 261 Termination of insolvent insurer status 263 Money payable into Non-Compliers Fund 264 Crown advance to Non-Compliers Fund 265 Regulator must estimate amount of Crown advance to Non-Compliers Fund 266 Annual insurers' levy 267 Payment of levy by insurers 268 Payments out of Non-Compliers Fund 269 Applications to Non-Compliers Fund 270 Regulator as insurer 271 Repayment of Crown advance 272 Regulator may contract out management or liabilities of Non-Compliers Fund 273 Provisions relating to contracting out 275 Investment of Funds 276 Interest on Crown advances 277 Accounting 279 Application of this Part 280 Duty of manager 283 Earners to pay premiums and levy 284 Rate of premiums and experience rating 285 Collection of premiums by deduction from employee earnings 287 Compensation for non-earners who purchase weekly compensation 288 Premiums for non-earners who purchase weekly compensation 289 Resumption of employment by non-earner who purchased weekly compensation 292 Rate of premiums and levy 293 Basis on which funds to be calculated 294 Experience rating 295 Collection of premiums 297 Rate of premiums and experience rating 298 Collection of premiums 300 Self-employed persons to pay premiums 301 Rate of premiums and experience rating 302 Classification of industries or risk 304 Liability to pay Residual Claims levy 305 Rate of levy 306 Classification of industries or risk 307 Promotion of employer involvement 309 Levies to be treated as premiums 310 Challenges to premiums 311 Manager may revise decisions 312 Effect of review or appeal about premium 313 Deduction of premium from payment due to defaulters 314 Power to assess premiums 315 Power in respect of small amounts of premiums 316 Agent to whom premiums may be paid 318 Adjustment of payments for part periods 319 Transfers of claim costs between certain accounts 320 Recovery of debts by manager 321 Penalties due to manager in respect of overpayments 322 Penalties due to manager in respect of unpaid premiums 323 Limitation period 324 Write-offs 325 Application of sections 320 to 324 to third parties 326 Production of documents 329 Powers of Corporation 330 Relationship between Corporation and subsidiaries 331 Functions of Corporation 332 Prevention of personal injury 333 Provision of services to other insurers 334 Provisions relating to subsidiaries 335 Company to be formed to provide claims management and network services 336 Board of Corporation 337 Protection of name ``Accident Compensation Corporation'' and ``Accident Rehabilitation and Compensation Insurance Corporation'' 339 Corporation to comply with Government policy 340 Service agreements between Corporation and Minister 341 Statement of intent 342 Provision of financial information 343 Management of Accounts 344 Investments 345 Power to borrow, etc 346 Loans and grants to Corporation 349 Application of employment contracts 350 Employment to be continuous 351 No compensation for technical redundancy 354 Disclosure of information by Corporation 357 ``Personal injury caused by medical misadventure'': addition to section 35 358 No contracting out of cover or statutory entitlements 359 Public interest 361 Funder with funding agreement may purchase public health acute services from hospital and health services on behalf of insurers 362 Insurers to contribute to payment under funding agreement 363 Service agreements between funder and hospital and health services 364 Effect of service agreement on insurer's liability 365 Decision of others is insurer's decision in some cases 366 Saving of transactions 367 No entitlement to review of certain arrangements 370 Information available to Regulator 371 Information available to Regulator to assess sanctions for employers without accident insurance contracts 374 Relationship with social security benefits: reimbursement to insurers 376 Offence not to provide requested information to insurer 377 Offence not to provide earnings information to insurer 384 Civil penalty 385 Procedure for requiring civil penalty 386 Civil penalty where no objection made 387 Penalty where objection made 388 Collection of civil penalty 389 Penalties payable into Non-Compliers Fund 390 Proof of premium to which penalty linked 391 Offence of knowingly failing to insure 392 Person not liable for double penalties 393 Defence available under this Act 395 Proceedings for personal injury caused by a work-related gradual process, disease, or infection 396 Exemplary damages 397 Insurer to be heard 398 Powers of insurer when claimant has right to bring proceedings 400 Regulations relating to claims process (Part 4) 401 Regulations relating to tests for deafness (Part 4) 402 Regulations relating to treatment or rehabilitation (Part 5) 403 Regulations relating to independence allowance (Part 5) 404 Regulations relating to indexation (Part 5) 405 Regulations relating to reviews and appeals (Part 6) 406 Regulations (Parts 7 to 9) 407 Regulations (Part 10) 408 Consultation requirements for regulations relating to classifications, experience rating, or medical misadventure 409 Consultation requirements for regulations relating to premium setting 410 Regulations relating to public health acute services (Part 12) 411 Regulations (transition) 412 General power to make regulations 413 Regulations may confer discretion 414 Regulations may prescribe offences and penalties 416 Consequential tax amendments 417 Consequential repeals and revocations 419 References to former Acts 422 Claims for cover lodged but not yet determined under former Acts 423 Claims for cover not lodged under 1992 Act 424 Exclusion of cover for personal injury caused by a work-related gradual process, disease, or infection if events before 1 April 1974 and death before 1 July 1992 429 Weekly compensation due under 1972 and 1982 Acts 430 Abatement of compensation 431 Weekly payments for permanent incapacity under 1972 and 1982 Acts: increases 432 Compensation payable to persons outside New Zealand 433 Cessation of weekly compensation under any former Act because of capacity to work 434 Cessation of weekly compensation under any former Act because of receipt of national superannuation 435 Cessation of weekly compensation under 1972 and 1982 Acts because of age 437 Compensation for pecuniary loss not related to earnings under 1972 and 1982 Acts: attendant care and household help 438 Compensation payable outside New Zealand for pecuniary loss not related to earnings under 1982 Act: attendant care 439 Compensation for pecuniary loss not related to earnings under 1972 and 1982 Acts 440 Time limit on vocational rehabilitation 442 Entitlement to independence allowance of persons who received lump sums under former Acts and suffer further impairment 444 Lump sum payments to surviving spouses, children, and other dependants for death before 1 July 1999 445 Compensation payable to surviving spouses, children, and other dependants for entitlements under 1992 Act 446 Compensation payable to surviving spouses under 1972 and 1982 Acts 447 Compensation payable to children and other dependants under 1972 and 1982 Acts 448 Child care payments for children of deceased persons 449 Compensation for pecuniary loss not related to earnings under former Acts: child care for child of deceased person 455 Liabilities of Subsequent Work Injury Account 456 Recognition of outstanding claims and premium revenue in financial statements of former Corporation on 30 June 1999 457 Levies, premiums, and other payments under former Acts 458 Interest on late payments 459 Accredited Employers Programme 460 Indexation of money entitlements payable under former Acts 461 Regulations providing for transitional matters 462 Expiry of section 461 463 Regulator may provide information to insurers or intending insurers 465 ``Clean slate'' purpose 467 Employer base premiums in relation to 3-month premium 468 Self-employed base premiums for 1998/99 premium year 469 Self-employed base premiums for 1998/99 premium year in relation to Earners' Account 470 Self-employed base premiums in relation to 3-month premiums 473 Reserves portion of employer and earner premium for 1998/99 premium year for all self-employed 476 Regulations made under former Acts 480 Amendment to Accident Rehabilitation and Compensation Insurance Act 1992 about married rate of social security benefits 482 Carry-over from former Corporation to new Corporation Schedule(s)
1 SCHEDULE 1: Statutory Entitlements |
||||||
|
. |
|
. | ||||
 |
 |
 |
|
||||
