ACC reviews ‘invalid’
Lawyers are questioning the independence and legal authority of privately contracted ACC reviewers, raising an issue potentially affecting thousands of current and former review decisions.
The Government agency contracts out its dispute resolution responsibility to private company Fairway Resolution Services.
Barrister Warren Forster, who represents ACC claimants, said ACC did not have the required written permission from the minister and the ACC board to delegate its review powers to Fairway. The company employs about 40 reviewers.
Under ACC law, claimants can request a review of an ACC decision. Review decisions are final, often life-changing for the claimant and worth thousands of dollars in compensation and treatment.
An ACC spokesman said ACC’s 2014 contract with Fairway met the delegation requirements of the ACC Act and Crown Entities Act.
‘‘Ministerial prior approval of a delegation of review services is not required because under the Act, dispute resolution is a ‘service’ provided to claimants, and the Act expressly authorises delegation of services without prior ministerial approval.’’
But Forster said the contract with Fairway was not enough to provide statutory authority as reviews were not a service but a function and duty of the ACC Act, which was to be administered by the board.
The Crown Entities Act required Government departments
to provide written delegations when asked but despite several requests ACC had not provided them, he said.
Documents released to Forster under the Official Information Act include Fairway’s service contract and selected feedback from ACC’s review monitoring panel.
They reveal that ACC set key performance indicators for reviews and gave ‘‘feedback’’ on decisions made in favour of the
claimant. Forster said the comments showed the independence of the dispute resolution service was compromised.
‘‘If a reviewer decides against ACC, their case gets reviewed against another reviewer and they get told not to do it again. If they decide in favour of ACC, there’s no problem, they don’t ask any questions,’’ Forster said. ‘‘So the whole set up there is to culturally reinforce to people to decide in ACC’s favour.’’
Of 6761 reviews in the 2017-2018 financial year, 69 per cent found in favour of ACC.
An ACC review monitoring panel gave Fairway feedback on the remaining 31 per cent of cases decided in favour of the client. ACC stood by the process. ‘‘The panel provides monthly feedback to Fairway about adverse decisions where we feel it is warranted. Our feedback largely focuses on the weighting given to clinical evidence or legal application of the AC Act,’’ the ACC spokesman said.