ACC disputes resolution company accused of sending complainants cut-and-paste decisions

Some people challenging ACC decisions have received identical dispute rulings with wording that appears to have been 'copied and pasted' from previous cases.

Lawyers say the word-for-word rulings, written by Independent Complaints and Review Authority (ICRA) - one of two private companies paid to resolve disputes between ACC and claimants - throw the independence of the process into question.

In addition to decisions being copied, ICRA's use of 'case law templates' has also come under scrutiny because of concerns they could influence how cases are decided. ICRA reviewers have access to a library of templates that provide case law arguments for nearly every kind of injury.

The Accident Compensation Act requires review decisions to be independently reached.

ICRA, which reviews about 4000 disputes a year, said all its decisions were "independently reached", but acknowledged in one instance its reviewers collectively "drafted and adopted" text over an issue they had debated amongst themselves.

That particular issue involved a lengthy decision on costs issued to a client represented by ACC Advocacy Service in January.

ACC Advocacy Service owner Warren Forster, a lawyer and researcher specialising in accident compensation law, said another client was issued the same word-for-word decision on costs by a different reviewer a month later.

The identical text appeared in a third client's decision in March, again written by a different reviewer.

The decisions, seen by RNZ, declined some costs on a point of law, but it was the verbatim wording that raised legal and ethical concerns, Forster said.

"What the law requires is for them to act independently, and if they're copying and pasting someone else's decision, it's arguable they are not."

Part five of the Accident Compensation Act 2001 established requirements for reviewers to comply with the principles of natural justice and adopt an investigative approach.

"The whole thing really, at this point, looks like a complete sham. It's just cut-and-paste," Forster said.

"There's half a dozen [cases] word-for-word that we've identified, and that's just our cases."

ICRA declined to be interviewed, but in a statement told RNZ all three decisions relating to the costs issue were "independently reached".

"The shared wording you have seen reflects a best practice way of communicating reasoning, not a shared or pre-set outcome."

Reviewers had "debated the costs principles" at a meeting in August 2024 and "drafted for their own use wording they considered best practice to capture the point", it said.

"ICRA did not draft or supply this text."

Forster said he sent the three identical rulings to ACC in March but did not get a satisfactory response.

ACC responds

ACC declined to be interviewed, but said in a statement that allegations that any reviewer was pre-determining outcomes without considering every decision on its own merits were serious.

"When these concerns were raised, we contacted ICRA, and they confirmed that this was not happening," ACC deputy chief executive Michael Frampton said.

"'Template' implies that reviewers are not considering the merits of individual claimants' claims in their decision-making. We are satisfied that reviewers are considering every application on its own merits.

"To date we haven't seen anything that substantiates the claims that reviewers are not acting independently, or that they are not dealing with each case before them on its own merits."

Case law templates questioned

John Miller Law, one of the biggest law firms specialising in ACC cases, said it had also seen instances of identical rulings being issued by ICRA to its clients.

Firm solicitor Merlyn Remiens said another concern was the use of law templates used by ICRA's reviewers to help them make rulings.

ICRA had an online database of these templates, as well as a decision database that reviewers could refer to.

ICRA said reviewers were under no obligation to use the templates, but internal training documents seen by RNZ strongly encouraged their use.

Remiens said rulings that used these templates often failed to take into account specific case law or arguments put forward by counsel during a hearing.

He provided RNZ with a recent decision issued to a client in which this had occurred.

"We perceive this issue to have arisen because it didn't fit within a template… None of the legal points raised were actually looked into, and in that manner, we perceived our client didn't actually achieve access to justice."

It could also be a breach of the law, Remien said.

"I stress that often templates are usable and efficient and non-prejudicial, but in instances where an argument has been disregarded, we would view that as a breach of their legal obligation."

His client was now appealing the decision in the district court.

John Miller Law had raised its concerns with ICRA about the use of templates, Remiens said.

"They seem pleasingly willing to work with us to resolve it.

"They've requested examples and they highlighted from their end that they've seen a 40 percent increase recently in reviews, which of course might predicate the use of these templates as an efficiency mechanism," he said.

Forster agreed the use of templates could be problematic.

"There are templates for different kinds of decisions, so if it's about surgery there's a template for that, and that starts straying into the area where it's going to impact how people make decisions because they're following, basically, a paint-by-numbers for a review decision."

Internal ICRA documents seen by RNZ show the company was aware of complaints about its minutes or decisions not reflecting proceedings as far back as February 2023.

A minute from a meeting of reviewers noted "an increasing number of complaints from advocates pointing out discrepancies such as template text left in … on matters which were not in fact discussed."

Reviewers were urged to "take care and make your own notes" to ensure minutes reflected proceedings.

ICRA said its '"relevant law templates" were designed as "a resource to support reviewers and enable consistency and efficiency - not predetermine outcomes".

"As part of the resources provided to reviewers for training purposes, redacted draft decisions that are well-written and deal with novel issues or questions may be shared as learning tools," its statement said.

"ICRA does not condone any practice that would undermine independence or accuracy.

"We are confident that reviewers make their determinations independently, applying the ACC Act, regulations, and case law to the facts of each case."

Over 95 percent of ICRA's reviewers were legally qualified, with more than 80 percent currently practising as lawyers across ACC, privacy and medical law, it said.

The second company contracted to provide dispute resolution services for ACC is Fair Way.

In a statement, it said its reviewers only used templates for formatting documents.

"This template does not contain any sample paragraphs, case law or any other information. Each case is reviewed and a decision is prepared individually..

"Fair Way's standard procedure is for each case to have a reviewer assigned and their decision is peer reviewed by another Fair Way team member for quality purposes. Individual review decisions are not circulated beyond this."

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