Why we ask for your authority to collect your medical and other records
To establish your entitlement to compensation we may need to collect medical and other records about you from a third party, such as your General Practitioner (GP), other medical professional or employer.
We need your authority to collect them
These records could include:
details of your accident
medical history relevant to your claim
specialist reports and assessments
your employment details and history.
In each case, we’d only seek records that are or may be relevant to your claim during the life of your claim.
We’ll let you know about the types of records we need to collect, and why we need to collect them to make these decisions about your claim. Please contact us if you’d like to discuss this further.
How you can provide your authority
You can either sign this form or contact us if you’d like to discuss other ways to provide your authority. These may include for example, setting the duration of your authority or asking us to contact you for authority on a case by case basis.
We’ll comply with the legislation
We’ll comply with the Privacy Act 1993, the Health Information Privacy Code 1994 and the Accident Compensation Act 2001 when collecting, using and managing personal information.
Under the Privacy Act 1993 and Health Information Privacy Code 1994, you have the right to access any information we hold about you. You can also ask us to correct the information that we hold about you.
For more details see ACC’s privacy notice at www.acc.co.nz/privacy.