ACC Claims Analysis NZ

This comprehensive 2026 guide provides a definitive ACC Claims Analysis NZ, examining the record-breaking surge in injury costs and evolving claim trends across Aotearoa. We analyze the latest data from the 2024/25 financial year, which saw ACC pay out a staggering $8.23 billion—a 125% increase over the last decade. Whether you are a business owner navigating rising work levies, a self-employed contractor weighing CoverPlus Extra, or a resident seeking to understand common injury hotspots like the home and sports field, this article delivers actionable insights on claim frequency, regional risk profiles, and the impact of an aging population on rehabilitation times. You will find practical advice on the 2026 levy hikes, the critical gap where ACC does not cover illness, and how to maximize your entitlements through efficient recovery and vocational support.

The State of Accident Compensation in New Zealand 2026

The New Zealand accident compensation landscape in 2026 is defined by a significant "cost-claim gap," where the financial burden of injuries is rising six times faster than the number of new claims. In the year ending June 2025, ACC processed nearly 2.3 million claims, representing roughly 43 injuries for every 100 New Zealanders. While the volume of claims grew by just 1.8% year-on-year, total costs surged by 11.5%, driven primarily by medical inflation and higher wage replacement payments linked to rising median salaries. The average cost per claim has now hit $3,585, more than double the $1,695 recorded ten years ago, placing unprecedented pressure on the scheme's long-term sustainability and prompting significant levy increases for the 2025–2027 period.

  • Total Payout: $8.23 billion in 2024/25, up from $3.66 billion a decade ago.
  • Claim Volume: 2,295,685 new claims filed, a 6.3% increase over 10 years.
  • The "Home" Risk: Nearly half of all injuries (48.7%) occur in the home, yet these are often the hardest to regulate.
  • Aging Impact: Claims for those aged 70–79 have grown by 57% in a decade, as older bodies require more intensive rehabilitation.

Total Payout: $8.23 billion in 2024/25, up from $3.66 billion a decade ago.

Claim Volume: 2,295,685 new claims filed, a 6.3% increase over 10 years.

The "Home" Risk: Nearly half of all injuries (48.7%) occur in the home, yet these are often the hardest to regulate.

Aging Impact: Claims for those aged 70–79 have grown by 57% in a decade, as older bodies require more intensive rehabilitation.

Regional Risk Profiles and Adventure Hotspots

Geographic analysis reveals that Otago is the highest-risk region in New Zealand, recording 55 claims per 100 people. This is largely driven by Queenstown's adventure tourism sector, where activities like skiing, bungy jumping, and jet boating generate high claim volumes. In contrast, Wellington remains the lowest-risk region with 33.9 claims per 100 people, a trend attributed to its office-based, service-heavy workforce. Other high-risk areas include Northland and the Bay of Plenty, where outdoor recreation and water sports significantly boost injury rates.

Analysis of Common Injury Causes and Costs

When performing an ACC Claims Analysis NZ, the data confirms that "loss of balance" and "lifting strain" are the two primary drivers of both claim volume and financial cost. Together, these everyday mishaps account for 45% of all claims and over $3.1 billion in annual spending. While falls at home are the most frequent, road accidents remain the most expensive per incident, averaging $8,210 per claim—more than 3.5 times the cost of a typical home-based injury. This disparity highlights the high severity of motor vehicle trauma and the long-term rehabilitation support required for survivors.

Injury CauseTotal Annual Claims% of All ClaimsTotal Cost (Millions)
Loss of Balance624,84927.2%$2,058.9M
Lifting / Strain413,36418.0%$1,076.9M
Twisting Movement184,0958.0%$484.5M
Road Accidents~135,0005.9%High (Avg $8,210/claim)
Slipping on Foot126,7645.5%$509.3M

The Standout Industry: Transport and Construction

Workplace injuries accounted for roughly 10% of total claims in 2024, yet they involve significantly longer rehabilitation periods. The transport, postal, and warehousing sector is currently the most expensive for work claims, averaging $6,195 per incident. Construction follows closely, generating the highest volume of work injuries with over 45,000 new claims annually. A staggering statistic from 2024 reveals that the average weekly compensation for a work injury has reached 127 days, reflecting a decline in rehabilitation performance that the government is now actively monitoring.

Understanding ACC Levies for 2025 and 2026

To fund these surging costs, ACC levies are undergoing a period of sustained increases. For the 2025/26 tax year, the "Earners' Levy" is set at $1.67 per $100 of liable earnings (including GST), covering non-work-related accidents. However, starting April 1, 2026, this rate is confirmed to rise to $1.75 per $100. The maximum liable earnings threshold—the cap above which you no longer pay levies—will also increase from $152,790 in 2025 to $156,641 in 2026. Businesses must also navigate the "Work Levy," which varies by industry risk, and the "Working Safer Levy," currently a flat $0.08 per $100 for all employers.

  • Earners' Levy (2025/26): $1.67 per $100 of income.
  • Earners' Levy (2026/27): $1.75 per $100 (confirmed hike).
  • Liable Income Floor: No levies are paid on earnings below roughly $49,365 for some categories.
  • Maximum Levy Cap: For the 2025/26 year, the most an individual will pay for the Earners' Levy is approx. $2,500.

Earners' Levy (2025/26): $1.67 per $100 of income.

Earners' Levy (2026/27): $1.75 per $100 (confirmed hike).

Liable Income Floor: No levies are paid on earnings below roughly $49,365 for some categories.

Maximum Levy Cap: For the 2025/26 year, the most an individual will pay for the Earners' Levy is approx. $2,500.

CoverPlus vs. CoverPlus Extra for Self-Employed

Self-employed New Zealanders are automatically enrolled in "CoverPlus," which pays up to 80% of their prior year's reported income following an injury. However, many contractors opt for "CoverPlus Extra" (CPX), which allows them to negotiate a fixed level of compensation. CPX is particularly valuable for those with fluctuating incomes or those who want 100% of an agreed amount paid "no questions asked" without having to prove a specific loss of earnings at the time of the claim. This choice is a vital part of financial planning for the 500,000+ Kiwis who work for themselves.

Entitlements and What ACC Covers

ACC operates as a "no-fault" scheme, meaning you are covered regardless of who caused the accident. This comprehensive policy replaces the right to sue for personal injury in New Zealand courts. Entitlements are split into two stages: establishing "cover" (that an accident occurred) and then applying for specific "benefits". These benefits include medical treatment, weekly compensation for loss of income (up to 80%), social rehabilitation (home help), and lump-sum payments for permanent impairments. Read more on the Wiki page for the Accident Compensation Corporation.

Entitlement TypeDescriptionKey Limitation
Weekly Compensation80% of pre-injury weekly earningsCapped at maximum liable earnings
Medical TreatmentSubsidized physio, surgery, podiatrySubcharges often apply at private clinics
Home HelpCleaning, meal prep, child careMust be assessed as “necessary” for independence
Lump SumOne-off payment for permanent disabilityOnly for impairment over specific thresholds

The Critical Gap: Accidents vs. Illness

A major finding of this ACC Claims Analysis NZ is the widespread misunderstanding of what the scheme doesn't cover. ACC strictly covers accidents—sudden, unforeseen events—and certain work-related gradual process conditions like deafness or asbestos exposure. It does not cover illness, contagious diseases (e.g., measles), or age-related conditions like arthritis. If a New Zealander cannot work due to cancer, heart disease, or a mental health breakdown unrelated to a physical accident, ACC pays nothing. For this reason, supplemental Income Protection Insurance remains a cornerstone of private financial security in 2026.

Non-Work Injuries and Their Economic Impact

Statistically, the most dangerous place for a New Zealander is not the workplace, but the community. Roughly two-thirds of the 16 million days of weekly compensation paid by ACC annually are for injuries occurring outside the workplace. In sectors like building and dairy manufacturing, non-work injuries (such as sports or DIY mishaps) actually result in more days lost than on-the-job accidents. For a business, an employee off work due to a weekend rugby injury is just as disruptive to productivity as a workplace fall, leading many firms to invest in holistic "wellbeing" programs that extend beyond the office walls.

  • Lost Days: Non-work injuries resulted in nearly 1 million lost days in the building sector alone over a five-year study.
  • Duration: The average number of days off for a non-work injury is 86–88 days, comparable to workplace incidents.
  • Age Tiers: Younger workers (<30) are more likely to be injured playing sport, while those over 45 are more likely to suffer injuries from falls around the home.
  • Privacy: Employees can choose to have their non-work claims managed by private third-party administrators (like Wellnz) to maintain privacy from their employer.

Lost Days: Non-work injuries resulted in nearly 1 million lost days in the building sector alone over a five-year study.

Duration: The average number of days off for a non-work injury is 86–88 days, comparable to workplace incidents.

Age Tiers: Younger workers (<30) are more likely to be injured playing sport, while those over 45 are more likely to suffer injuries from falls around the home.

Privacy: Employees can choose to have their non-work claims managed by private third-party administrators (like Wellnz) to maintain privacy from their employer.

The 2026 Claim Process: How to Ensure Approval

Lodging an ACC claim in 2026 is primarily handled by your health professional—usually a GP, physiotherapist, or osteopath—during your first appointment. You do not need a formal referral to see a physio for an accident; they can assess, diagnose, and submit the ACC forms on your behalf. ACC typically makes a decision within 21 days for standard claims, although "Sensitive Claims" (mental harm from sexual abuse) or work-related gradual conditions are managed by specialist units and can take up to four months for a decision.

Steps to a Successful Claim

Seek Immediate Care: Visit a registered professional within 12 months of the injury.

Provide Detail: Clearly explain what happened, when, and where to establish the "accident" definition.

Obtain a Medical Certificate: If you need time off, you must get an ACC45 or medical certificate for your employer.

Engage in Rehabilitation: Entitlements can be suspended if you "unreasonably refuse" to follow a rehabilitation plan.

Check Your Text/Mail: Most confirmation is now sent via text message within a few days of lodging.

Financial Planning for Higher ACC Levies

With levies set to rise 5% annually for the next several years, New Zealanders must factor these costs into their 2026/27 budgets. For an employee earning $100,000, the earners' levy will jump from $1,670 to $1,750 in April 2026. Self-employed individuals are hit hardest as they essentially pay both the earner and business portions of the levy. To manage these costs, it is essential to ensure your "Classification Unit" (CU) is correct; being misclassified in a higher-risk industry (e.g., being listed as a "builder" when you are an "architect") can lead to significantly overpaying for the Work Levy.

Liable Earnings2025/26 Levy ($1.67)2026/27 Levy ($1.75)Net Increase
$60,000$1,002.00$1,050.00+$48.00
$100,000$1,670.00$1,750.00+$80.00
$152,790+$2,551.59$2,673.83 (on $152k)~$120+

Final Thoughts on ACC Claims Analysis NZ

As we navigate through 2026, the ACC Claims Analysis NZ highlights a scheme at a critical crossroads. While New Zealanders enjoy world-leading injury protection, the doubling of claim costs and the demographic shift toward an older population have forced a new era of performance monitoring and levy hikes. For individuals, the lesson is clear: the home remains a high-risk zone, and the "no-fault" safety net has a massive gap when it comes to illness. By understanding your entitlements, ensuring your levy classifications are accurate, and supplementing ACC with private insurance, you can navigate life's inevitable accidents with both physical and financial resilience.

FAQ

What does the 2026 ACC levy hike mean for my pay? From April 1, 2026, the earners' levy rises from $1.67 to $1.75 per $100 of income. For someone on a $100k salary, this is an $80 annual increase.

Does ACC cover me if I am injured while overseas? Yes, if you are a New Zealand resident and return home with an injury that happened while you were travelling for under six months, ACC can help cover treatment costs.

Why are ACC costs rising faster than claim numbers? Medical treatment inflation (surgery/rehab) and higher wage replacement payments (due to rising NZ salaries) are the two primary drivers.

What is the "Sensitive Claims" unit? This is a specialized unit that manages mental harm claims resulting from sexual abuse or assault, providing confidential therapy and support.

Can ACC decline my claim? Yes. Claims can be declined if they don't meet the legal definition of an "accident" or if the injury is deemed purely age-related (like wear-and-tear).

How long do I have to make a claim? You should make a claim as soon as possible, but ACC can accept claims up to 12 months after the injury occurred.

What is the difference between CoverPlus and CoverPlus Extra? Standard CoverPlus pays 80% of your last year's earnings. CoverPlus Extra lets you choose an agreed amount to be paid 100% without proof of loss.

Does ACC pay for 100% of my physiotherapy? No. While ACC contributes a significant portion, most private clinics charge a "sub-charge" or co-payment that the patient must pay.

Which region has the most injuries in NZ? Auckland has the highest volume (over 4,700 claims), but Otago has the highest rate per capita due to adventure tourism.

What happens to my claim if I return to work part-time? ACC can pay a "Partial Disability" benefit, topping up your earnings to ensure you aren't financially worse off while transitioning back to full-time work.

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