VOTE Accident. Insurance. B.5 Vol.I 1

VOTE Accident Insurance B.5 Vol.I 1

Accident Insurance Overview Appropriations sought for Vote Accident Insurance in 2000/01 total $490.701 million. This is intended to be spent as follows: $3.438 million (less than 1% of the Vote) on purchasing a range of services in relation to accident insurance including policy advice, analysis, evaluation, research, monitoring, purchase advice, legislation support and ministerial servicing. $5.343 million (1% of the Vote) on purchasing services to monitor work related claims made against Accident Insurance contracts during 1999/2000 that are still receiving entitlements in 2000/01, and to maintain the Accident Insurance information database. $0.398 million (less than 1% of the Vote) on managing the transition of workplace accident insurance to a single public fund administered by the Accident Compensation Corporation (ACC). $2.675 million (less than 1% of the Vote) to cover the cost of claims on the Non- Compliers Fund and the cost of administering the Fund. $32.275 million (7% of the Vote) on purchasing case and claims management and injury prevention services in respect of the Non-Earners Account from ACC. $347.460 million (71% of the Vote) on purchasing medical, social rehabilitation, elective health care and public health acute services by ACC in accordance with the Accident Insurance Act 1998 on behalf of non-earners. $30.936 million (6% of the Vote) on providing income maintenance, independence allowance and other compensation provided to claimants under the Non-Earners Account from ACC. $68.176 million (14% of the Vote) of Motor Spirits Excise Duty to be paid to ACC to contribute to financing of entitlements for the Motor Vehicle Account. Details of how the appropriations are to be applied appear in Parts B1 and C of this Vote. Details of Crown revenue appear in Part F. 2 B.5 Vol.I

Terms and Definitions Used ACC Accident Compensation Corporation Footnotes Note 1 Note 2 Note 3 Note 4 Not applicable as Crown revenue is not appropriated. Appropriations are stated GST inclusive (where applicable). Expense incurred pursuant to Section 268 of Accident Insurance Act 1998 The $20 million relates to insurer payments for public health acute services. With the competitive market ending on 1 April 2000, no provision has been made in 2000/01. B.5 Vol.I 3

Accident Insurance VOTE MINISTER: Minister for Accident Insurance ADMINISTERING DEPARTMENT: Department of Labour The Minister of Labour is the Responsible Minister for the Department of Labour Part A - Statement of Objectives and Trends Part A1 - Objectives for Vote Accident Insurance Related Government Outcomes The appropriations in Vote Accident Insurance provide accident rehabilitation services to people who receive an injury but are not earning an income (excluding motor vehicle accidents, which are funded from the Motor Vehicle Account). The appropriations also fund policy advice, purchase advice and monitoring related to protecting, maintaining and restoring people s capacities, injury prevention, and minimising the economic and social costs of injury. The appropriations in Vote Accident Insurance will make a contribution to the following Government key goals: Strengthen national identity and uphold the principles of the Treaty of Waitangi Grow an inclusive, innovative economy for the benefit of all Restore trust in Government and provide strong social services Close the gaps for Maori and Pacific people in health, education, employment and housing. Output Classes To achieve these objectives, the appropriations are intended to fund a range of activities, including: a comprehensive range of services in relation to accident insurance including policy advice, analysis, evaluation, research, monitoring, purchase advice, legislation support and ministerial servicing monitoring work related claims made against Accident Insurance contracts during 1999/2000 that are still receiving entitlements in 2000/01, and maintaining the Accident Insurance information database management of the transition of workplace accident insurance to a single public fund management of the Non-Compliers Fund administration and operation of the Non-Earners Account of the Accident Insurance scheme and medical, case management and rehabilitation services to accident victims administration of the Motor Spirits Excise Duty. 4 B.5 Vol.I

Part A2 - Trends in Vote Accident Insurance The time series of non-departmental flows detailed in the table Trends in Vote Accident Insurance shows overall increases in non-departmental outputs purchased by the Crown. It also reflects fluctuations in non-departmental expenses. Output Trends: 1995/96 to 2000/01 Vote Accident Rehabilitation and Compensation Insurance (ARCI) was established in 1993/94 as a separate Vote and transferred to Vote Accident Insurance for the 1999/2000 year, at the same time as the Accident Rehabilitation and Compensation Insurance Corporation was renamed the Accident Compensation Corporation. In 1995/96 the provision of policy advice was separated from the management of the scheme. The output class was renamed Policy and Monitoring and additional appropriation provided for a policy and monitoring unit within the Department of Labour. Output classes Earner Elective Health Care Services and Non-Earner Elective Health Care Services were included in 1996/97. Previously these services were funded via Vote Health. From 1 July 1997, Earner Elective Health Care Services were funded via the earners premiums and the output class was disestablished. From 1998/99 the separate output classes for Medical Treatment, Health Care and Social Rehabilitation were included in one output class - Claim Entitlements and Services. Competition was introduced for work related accident insurance from 1 July 1999 and the output class Regulatory Services was set up to fund the market Regulator. The Accident Insurance Regulator s task was to ensure that employers purchase insurance and to provide accident insurance information to stakeholders. The Regulatory Services output class is funded by levies from insurers. The role of the Accident Insurance Regulator has changed as a result of the passing of the Accident Insurance (Transitional Provisions) Act 2000 which came into force on 1 April 2000. This Act returns accident insurance to a single public fund. From 1 July 2000, the primary objectives of the Regulator are to monitor work related claims made against Accident Insurance contracts during 1999/2000 that still receive entitlements in 2000/01, and to maintain the Accident Insurance information database. The Regulator will also manage the Non-Compliers Fund which funds those claims made by claimants whose employer did not have an accident insurance contract in force at the time of injury. The management of the introduction of competition in workplace accident insurance was provided through the ACC Competition Transition output class which was established in 1998/99. The final appropriation was in 1999/2000. The two Non-Departmental Expenses for the payment of claims related to insurer insolvency and employer non-compliance were disestablished following a Cabinet decision on 1 May 2000. Two departmental output classes were established: Non- Compliers Fund and Insolvent Insurers Fund. A new departmental output class, ACC Transition, was established in 1999/2000 for the management of the transition of workplace accident insurance to a single public fund. B.5 Vol.I 5

Crown Expenditure and Revenue Trends: 1995/96 to 2000/01 Changes in non-departmental output expenditure principally reflect changes in output class O2 Claim Entitlements and Services. The main component of Claim Entitlements and Services is expenditure on medical services, support for independence services and elective health care services. Growth in medical treatment spending since 1994/95 reflects increasing service levels, increased cost per treatment, demographic growth and an increasing number of seriously injured claimants in the Non-Earners Account. The increase in funding of Case Management and Supporting Services in 1998/99 reflects a change in the method of allocating costs between ACC accounts. There are marked variations in Benefits and Other Unrequited Expenses - Other Compensation, arising from phasing out lump sums and the amount of the surplus/deficit carried forward each year. Previously claimants affected by serious injury were entitled to lump sum claim payments. These payments were removed in the 1992 Act but some payments were continued until 1997/98 as a result of appeals. Expenditure for 1997/98 and 1998/99 also included payment for backdated attendant care for complex personal injury claimants. The Accident Insurance Act 1998 provided that insurers and ACC (for all accounts including non earners) pay a levy to the Crown to cover costs of public health acute services provided to those injured by accidents. There is a fiscally neutral transfer in 1999/00 to fund the cost of public health acute services provided to non-earners. ACC s baseline was adjusted in 1999/00 to reflect higher volumes and costs of elective hospital treatment. Analysis by Appropriation Type: 1999/2000 and 2000/01 Compared Departmental output classes Annual appropriations are expected to decrease by $1.323 million in 2000/01. The final additional funding to introduce an element of competition to the accident compensation market was provided in 1999/2000 ($1.930 million). The decrease in appropriations in 2000/01 was due to the removal of the ACC competition transition funding. This reduction in funding 2000/01 is offset by an increase in appropriation for regulatory services ($0.934 million, being additional costs associated with the data warehouse). A new departmental output class called ACC Transition was introduced towards the end of 1999/2000 to fund the management of the transition of workplace accident insurance to a single public fund. Non-departmental output classes Annual appropriations for purchasing non-departmental outputs are expected to increase by $11.923 million (3%) for 2000/01 relative to 1999/2000. The increase reflects increased expenditure on elective hospital treatment (due to both cost and volume increases) and the costs associated with an increasing number of seriously injured claimants. 6 B.5 Vol.I

Benefits and unrequited expenses Expenditure is expected to decrease by $6.820 million in 2000/01, reflecting settlement of the final backdated attendant care claims during 1999/00. Reduced expenditure related to backdated attendant care in 2000/01 is offset by increases in weekly compensation costs (due to greater volumes of these claims). Other expenses Motor Spirits Excise Duty related payments to fund compensation and services from the ACC Motor Vehicle Account will increase by $1.008 million (or 1.5%) in line with forecasted increases in motor spirits consumption. The Motor Vehicle Account is funded through excise duty and motor vehicle licensing fees. B.5 Vol.I 7

Trends in Vote Accident Insurance - Summary of Appropriations and Crown Revenue 1995/96 1996/97 1997/98 1998/99 1999/2000 2000/01 Appropriations to be Used Types of Appropriation Actual Actual Actual Actual Budget Estimated Actual By the Department Administering the Vote Annual Other For Non-Departmental Transactions Annual Other Total Operating Flows Classes of Outputs to be Supplied 180,057 197,585 183,409 217,836 380,989 380,989 9,179 2,675 379,735-391,589 Benefits and Other Unrequited Expenses 33,215 22,553 64,419 60,172 37,756 37,756 N/A N/A 30,936-30,936 Borrowing Expenses - - - - - - N/A N/A - - - Other Expenses 66,150 64,305 64,935 66,037 67,168 67,168 - - - 68,176 68,176 Capital Flows Capital Contributions - - - - - - - - - - - Purchase or Development of Capital Assets - - - 967 - - N/A N/A - - - Repayment of Debt - - - - - - N/A N/A - - - Total Appropriations 279,422 284,443 312,763 345,012 485,913 485,913 9,179 2,675 410,671 68,176 490,701 Total Crown Revenue and Receipts (see note 1) - 7,902 9,818 16,586 23,919 23,919 N/A N/A N/A N/A 3,884 8 B.5 Vol. I

Part B - Statement of Appropriations Part B1 - Details of 2000/01 Appropriations (see note 2) 1999/2000 2000/01 Vote Estimated Actual Vote Appropriations Annual Other Annual Other Annual Other Description of 2000/01 Appropriations Departmental Output Classes (Mode B Gross) D1 Policy and Monitoring 3,435-3,435-3,438 - Purchase of a comprehensive range of services in relation to accident insurance including policy advice, analysis, evaluation, research, monitoring, purchase advice, legislation support and ministerial servicing. D2 Regulatory Services 4,409-4,409-5,343 - Purchase of services to monitor work related claims made against Accident Insurance contracts during 1999/2000 that are still receiving database entitlements in 2000/01, and to maintain the Accident Insurance information. D3 ACC Transition 728-728 - 398 - Management of the transition of workplace accident insurance to a single public fund. D4 Non-Compliers Fund (see note 3) - 2,675-2,675-2,675 This output class covers the cost of claims on the Non-Compliers Fund and the costs of administering the Fund. Costs are funded by penalties imposed on non-complying employers and an annual levy on insurers. ACC Competition Transition 1,930-1,930 - - - Purchase of services to manage the introduction of competition in workplace accident insurance. Total Appropriations for Departmental Output Classes (Mode B Gross) 10,502 2,675 10,502 2,675 9,179 2,675 Non-Departmental Output Classes O1 Case Management and Supporting Services 32,275-32,275-32,275 - Case and claims management and injury prevention services for the Non- Earners' Account. B.5 Vol. I 9

Part B1 - Details of 2000/01 Appropriations (continued) 1999/2000 2000/01 Vote Estimated Actual Vote Appropriations Annual Other Annual Other Annual Other Description of 2000/01 Appropriations Non-Departmental Output Classes cont d O2 Claim Entitlements and Services 335,537-335,537-347,460 - Purchase of medical services, social rehabilitation services, elective health care services and public health acute services for the Non-Earners' Account. Total Appropriations for Non- Departmental Output Classes 367,812-367,812-379,735 - Refer to Part C2 for a full description. Benefits and Other Unrequited Expenses Other Compensation 37,756-37,756-30,936 - Entitlements under the Accident Insurance legislation for non-earners' income maintenance, independence allowance, lump sum payments, death benefits, and vocational rehabilitation. Total Appropriations for Benefits and Other Unrequited Expenses 37,756-37,756-30,936 - Other Expenses to be Incurred by the Crown Motor Spirits Excise Duty - 67,168-67,168-68,176 Section 291 of the Accident Insurance Act 1998 provides for a Motor Spirits Excise Duty to be collected and paid to ACC for crediting to the Motor Vehicle Account. Total Appropriations for Other Expenses to be Incurred by the Crown - 67,168-67,168-68,176 Total Appropriations 416,070 69,843 416,070 69,843 419,850 70,851 10 B.5 Vol. I

Part C - Explanation of Appropriations for Output Classes Part C1 - Departmental Output Classes For more detailed analysis of Departmental Output Classes, including financial and non-financial performance measures, please refer to the Department of Labour's Departmental Forecast Report (DFR). Output Class D1 - Policy and Monitoring Description Through this output class the Minister purchases policy advice, purchase advice and monitoring related to protecting, maintaining and restoring people s capacities, injury prevention, and minimising the economic and social costs of injury. This work includes: advice on the policy requirements to achieve the Government s accident insurance objectives policy advice, analysis, evaluation, research and monitoring on the accident insurance legislation and other issues related to ACC and the accident insurance environment applied research on issues that relate to changes in the delivery of the accident insurance scheme negotiation of an annual Service Agreement and Statement of Intent with ACC, on behalf of the Minister for Accident Insurance development of a Purchase Agreement between the Minister for Accident Insurance and the ACC Board for the Non-Earners Account quarterly monitoring reports that highlight key issues and trends for ACC, its subsidiaries and the Accounts against performance criteria specified in the annual Service Agreement advice on ACC forecasts for inclusion in the Economic and Fiscal updates advice on forecast trends and expenditure in the Non-Earners Account during baseline update processes administration and monitoring of Crown payments for the Non-Earners Account and the Motor Spirits Excise Duty monitoring and reporting on labour market trends and statistics advisory support and information for Ministers as required in Cabinet Committees, Select Committees and Parliament other ministerial servicing including replies to ministerial correspondence, parliamentary questions, official information requests, speech and briefing notes and other information required by the Minister. B.5 Vol.I 11

Output Class D2 - Regulatory Services Description The introduction of competition to the workplace accident insurance market required the establishment of an Accident Insurance Regulator. The Regulator is funded by levies recovered from registered insurers. The role of the Accident Insurance Regulator has changed as a result of the passing of the Accident Insurance (Transitional Provisions) Act 2000 which came into force on 1 April 2000. The Act returns accident insurance to a single public fund. From 1 July 2000, the primary functions of the Regulator are: Compliance monitoring identifying potential non-compliance with the Accident Insurance Act 1998, investigating non-compliance and taking enforcement action where appropriate Information management collecting claims data from registered insurers and ACC and publishing related statistics Non-compliant claims management managing the Non-Compliers Fund which funds claims made by claimants whose employers did not have an accident insurance contract in force at the time of injury Funds management setting various charges to be levied on registered insurers and collecting those levies. This output class also includes the functions associated with the Department of Labour s administration of the Accident Insurance Act 1998. This involves the following activities: receiving and responding to enquiries and complaints (non-ministerials) key stakeholder liaison production of fact sheets and brochures on the overall ACC scheme. Output Class D3 ACC Transition Description This output class provides for the management of the transition of workplace accident insurance to a single public fund administered by the Accident Compensation Corporation. The key areas of work are risk monitoring, communication and the realignment of the Accident Insurance Regulator s activities. A risk management programme will be in place to monitor risks associated with the accident insurance reforms. A key priority will be on the development of a framework for monitoring ACC s implementation of the reforms. A communications strategy will ensure effective communication with stakeholders affected by the reforms, particularly claimants, treatment providers, employers and selfemployed. 12 B.5 Vol.I

Output Class D4 Non-Compliers Fund Description The Accident Insurance Act 1998 established a Non-Compliers Fund to guarantee the provision of statutory entitlements to claimants whose employer failed to purchase an accident insurance contract during the period 1 July 1999 to 31 March 2000. The Accident Insurance Regulator is responsible for administering the Fund and has contracted out the management of claims made against the Fund. The cost of those claims made against the Non-Compliers Fund is met by penalties collected from noncompliant employers, with any shortfall to be met by way of a levy against registered employers. Part C2 - Non-Departmental Output Classes Performance Targets for ACC The Minister for Accident Insurance purchases claim entitlement services and case management on behalf of non-earners who have suffered personal injury (other than motor vehicle injury). The purchasing activities are specified in a Purchase Agreement between the Minister for Accident Insurance and ACC and are monitored by the Department of Labour. In assessing the performance of the Corporation in delivering entitlements and services to non-earners, the following are the generic performance measures that will be used: Proportion of new claimants who exit the scheme within three and 12 months from time of registration. Number of entries to and exits from the tail of long-term claimants exceeding 12 months duration. Average monthly expenditure for personal care, other support for independence, vocational rehabilitation, independence allowance and complex personal injury. Payment accuracy. The number of successful reviews and appeals against ACC decisions. Other performance information on the Non-Earners Account is included in the Service Agreement between the Minister for Accident Insurance and the ACC Board. Output Class O1 - Case Management and Supporting Services Description This output class covers purchasing injury prevention, claim processing, assessment, payment services and case management for non-earning accident victims. Financial grants, primarily for research, are also included in this output class. B.5 Vol.I 13

Performance measures Injury prevention (IP) programmes will result in savings in the Non-Earners Account. Claims will be allocated accurately to scheme accounts in accordance with the Accident Insurance legislation. All payments will be made to the correct parties for the correct amount. Cost This output class will be provided within the appropriated sum of $32.275 million (inclusive of GST). The 1999/2000 final appropriated sum for this output class was $32.275 million. Output Class O2 - Claim Entitlements and Services Description This output class relates to purchasing medical services, support for independence services and elective health care services. Services purchased include: primary medical services, including the services of general practitioners, specialists, physiotherapists, radiologists and pharmaceuticals hospital treatment, required as a result of an accident (defined within the Accident Insurance Act) dental treatment conveyance for medical treatment personal care (home help, attendant care and childcare) alteration of home or work ambulatory aids. Performance measures The quantity of services provided is dependent upon the number of claims made under the Accident Insurance Act 1998 but will include approximately 2.8 million medical treatments, 58,000 support for independence payments and 7,000 elective surgical interventions. All payments for claim entitlements and services will be paid in accordance with either the relevant Accident Insurance legislation/regulations or discretion granted by the Minister for Accident Insurance. Cost This output class will be provided within the appropriated sum of $347.460 million (inclusive of GST). The 1999/2000 final appropriated sum for this output class was $335.537 million. 14 B.5 Vol.I

Part D - Explanation of Appropriations for Other Operating Flows Part D1 Benefits and Other Unrequited Expenses Information regarding this is provided in Part B1 - details of 2000/01 appropriations. Part D2 Borrowing Expenses There are no appropriations for borrowing expenses Part D3 Other Expenses There are no appropriations for other expenses B.5 Vol.I 15

Part E - Explanation of Appropriations for Capital Flows Part E1 - Capital Contributions There are no appropriations for capital contributions. Net Worth of Entities Owned Statement of Estimated and Forecast Net Worth Crown Entities: Balance Date Estimated Net Worth 2000 $ million Forecast Net Worth 2001 $ million ACC 30 June (3,869) (3,699) Part E2 - Purchase or Development of Capital Assets by the Crown There are no appropriations for purchase or development of capital assets by the Crown. Part E3 - Repayment of Debt There are no appropriations for repayment of debt. 16 B.5 Vol.I

Part F - Crown Revenue and Receipts Part F1 - Current and Capital Revenue and Receipts 1999/2000 2000/01 Budgeted Estimated Actual Budget Description of 2000/01 Crown Revenue Current Revenue Non-Tax Revenue Levy from Insurers for Regulator Costs 3,919 3,919 3,884 Accident Insurance Act 1998 (section 236) states the Market Regulator is funded through an annual levy from insurers. Public Health Acute Services Levy (see note 4) 20,000 20,000 - Total Non-Tax Revenue 23,919 23,919 3,884 Total Current Revenue 23,919 23,919 3,884 Total Crown Revenue and Receipts 23,919 23,919 3,884 B.5 Vol. I 17