The introduction of artificial intelligence by the Accident Compensation Corporation (ACC) to help determine which long-term claimants may be ready to return to work has prompted concern among claimant advocates.
Warren Forster, an ACC advocate, described the move as a shift away from rehabilitation and questioned whether the technology aligns with the statutory purpose of the scheme. “Nothing in ACC’s proposals actually looks at rehabilitation. It’s all about ‘how can we ramp up exits, how can we get more people coming off the scheme’, and that’s the antithesis of the statutory purpose. It’s the antithesis of why we have ACC in New Zealand,” Forster said, as reported by RNZ.
Forster also raised issues with the reliance on automated assessments, suggesting that AI may not capture the complexity of individual cases. “The AI will tell you, ‘person X has a sprain, they’ve been off work for six years’ or whatever the case might be,” he said. He warned that such models could overlook misdiagnoses or mental health factors, adding: “AI can tell you that this person has a problem, but AI is not going to tell you what that problem is. What we have is AI identifying someone who ACC can exit.”
ACC’s adoption of AI comes as the organisation seeks to reduce the number of long-term claimants, which has reached a record high of around 25,000 people receiving compensation for more than a year. Under ministerial direction, ACC has set ambitious targets: in the year ending June 2025, 8,000 long-term claimants were removed from the scheme after being assessed as “work ready.” The goal for the following year is to increase this figure to 11,675, with the intention of having more claimants exit than enter the long-term pool by 2028.
Earlier this year, ACC commissioned external advice on strategies to both decrease the existing pool and prevent new long-term claimants from entering. These efforts have sparked debate among industry stakeholders about the balance between efficiency and claimant support.
ACC deputy chief executive Michael Frampton said the organisation is taking steps to assist injured people in returning to independence or adapting to new circumstances following significant injuries. “It’s important that we manage the scheme sustainably so it’s there for Kiwis when they need it, now and in the future,” Frampton said, as reported by RNZ.
Frampton noted that some claimants require ongoing support due to the severity of their injuries, while others may be able to return to work with additional assistance. “That suggests they might not have had the right support, and we’re actively working with them to help them back to independence,” he said.
ACC has implemented one-to-one case management for all long-term claimants. Frampton said this change is already resulting in better outcomes for claimants. “ACC is using AI to help identify cases where the client may benefit from a further review by staff member to help ensure that they’re receiving the right support,” he said. The technology also provides recommendations for next steps in the management process.
ACC’s use of AI is part of a wider trend in New Zealand’s insurance sector, where machine learning, data analytics, and automation are increasingly being integrated into underwriting, claims processing, and customer service. These technologies are intended to streamline operations and support staff, rather than replace them.
Industry observers note that while AI can improve efficiency and accuracy, its implementation presents challenges, including costs and maintaining consumer trust. Recent research shows that many policyholders recognise the benefits of AI, such as faster service, but concerns remain regarding data privacy and transparency in decision-making.
As the insurance industry continues to evolve, the use of AI in claims management and other processes is expected to grow, prompting ongoing discussion about the balance between operational efficiency, fairness, and the human element in insurance.
