SmartCare vs Health Positive: ACC interaction
In NZ, ACC covers accidental injury and treatment-injury costs. Health insurance generally excludes ACC-covered events but most policies offer an ACC Top-Up benefit for any shortfall. This page summarises each insurer's ACC interaction rules verbatim.
Accuro SmartCare
Wording effective 2026-05-16
The SmartCare Health Plan is designed to complement ACC and will not cover claims related to accidents that ACC covers. If ACC doesn't cover the full amount for treatment, the policy may pay the difference if there is cover for that treatment under the policy. Under the ACC full payment option, all claims must be submitted to ACC. Under the ACC partial payment option, the policy covers the difference in cost up to Reasonable charges or the benefit limit, whichever is less. If ACC declines cover, UniMed may ask for a review or appeal with the member's support; if ACC reverses its decision, UniMed may seek reimbursement. If ACC refuses or stops cover because the member is not complying with ACC's requirements, no claim can be made under the policy. Any expense recoverable from ACC is excluded. Any medical costs declined by ACC if injury is caused by an accident outside New Zealand are not covered.
UniMed Health Positive
Wording effective 2016-01-22
Not on file for this product.