Navigating dental claims with ACC (Accident Compensation Corporation) can feel daunting, but with the right knowledge, you can ensure a smoother experience. ACC covers dental injuries caused by accidents, but it's essential to understand their criteria to avoid confusion. Here are some key tips to help you successfully manage your dental claim with ACC.
Understand ACC’s Coverage Criteria
ACC covers dental injuries resulting from accidents, but not those caused by everyday wear and tear or pre-existing conditions. Claims must be linked to a specific incident, such as a fall, sporting injury, or vehicle accident. It's important to confirm that the injury meets ACC’s definition of an accident before starting the claim process. If you’re unsure, consult your dentist or ACC directly.
Normal Use of Teeth
One area that can cause confusion is the concept of "normal use of teeth." ACC does not cover dental injuries resulting from biting or chewing, even if an injury occurs biting or chewing on an object that is unexpectedly hard or foreign. For example, if you damage a tooth by biting into an unexpected item in food, ACC considers this "normal use" of teeth and will not cover it. Additionally, ACC generally does not cover injuries from teeth grinding, unless it is directly caused by a separate injury. Claims are only accepted if the injury occurred due to an unusual or unexpected accident—like slipping and hitting your teeth or getting struck during a sporting activity.
Seek Treatment Early
Prompt treatment is essential for both your recovery and the success of your claim. Visit a dentist or medical professional immediately after the accident so they can assess your injury and provide a detailed report. The sooner you seek care, the stronger your case will be when ACC reviews your claim.
Choose the Right Dental Provider
Ensure that your dentist has experience with ACC claims. Many dentists are accredited with ACC and can lodge the claim on your behalf. Choosing a provider familiar with the process can make things easier and more efficient for you.
When making a dental claim with ACC, it's important to know who can provide the treatment. ACC will only cover dental treatment if it's done by a registered dentist. A dentist can assess your injury, provide treatment, and submit the ACC claim for you.
On the other hand, a dental technician helps by making or repairing things like dentures, but they cannot treat your injury or file an ACC claim. So, while a dental technician might be involved in part of your care (like making a new denture), ACC won’t pay for any work they do directly.
To be sure ACC will cover your treatment, always go to a registered dentist for your injury-related care.
Provide Complete and Accurate Information
When lodging your claim, make sure you include all the relevant details, such as the date and circumstances of the accident event, and any medical or dental reports. ACC relies on this information to assess your case, so ensure everything is accurate and complete before submitting your claim.
Follow Your Treatment Plan
Once your claim is approved, it’s important to follow your dentist’s treatment plan. Regular check-ups and completing recommended treatments show ACC that you are committed to your recovery, which could impact the ongoing approval of treatments.
Keep Records
Keep copies of all dental records, accident reports, and correspondence with ACC. Having this documentation can help if any issues arise during the claims process or if further questions are asked.
Surcharges
Even if your ACC dental claim is approved, be aware that some dental providers may charge a surcharge. ACC covers a set portion of the treatment cost, but some treatments might exceed this amount, leaving you with an out-of-pocket expense. It's a good idea to discuss potential surcharges with your dentist upfront, so you're aware of any additional costs before proceeding with treatment. If you're concerned about costs, ask your dentist if they offer alternatives within the ACC-funded amount or if a payment plan is available.
Ask Questions
If you're unclear about any part of the ACC process, don’t hesitate to ask your dental provider or contact us.
