ACC covers accidents, not illness: why a heart attack or cancer gets no ACC income support

Many New Zealanders assume that if something serious happens and they can't work, ACC will step in. For accidents, that's often true. For illness, it isn't. Cancer, a heart attack, a stroke or a mental health condition are generally not covered by ACC, and that surprises a lot of people at the worst possible moment.

What ACC does cover

ACC (the Accident Compensation Corporation) is a no-fault scheme that covers personal injury caused by an accident, whether it happens at work, at home, playing sport or on the road. It can help with treatment costs and rehabilitation. If an injury stops you working, ACC weekly compensation can pay up to 80% of your pre-injury earnings, up to a maximum amount set each year.

ACC also covers some injuries caused by medical treatment, and certain work-related conditions that develop gradually. But the core rule is simple: it is designed for injury, not for illness or the effects of ageing.

What ACC doesn't cover

• Most illnesses, such as cancer, heart attack and stroke.
• Most mental health conditions that aren't caused by a covered physical injury.
• Conditions caused mainly by ageing or gradual wear and tear outside work.

If illness stops you earning, there is no ACC weekly compensation. The main government option is a benefit through Work and Income, such as Jobseeker Support for people with a health condition or disability. It is a flat weekly amount, not linked to what you earned, and it can be reduced or unavailable depending on your partner's income. For most households with a mortgage, it won't come close to covering the bills.

Why this gap matters

Serious illness can mean months off work for treatment and recovery. During that time the mortgage, rent, groceries and power bills keep coming, and sometimes there are extra medical costs too. Without private cover, families often fall back on savings, KiwiSaver hardship withdrawals or selling assets.

How private cover fills the gap

• Income protection pays a monthly benefit if illness or injury stops you working, after a waiting period you choose. Policies take ACC payments into account, so check how yours works.
• Trauma (critical illness) cover pays a lump sum if you're diagnosed with a listed condition, such as certain cancers, heart attack or stroke, whether or not you can work.
• Mortgage protection covers your repayments if you can't work because of illness or injury.
• Private health insurance can help you get treatment sooner, rather than waiting on public lists.

Each policy has its own definitions, waiting periods and exclusions, and pre-existing conditions may not be covered. That's why it pays to set cover up while you're healthy and to have it reviewed when life changes.

Check your own position

Ask yourself: if illness stopped me working for six months, how would we pay the bills? If the answer is unclear, book a free review with MFSS. We'll look at what you already have, explain where ACC stops, and help you decide what cover makes sense for your budget, in English or Afrikaans.

This article is general information only and isn't financial advice. For details on ACC entitlements visit acc.co.nz, and for benefits visit workandincome.govt.nz.