What are Accident Benefits?

Accident benefits are available to those who are injured due to the use or operation of a motor vehicle regardless of who is responsible. This includes drivers, passengers, pedestrians, or cyclists.

Ontario automobile insurance companies require you to complete a series of Auto Insurance Claim Forms (“OCF Forms”) in order to consider your claim for benefits. These forms must be completed accurately but can be challenging to understand. The injured person must complete a majority of the documents, but others, such as healthcare workers and employers, must complete a specific few.

The certain OCF forms that will need to be completed and the schedule in which they need to be submitted vary depending on the situation of the injured person. As a result, filing these forms can be a complicated and rigorous process. It is highly recommended that an injured person consult a personal injury lawyer before submitting any of these forms, as these documents can be used by defence lawyers and adjusters throughout the duration of the case.

What do all of the forms mean?

• OCF-1: Application for Accident Benefits Form: The OCF-1 form is the first step in your accident benefits application and should be completed by anyone who has been injured as a result of a motor vehicle accident. This form must be filled out correctly and in a detailed manner. It is suggested that an injured person seeks out the professional eye of a personal injury lawyer when completing this form.

• OCF-2: Employers Confirmation Form: The OCF-2 form is to be completed by the injured person and their employer(s) for the past 4-52 weeks. The OCF-2 form sets out to claim income replacement benefits. If the injured person is self-employed, they are to complete the form in its entirety.

• OCF-3: Disability Certificate: The OCF-3 form must be completed by a healthcare provider and may be requested by insurers to be filled out as many times as needed throughout the accident benefits process. This form provides a professional medical opinion on the injures sustained as a result of the motor vehicle accident. In addition, the healthcare provider will give insights on the eligibility for essential benefits like the Non-Earner Benefit, the Caregiver Benefit, and the Income Related Benefit.

• OCF-5: Permission to Disclose Health Information: The OCF-5 form allows insurers complete access to all medical records from any hospital or healthcare provider, typically dating back no more than one year prior to the accident. An injured person should not submit an OCF-5 form unless specifically asked to do so and not before consulting a personal injury lawyer.

• OCF-6: Expenses Claim Form: When you have been involved in a motor vehicle accident, injury-related expenses are inevitable. It is strongly advised that someone who has been involved in a motor vehicle accident save all receipts from accident-related expenses. The OCF-6 allows an injured person to apply for the reimbursement of the costs incurred as a result of the accident. These expenses can include prescriptions, physiotherapy, ambulance charges…etc. 

• OCF-10: Election of Income Replacement Non-Earner or Caregiver Benefits: The OCF-10 form enables an injured person to select the proper benefit based on their employment status and financial needs. The OCF-10 informs an insurer of which benefits (Election of Income Replacement, Non-Earner or Caregiver Benefits) the injured person intends to claim.

• OCF-18: Treatment and Assessment Plan: The OCF-18 form determines the level of treatment required and requests approval for treatment due to accident-related injuries. This form is to be completed in part by the injured party, in addition to a healthcare provider or facility.

• OCF-19: Application for Determination of Catastrophic Impairment: The OCF-19 form is submitted to your auto insurance company if an injured person intends to apply for catastrophic impairment designation due to your motor vehicle accident. People who have sustained devastating impairment are entitled to enhanced automobile insurance benefits.

https://otlablog.com/guide-to-automobile-accident-benefits-forms/

https://www.fsco.gov.on.ca/en/auto/forms/pages/ocf_forms.aspx