OCF Whaaaat?!
- Dealing with insurance (companies) and their forms is daunting….
- There are many Insurance forms known as Ontario Claim Forms OCF-1, OCF-2, OCF-3, OCF-4, OCF-5. Sigh! The list goes on…
- Allow me to outline the ‘main’ or pertinent forms your insurer will require to process your Accident Benefit Claim when you have been injured in a motor vehicle accident or mva
- The OCF-1 is in fact the Application for Accident Benefits – some companies are waiving this form, however, I suggest completing it- You provide details about your employment and if you’re off work as a result of the mva. This is something you will want the insurer to know along with details of the accident and your doctor’s information
OCF-2 -Employer’s Confirmation of Income Form – if you were employed and working at the time of the accident, please have your employer complete this form (do not complete it if you are self-employed as an external accountant will be hired from the insurer to provide a calculation) this information allows the insurer to determine your Income Replacement Benefits – you should also provide a copy of your pre-accident paystubs (4 weeks prior to the mva) or your Record of Employment/T4 – NOTE: the maximum eligible amount for an Income Replacement Benefit is $400 per week and if you have short term disability benefits through your employer, this will be deducted from the total Income Benefit and payable up to $400/week, unless you have purchased Optional Benefits (I will touch on this topic in one of my upcoming blogs)
OCF-3 – Disability Certificate. This form is completed by your physician/family doctor – documenting your diagnosis or injuries, and whether you suffer from a disability to return to work or if you are unemployed or retired you must suffer from a complete inability to carry on a normal life – THIS FORM IS VERY IMPORTANT IN ORDER TO BE ELIGIBLE TO RECEIVE AN INCOME REPLACEMENT BENEFIT OR A NON-EARNER BENEFIT OR A CAREGIVER BENEFIT (please note that the caregiver benefits are only eligible if you are catastrophically impaired or if you have purchased Optional Benefits)
OCF-6 Expense Form – you can utilize this form if you have incurred out of pocket expenses; such as hospital parking, mileage, or visitor expenses, medications not covered by your Medical Plan/Extended Health Benefit Plan or the amount that was not paid by your EHC, pretty much anything that you had to incur (medically) as a result of the accident, including the ambulance bill, hospital expenses not paid by OHIP – if you have any questions on whether you can submit a certain expense – please reach out to your insurance adjuster to confirm coverage, NO QUESTION IS A DUMB QUESTION!
OCF-18 Treatment and Assessment Plan – This is completed by your clinic/treating provider, such as your Occupational Therapist, Physiotherapist, and any other treating professional. They will submit this form to your insurer via a platform called HCAI and submit their invoices directly to the insurer on your behalf – you should not be paying out of pocket for these sessions – the clinic should confirm that their Treatment Plan (OCF-18) was approved by the insurer prior to proceeding with the therapy. If you have extended health coverage – this is primary over your insurance coverage – in other words, you need to use up your medical benefit plan through your employer or private plan first, once the maximum has been used for that year then the remaining treatment costs are submitted to your motor vehicle insurance company
- you can visit the FSRA (formerly FSCO) Website to review or obtain any of the Statutory Accident Benefit forms or you can contact me directly – please visit my website at nfconsulting.ca or email me at natalie@nfconsulting.ca.
Thank you!