The OCF-1 Application for Accident Benefits is the first, and arguably, the most important form for starting any accident benefit claim following a car accident.
If you don’t know what accident benefits are; you can learn all about them on the Goldfinger Injury Lawyers Website, or the Toronto Injury Lawyers Blog. Our personal injury lawyers frequently discuss accident benefits, what they are, their value and how they work to clients and prospective clients alike. There is a lot of discussion about accident benefits because they’re so important (and confusing too!).
In Ontario, we have a no fault system of insurance following a car accident. These no fault benefits are referred to as accident benefits. They are NOT damages for pain and suffering. Accident Benefits are created by, and legislated under the Insurance Act and the Statutory Accident Benefits Schedule. These accident benefits are constantly changing because the provincial government is constantly tinkering with them. This results in many amendments to the Insurance Act and to the Statutory Accident Benefits Schedule which makes things very confusing for consumers, lawyers and insurance representatives alike.
The OCF-1 Application for Accident Benefits is the first form to start a claim. It’s the first drop that begins the waterfall. Without completing the OCF-1 Application for Accident Benefits, you won’t get any accident benefits. It’s as simple as that.
More importantly, the OCF-1 Application for Accident Benefits needs to be completed the right way; needs to be signed by the claimant or his/her guardian, and needs to be submitted to the insurer within 30 days after receiving the Accident Benefits package from the insurance company.
If you are filling out the OCF-1 Application for Accident Benefits on your own, it’s important that you’re completing the right version of the form. There are multiple versions out there and if you’re completing the wrong version; then it won’t be accepted by your insurance company.
There’s a version effective June 1, 2016. There’s a version effective November 1, 2014. There’s a version effective June 1, 2013. Completing the wrong version of the OCF-1 can spell disaster for your case, delay, or a lot of additional paperwork on your end which is never very fun.
One of the most important parts of the OCF-1 is the description of your accident and injuries. This is important for a variety of reasons.
For starters, it provides the accident benefit insurer the first view of how the accident happened, and the extent of your injuries.
How the accident happened will be important to two different insurers: the accident benefit insurer and the tort insurer for the pain and suffering case against the Defendant at fault driver. Even though you are completing the OCF-1 for your Accident Benefits claim, this does not mean that this form won’t be seen or used against you by the insurer in the tort claim. In fact, it’s completely normal for the tort lawyer for the Defendant to request a complete copy of the accident benefits file. It’s also routine for Courts to order production of portions of the accident benefits file; including the OCF-1.
If you as a claimant provide a description of the accident and your injuries which contradict the police and medical records; these contradictions will be used against you as the case progresses throughout the litigation. A Plaintiff wants to stay consistent with his/her story. Changing that story as time goes on is not a good thing. The OCF-1 is the first piece of evidence in sharing the Plaintiff’s narrative with respect to how the accident happened and with respect to his/her injuries.
The description of the accident is also important for the accident benefit insurer. Accident benefits are only triggered out of the “regular use or operation of a motor vehicle“. There have been a ton of cases decided at the Financial Services Commission or Ontario and the Courts in regards to what constitutes the regular use or operation of a motor vehicle.
These determinations are fact specific. Walking with your keys to unlock your car with keys in hand; even when your car is off; has been deemed to be an accident arising out of the regular use or operation of a motor vehicle thereby opening up an entitlement to accident benefits for the injured accident victim. Same thing for getting in to, or getting out of your car. But walking to your car outside of a certain distance has also been deemed NOT to be an accident arising out of the use or operation of a motor vehicle as well. It depends on the specific facts of the case.
Hitching a tow line to a pick up truck? Yes
Cleaning the interior of your car? Yes
Slip and fall on ice getting out of your car? Yes
Unloading a boat from a pick up truck in to a marina? Yes
This is why the descriptions contained in the OCF-1 Application for Accident Benefits are so important. They will be used to frame and to scrutinize the case at a later date.
Part 4 or Page 4 of the OCF-1 asks questions regarding insurance information. Whose policy of insurance are you covered by? Your spouse? Your own? Your employer? A rental car? Someone who lists you as a driver? More than one of the above? None of the above?
These questions are very important because they will be used to determine who pays for the accident benefits. One of the tricks which insurance companies play is passing the buck. No insurance company wants to pay the bill, so they attempt to pass the buck to another insurer. Why pay when someone else may?
If you don’t have any insurance information, it may prevent the claimant from sending in their OCF-1. Where is the claimant going to send their OCF-1 if they don’t know who the insurer is, and don’t have their contact information. This is why it’s important to lawyer up following a serious car accident. Your personal injury lawyer will know what to do to ensure that you get the accident benefits which you deserve.