The OCF-1 is the Application for Accident Benefits.
How do I get an OCF-1?
Getting an OCF-1 Application for Accident Benefits is very easy. You can download a copy here at from the website of the Financial Services Commission of Ontario. But most people get the OCF-1 from their car insurance company after a car accident. The car insurer will send the OCF-1 Application for Accident Benefits to you by regular mail, courier or by email. You can also ask a personal injury lawyer for the OCF-1. Most personal injury lawyers have access to these forms; not that it’s anything special because these are public forms.
The only problem with getting the OCF-1 on your own (not from the car insurer) is that you won’t know your claim number, or the name and contact information of the insurance adjuster who is assigned to your claim. What you don’t want happening is submitting the OCF-1 to the car insurer only for it to “get lost” in the void of mail which car insurers receive everyday. If there is no claim number and no adjuster assigned, you would hope that a file gets opened. But more often than not what happens is that the claim gets put aside and a file does not get opened. This isn’t right, but this is what can and what often happens if there isn’t a claim number or an insurance adjuster assigned.
Can an insurer be penalized for this sort lack of attention to a file? Sure. But getting to the bottom of that could take months or years. In the meantime the accident victim is not receiving the benefits which s/he needs. Take a more practical approach to this. Ask for a claim number and get the name and contact information of the insurance adjuster. Send the OCF-1 to him/her by email, fax and registered mail so that you know the adjuster receives it. This way your claim will get moving forward and you will get the benefits you need in a timely manner (we hope).
Why is the OCF-1 Application for Accident Benefits Important?
The OCF-1 Application for Accident Benefits is the first form which starts your case. It’s important to be both the tort claim, and the accident benefit claim. The tort lawyer who is defending your action will always want to see a copy of the OCF-1 Application for Accident Benefits even though they are defending the tort proceeding.
Without a completed and executed OCF-1 Application for Accident Benefits, the car insurer has no legal obligation to pay you anything after a car accident (save for the value of your damaged vehicle). That means that an injured accident victim will not receive any funding of their treatment to get better like physio or massage; nor will they receive any funding for assistive devices; or payment of an attendant care benefit or income replacement benefit. Your case won’t get up off the ground until the OCF-1 is completed and submitted to the car insurer.
How detailed do I have to be in completing the OCF-1 Application for Accident Benefits
The OCF-1 Application has to be as accurate as possible. But it does NOT have to be as detailed as possible. Simply because an OCF-1 is not detailed does not mean that it’s deficient.
Think of an OCF-1 Application for Accident Benefits as an outline. It provides very basic information about the application like their name, contact information, date of birth, insurance information, employment details, date of the accident, approximate location of the accident; along with a brief description about how the accident happened and what the accident related injuries are.
These descriptions do NOT need to go into dramatic detail. They just need to provide a broad outline of what happened. The details will eventually be filled in by the records necessary to support a case. These records include, but aren’t limited to:
- Copy of the Accident Report
- Copy of the Officer’s Notes and any witness statements
- Ambulance Call Report
- 911 Audio Recording (if avaiable)
- Hospital Records
- Doctor’s records
- Records from any Specialists and Service Providers
- OHIP Summary
- Tax Returns
- Employment File
- CPP, LTD, OW or ODSP Files
- Any photographs of the injuries or from the accident scene
It is better to be broad on the OCF-1 Application for Accident Benefits because things change over time. If you are too specific you may not be casting your net wide enough to encompass those injuries and deficits which you were not able to foresee at the time of preparing the OCF-1. It’s not uncommon for injuries to manifest in different ways in impact different parts of the body or areas of your day to day living which may have not been contemplated. This is often the mistake and the fear which we see for most self represented litigants and accident victims.
What happens if I don’t submit my OCF-1 Application for Accident Benefits or miss the deadline to do so?
The OCF-1 Application for Accident Benefits must be submitted within 30 days of receiving the Accident Benefit package from your car insurer. You have 7 days from the date of the car accident to report it to your car insurer.
Failure to meet any of these deadlines will delay your case and raise flags for the car insurer in handling your case. That’s not to say that your case will fail. It’s only to suggest that you are inviting a problem by submitting your documents late to the insurer. It’s already hard enough to get things approved. You don’t need to give an insurance company another reason to say “no” to your claim.
The insurer will also likely want an explanation for the late filing of documents. They can ask for that explanation in writing, or sworn in person (via Zoom) testimony by way of Examination Under Oath. This is a tool in the insurer’s toolbox to get answers. If they don’t like those answers; or find an inconsistency in your statement(s); it’s just another way for them to say “no” to your claim. These are headaches you don’t want and don’t need. So report the car accident as soon as possible and get your paperwork in to the insurer as soon as possible.