OCF Claim forms can be a big headache.
Car accidents litigation should be simple to understand.
But in Ontario, it’s far from simple.
The forms are intimidating, long, and hard to understand.
It’s scary; especially after you’ve been left seriously injured in a motor vehicle accident when you’re at your most vulnerable.
Goldfinger Injury Lawyers are there to help you every step of the way.
Let’s get started with a quick primer on what to expect.
First, let’s remove from the equation the damage to your vehicle, the interviews with the police (or lack thereof); along with any interactions with your employer, ODSP, or OW case worker.
Let’s just focus on the car accident and the accompanying injuries.
Immediately following a serious car accident, you need to report it right away to your own insurance company.
But Mr. Lawyer: the car accident was not my fault? Why should I have to report the car accident to my own car insurer if I wasn’t responsible for it?
Great question.
The laws for the province of Ontario when it comes to car accidents are unfair and work against innocent accident victims. In our no fault scheme of car insurance, the injured party is entitled to “accident benefits“.
Because we have a no fault system, these accident benefits are paid by your OWN car insurer; and NOT the other party’s insurance company.
This may seem really silly, and we struggle with the concept everyday. But, this is how our laws work.
And if you think of it really hard, it makes sense. What happens if the at fault driver did NOT have car insurance. Then who would pay for these benefits?
What happens if the at fault drive had insurance, but not enough insurance to satisfy your claim? Who would pay for the missing amount?
If we didn’t have a no fault accident benefit system, it would act as a dissicentive to get insurance; or adequate insurance. You would be incentived to purchase the bare minimum insurance required at law because of the flawed thinking that either an accident would never happen to you; or that you’re much too good a driver to ever be involved in a car accident.
This is exactly what we see in many American States where drivers purchase the bare minimum insurance required at law because there is little incentive (or so people think) to purchase proper insurance which would adequately compensate them in the event of a serious automobile accident injury.
Once you have reported the car accident to your insurer, the insurer should open what’s called an “accident benefits claim”. This is the drop of water which starts the waterfall.
The secret word to ask your insurer is “that you wish to open an accident benefit claim“. You cannot be more direct than that. Some intake operators may not understand you on the other line and fail to open a claim. This does not happen often because they are trained to take panicked calls; but it certainly does happen. So remember to mention that you wish to make an accident benefit claim. Once you’ve done this the intake operator will send your call along to an adjuster to conduct a detailed intake of your accident, injuries etc. They will also send you a accident benefit package containing a lot of forms either by way of email, regular mail, or both.
When that package arrives it will be like you’ve received a booklet or a binder of complicated forms. Some forms you will need to complete, others you may not. Regardless, the insurer will send you ALL of the forms they have to because it’s the law.
The important forms at the outset of the claim are as follows:
OCF-1 Application for Accident Benefits: For tips on completing the OCF-1 Application for Accident Benefits, take a read at the Toronto Injury Lawyer Blog instalment on this very topic. It will teach you what to do. When in doubt, lawyer up.
OCF-3 Disability Certificate: The OCF-3 Disability Certificate is completed by you, and your doctor, nurse practitioner, specialist, psychologist, occupational therapist, or physiotherapist. It basically tells the insurance company what your injuries are; how those injuries are impacting your ability to work or engage in your regular day to day activities; and provides a prognosis for your recovery time. It ask the health practitioner completing the form to gaze in to his/her crystal ball and PREDICT how long it will take you to recover from your injuries.
OCF-6 Application for Expenses: Out of pocket expenses mount up significantly following a car accident. Bills need to be paid and your resources aren’t endless. Filing out this form and enclosing ORIGINAL receipts will go a long way towards getting your money back for eligible expenses you’ve paid out of your pocket as a result of the car accident.
OCF-10 Election Form: Want to get paid weekly benefits following a motor vehicle accident? Then it’s very important that you complete this form properly. Failure to complete the OCF-10 Election Form may result in a lesser amount of weekly benefits; or no benefits at all being paid to you. You can elect the Non Earner Benefit or the Income Replacement Benefit. If you were working at the time of the motor vehicle accident and able to show your income, then the income replacement benefit is the way to go. It pays up to $400/week based on 70% of your gross weekly income, less deductions from other sources. The calculation can get confusing so both personal injury lawyers and insurers hire forensic accountants. That $400/week can increase if you’ve purchased optional benefits which unfortunately too few people actually do. The second weekly benefit is the Non Earner Benefit which tops out at $185/week and is payable for only the first two years after the car accident. For both the Income Replacement Benefit and the Non Earner Benefit, you must qualify under a specified disability test. That means that just because you’ve been involved in a car accident does not automatically qualify you for the benefit. You have to meet a certain injury threshold to qualify for the benefit.
OCF-19 Application for Catastrophic Benefits: The OCF-19 is a very important form for the most seriously injured accident victims. Read more about the OCF-19 in this edition of the Toronto Injury Lawyer Blog here.