This video will help you complete the Ontario government form that gets your claim started. It’s called the Application for Accident Benefits (OCF-1).
By completing it and sending it back to us as soon as possible, you’re starting the process of applying for benefits to help you recover from the accident.
Context: An animation shows how to complete the application form for Accident Benefits. Each part of the application form is highlighted as the voice-over provides instruction.
[text on screen] Completing the Application for Accident Benefits Form OCF-1
[voice over] Your Claims Advisor will be there every step of the way to help in your recovery from your accident. And this video will help you complete the government form that gets your claim started – it’s called the Application for Accident Benefits. We know it’s quite a bit of paperwork, but if you follow along with the video we can help make the process go as smoothly as possible. By completing it and sending it to back to us as soon as possible, you’ll be applying for benefits to help you recover from the accident.
[text on screen and voice over] You can speak with your Claims Advisor for further help completing the form and to discuss details about your claim. They’re here for you.
[voice over] At the start of the Application Package there are two pages. The first page explains all of the forms in the package that we’ve sent you.
The second page is for people who aren’t sure where to send this form – but, since you’re sending it to us, you don’t need to worry about this page.
Page three is where the Application Form starts. Let’s go through each section now so you can complete it accurately and smoothly.
[text on screen] Part 1 – Applicant Information
[voice over] Provide all of your information here. By giving us your current and complete contact information we can reach you the way you’d like. Be sure to fill-out the best time to reach you.
[text on screen] Part 2- Applicant’s Representative
[voice over] If someone is helping you with your claim, they need to complete this section.
Parents or guardians completing this form on behalf of a child or minor must fill-in this with their information.
[text on screen] Part 3- Accident Details and Health Information
[voice over] This section is where you provide details about the accident and the treatment you received afterward.
[text on screen and voice over] Your Claims Advisor can work with you to find a health care practitioner who can help in your recovery.
[voice over] You can add another page if you have several health care practitioners currently involved in your care.
[text on screen] Part 4 – Details of Automobile Insurance
[voice over] We need to know about all of the automobile insurance policies that you might be covered under. Please note that these are not group health care policies – we’ll cover that later in Part 9.
You’ll notice that there are two sections in this part that could apply: “Section A” relates to any automobile insurance that covers you or your spouse, is [text on screen and voice over] available through your work, or through someone you’re dependent on – like your parents or any other family members. You may be covered under another automobile insurance policy other than the one insuring the car involved in the accident.
If you do not have other automobile insurance in Section “A” that covers you, then complete Section “B”. Section “B” is about the automobile insurance of [text on screen and voice over] the vehicle you were involved in, the vehicle that hit you, or any other vehicle that may have been involved in the accident.
[text on screen] Parts 5 through 8 - Applicant Status
[voice over] These next few sections are able to tell us about your activities before the accident, and if you are still able to do them now.
[text on screen] Part 5 Applicant Status
[voice over] Part 5 is asking for your employment information in the year before the accident happened. There’s also more information about your employment in Part 8 of this Application form.
[text on screen] Part 6 Student Attending School
[voice over] Part 6 asks if you were attending school or had finished school less than one year before the accident. Let us know if you were able to go back to school after the accident, and if you are currently attending school.
[text on screen] Part 7 Caregiver
[voice over] Part 7 is about caregiving. If you were taking care of anyone living with you before the accident you’ll need to complete this section.
If you were not getting paid for providing care (for family members, like your kids), and you cannot provide that care now because of the accident, please complete the rest of section 7.
If you were paid for providing that care, please mark “No” where it asks and continue to Part 8.
[text onscreen] Part 8 Income Replacement Determination
[voice over] In Part 8 of the form, we will need the details of your employment before the accident. If you were self-employed, list yourself as the “Employer”. If you worked at several jobs over the past one year before the accident, please list all of your employment information.
It’s important for us to know if your injuries from the accident are preventing you from working now. If you returned to work after the accident, please let us know when that happened.
If you didn’t return to work within 7 days after the accident, your Claims Advisor may ask you to have your health provider complete the Disability Certificate.
You may also be asked for an Employer’s Form for each of your employers over the past year before the accident. Your Claims Advisor may ask for additional information like pay stubs or statements, or employment records that show your income.
[text on screen] Part 9 – Other Insurance or Collateral Payments
[voice over] Part 9, Collateral Insurance. In this section, you will need to list all the other insurance policies you may have available to you for health care.
Unlike in the earlier Part 5, these aren’t limited to automobile insurance. Instead, these could be from your school, employer, your spouse, your parents, any disability plan, or the government (things like Employment Insurance or Social Assistance).
Please include as much detail about those plans as possible – including the policy numbers.
[text on screen and voice over] Part 10 – Motor Vehicle Accident Claims Fund
[voice over] Since you’re applying to us, this Part doesn’t apply to you. You don’t need to sign and date the Form here. Instead, that happens later, in Part 12.
[text on screen and voice over] Part 11 – Direct Payment Assignment by Applicant
[voice over] This part is where you tell us if you want us to pay your licensed service provider or facility directly for your treatments. If you want that, please check the box, and initial underneath. Otherwise, we will pay you directly and you will then be responsible for paying them.
If you go to an unlicensed provider or facility, you’ll have to pay out of pocket for the services, and then submit their invoice to us for reimbursement.
[text on screen and voice over] Part 12 – Signature
[voice over] You’re almost done!
Before you can send the Application Form to us, please review, sign and date the form here.
Your Claims Advisor will be there every step of the way to help in your recovery from the accident and will answer any questions you have!
If you need help completing the forms or if you have questions about your claim, talk to your claims advisor. They’re there for you at every stage of the process.