Auto Insurance Claims Forms (OCF Forms)

The OCF forms and Settlement Disclosure Notice form, available for printing or downloading in Adobe Acrobat (.pdf), have been approved by the Superintendent for use in the circumstances described on each form.

The revised Assessment of Attendant Care Needs (Form 1) is also available below.

Please note that pursuant to Regulation 7/00 (Unfair or Deceptive Acts or Practices), the use of a document in place of a form approved by the Superintendent constitutes an unfair or deceptive act or practice unless none of the deviations in the document affects the substance or is calculated to mislead.


** Please note: All forms effective September 1, 2010 are fillable and saveable. **

OCF-1: Application for Accident Benefits

• Effective as of September 1, 2010 (PDF)*
• Effective as of May 1, 2007 (PDF)*
• Effective as of March 1, 2006 (PDF) (MS Word)
• Effective as of December 1, 2004 (PDF)

OCF-2: Employer's Confirmation Form

• Effective as of December 1, 2004 (PDF)

OCF-3: Disability Certificate

• Effective as of September 1, 2010 (PDF)*
• Effective as of May 1, 2007 (PDF) (MS Word)
• Effective as of March 1, 2006 (PDF) (MS Word)
• Effective as of December 1, 2004 (PDF)

OCF-4: Death and Funeral Benefits Application

• Effective as of March 1, 2006 (PDF) (MS Word)
• Effective as of December 1, 2004 (PDF)

OCF-5: Permission to Disclose Health Information

• Effective as of September 1, 2010 (PDF)*
• Effective as of May 1, 2007 (PDF) (MS Word)
• Effective as of March 1, 2006 (PDF) (MS Word)
• Effective as of December 1, 2004 (PDF)

OCF-6: Expenses Claim Form

• Effective as of September 1, 2010 (PDF)*
• Effective as of December 1, 2004 (PDF)

OCF-9: Explanation of Benefits Payable by Insurance Company

• Effective as of March 1, 2006 (PDF) (MS Word)
• Effective as of December 1, 2004 (PDF)

OCF-10: Election of Income Replacement, Non-Earner or Caregiver Benefit

• Effective as of September 1, 2010 (PDF)*
• Effective as of December 1, 2004 (PDF)

OCF-11: Designated Assessment Centre Referral, Plan and Summary Form

• No longer in use.

OCF-12: Activities of Normal Life

• Effective as of March 1, 2006 (PDF) (MS Word)
• Effective as of November 1, 1996 (PDF)

OCF-13: Declaration of Post-Accident Income and Benefits

• Effective as of December 1, 2004 (PDF)*

OCF-14: Permission to Disclose Health Information to the Designated Assessment Centre

• No longer in use.

OCF-17: Notice of Stoppage of Weekly Benefits and Request for Assessment

• Discontinued as of March 1, 2006.

OCF-18: Treatment and Assessment Plan

• Effective as of September 1, 2010 (PDF)*
• Effective as of January 7, 2008 (PDF) *
• Effective as of May 1, 2007 (PDF) (MS Word)
• Effective as of March 1, 2006 (PDF) (MS Word)
• Effective as of December 1, 2004 (PDF)

OCF-19: Application for Determination of Catastrophic Impairment

• Effective as of September 1, 2010 (PDF)*
• Effective as of May 1, 2007 (PDF) (MS Word)
• Effective as of March 1, 2006 (PDF) (MS Word)
• Effective as of December 1, 2004 (PDF)

OCF-20: Catastrophic Impairment Determination and Request for Assessment

• Discontinued as of March 1, 2006.

OCF-21: Auto Insurance Standard Invoice

• Effective as of September 1, 2010 (PDF)*
• Effective as of January 7, 2008 (PDF)*
• Effective as of April 2, 2007 (PDF)
• Effective as of March 1, 2006 (PDF) (MS Word)
• Effective as of December 1, 2004 (PDF)

OCF-22: Application for Approval of an Assessment or Examination

NB: Discontinued as of September 1, 2010.

• Effective as of January 7, 2008 (PDF)*
• Effective as of May 1, 2007 (PDF) (MS Word)
• Effective as of March 1, 2006 (PDF)
• Effective as of December 1, 2004 (PDF)

OCF-23: Treatment Confirmation Form

• Effective as of September 1, 2010 (PDF)*
• Effective as of January 7, 2008 (PDF)
• Effective as of March 1, 2006 (PDF) (MS Word)
• Effective as of December 1, 2004 (PDF)

OCF-24: Minor Injury Treatment Discharge Report

• Effective as of September 1, 2010 (PDF)*
• Effective as of October 1, 2007 (PDF)
• Effective as of December 1, 2004 (PDF)

OCF-25: Notice of Examination

• Effective as of March 1, 2006 (PDF)* (Fillable MS Word)

OCF-26: Voluntary Consent for Pre-Claim Examination

• Effective as of March 1, 2006 (PDF) (MS Word)

Settlement Disclosure Notice

• Effective as of September 1, 2010 (PDF)*
• Effective as of October 1, 2003 (PDF)

Form 1: Assessment of Attendant Care Needs

• On and after September 1, 2010, use this form for accidents occurring on or after March 31, 2008 (PDF)
• Until August 31, 2010, use this form for accidents occurring on or after March 31, 2008 (PDF)*
• Use this form for accidents occurring on or after February 1, 2007 and before March 31, 2008 (PDF) (MS Word)
• Use this form for accidents occurring on or after March 1, 2006 and before February 1, 2007 (PDF) (MS Word)
• Use this form for accidents occurring on or after October 1, 2003 and before March 1, 2006 (PDF)

Adobe Acrobat® Reader enables you to view and print PDF documents, as well as use Fillable/Saveable PDF* forms. Download the latest version of Adobe Acrobat® Reader by visiting the Adobe Website.

* Please Note: In order to make use of the "SAVE" feature, Adobe Acrobat® Reader version 7.0 or higher must be installed.