In order for an insurance company to pay for your treatment, you must complete an OCF-18 form in the course of your application for Ontario’s Statutory Accident Benefits after a serious injury accident. This document, known as the Treatment and Assessment Plan, is crucial in securing your owed Medical and Rehabilitation Benefit.
Your treatment providers will be paid in a fair and timely manner provided that the treatment plan being submitted is medically supported, necessary and reasonable.
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Tip 1 – Ensure you need an OCF-18
You should complete and submit an OCF-18 when seeking benefits to address non-minor and catastrophic injuries. This form is not required when requesting compensation for:
- impairments and injuries that fall under the classification of “minor injury” and those sustained on or after September 1, 2010. (Note: Minor injuries require the submission of an OCF-23 – Treatment Confirmation Form);
- medical care and emergency services provided within five business days of the accident;
- prescription drug costs;
- medical items and devices that are $250 or less each; or
- dental services (Note: this requires the submission of the Standard Dental Claim.)
You may consult a car accident lawyer if you are unclear as to whether or not your claim necessitates an OCF-18.
Tip 2 – Accurately complete all specified sections.
You are responsible for completing – or providing the information necessary to complete – the first three sections of the OCF-18. These sections include information such as:
- your name;
- date of birth;
- insurance provider;
- insurance adjuster’s name;
- claim number;
- date of accident;
- insurance policy number; and
- details about all other insurers.
A qualified health care professional is tasked with completing the remainder of the form.
Tip 3 – Ask a qualified professional to complete the OCF-18.
Your OCF-18 should be completed by a regulated health professional. The document – and specifically part four – must be signed and authorized by a health practitioner, such as a:
- physical therapist;
- nurse practitioner; or
- speech language pathologist.
Your healthcare providers are responsible for including all applicable goods and services recoverable under the Accident Benefits.
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Tip 4 – Meet all filing deadlines.
Notify your insurance provider of your accident within seven days. Confirm the deadline for submitting your OCF-18 and note that an application for Accident Benefits is due within 30 days of your having received the blank forms.
Tip 5 – Hire a motor vehicle accident lawyer.
Many lawyers offer a free case evaluation. This allows you the opportunity to learn what he or she can do to assist you in the benefits claims process. In many cases, this includes overseeing the completion and filing of all benefit application forms.
Your lawyer may assess a completed OCF-18 to ensure the information is accurate and reflective of your injuries and prognosis. Your lawyer also can ensure you meet all filing deadlines.
Call Preszler Law at 1-800-JUSTICE® to consult with a lawyer who understands the Ontario Accident Benefits claim process.