Revised Certificate of Automobile Insurance Form and Data Elements



No. A-02/03
- Auto
Property & Casualty
[To the attention of all insurance companies licensed
to transact automobile insurance in Ontario]

This Bulletin advises insurers of new requirements for the "Certificate of Automobile Insurance (Ontario)" form, also called the "Declaration Page," for use with the Ontario Automobile Policy form (OAP 1) (Owner's Policy).


Attached is a revised specimen of the Certificate. Also included, for insurers wishing to custom design their own certificate, is a revised list of the required data elements. Insurers that wish to use their own custom designed certificate must obtain approval from the Financial Services Commission of Ontario (FSCO), as required under Section 232(5) of the Insurance Act.



Effective date for use of Certificate


You are encouraged to obtain approval and to implement the new certificate as soon as possible. The new certificate is flexible enough to be used before the effective date of the Automobile Insurance Reform resulting from Bill 198. The new certificate must be in place for both new and renewal business as of the effective date of the Automobile Insurance Reform. You will be advised of the effective date once it becomes known.


Other forms will also be affected by the provisions of Bill 198. All new and revised automobile insurance forms, as well as other forthcoming changes associated with the implementation of Bill 198, are being developed in consultation with the industry.



Changes to the Certificate


There are two significant changes required from the current approved form and data elements:


  1. Theft deductible - As part of the Automobile Insurance Reform, it has been proposed that a deductible will apply where there is theft of the entire automobile. There has been a change to the Certificate to eliminate the following: "There is no deductible for loss or damage due to fire, lightning or theft of the entire automobile". There is replacement wording that says: "A deductible applies for each claim except as stated in your policy." (Please refer to data element 64).

  2. Warning - Offences - A new data element has been added to the Certificate to identify offences under the Insurance Act and the Criminal Code. (Please refer to data element 130).

There are two other changes, minor in nature, as noted in the attached Explanatory Notes.



Guidelines on use of forms


If you wish to use the specimen as the certificate that will be issued to consumers, you will not need approval from FSCO. However, you must file a copy of the form with FSCO’s Automobile Insurance Division. The copy should include your company logo and an example of how the form would be completed.


If you are designing your own certificate based on the data elements provided in this Bulletin, it must be approved by FSCO. You should, as soon as possible, submit to FSCO the following:


  • one copy of the blank certificate; and
  • another copy of the certificate showing how you would complete it before issuing it to a consumer.

Should you have any inquiries regarding this Bulletin, please contact your rate analyst in the Automobile Insurance Division at FSCO. Please note that this bulletin and the attachments are posted on FSCO’s website at:



Bryan P. Davies
Chief Executive Officer and
Superintendent of Financial Services
March 21, 2003


Attachments (PDF):


  1. Specimen "Certificate of Automobile Insurance (Ontario)" form [PDF Document] Size: 139 kb
  2. List of the data elements for the certificate. [PDF Document] Size: 139 kb
  3. Explanatory notes about the data elements [PDF Document] Size: 50 kb

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