Revised Statutory Accident Benefits Claims Forms

With this Bulletin, the Financial Services Commission of Ontario (FSCO) is issuing a number of amended forms approved by the Superintendent for use in connection with statutory accident benefits claims.

These forms have been amended to reflect Bill 31, the Personal Health Information Protection Act, 2004, which came into force on November 1, 2004.

Changes to these forms have been made in consultation with the insurance industry, health professionals and other stakeholders. Revisions also include form improvements requested by these stakeholders.

Use of the Forms

The amended forms are to be put into use in place of any previous versions effective immediately, and in any event by no later than November 15, 2004. The amended forms apply to accidents occurring both before and after November 1, 2004.

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.

How to obtain the revised/new forms

Specimen copies of the amended forms are attached to this Bulletin. You can also access the forms at FSCO’s website at: www.fsco.gov.on.ca.

Bryan P. Davies
Chief Executive Officer and
Superintendent of Financial Services

November 8, 2004

Attachments:

OCF-1  Size: 362 kb​, OCF-2  Size: 173 kb​, OCF-3  Size: 310 kb​, OCF-4  Size: 163 kb​, OCF-5  Size: 129 kb​, OCF-6  Size: 91 kb​, OCF-9  Size: 186 kb​, OCF-10  Size: 79 kb​, OCF-11  Size: 427 kb​, OCF-12  Size: 143 kb​, OCF-13  Size: 159 kb​, OCF-14  Size: 100 kb​, OCF-17  Size: 161 kb​, OCF-18  Size: 337 kb​, OCF-19  Size: 175 kb​, OCF-20  Size: 113 kb​, OCF-21  Size: 686 kb​, OCF-22  Size: 448 kb​, OCF-23  Size: 287 kb​, OCF-24  Size: 209 kb​