Revised Minor Injury Guideline and Treatment and Assessment Plan (OCF-18)

Bulletin

No. A-01/14

Property & Casualty

– Auto

To all insurance companies licensed to transact auto insurance in Ontario and all health care providers

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The Financial Services Commission of Ontario (FSCO) is releasing a revised Minor Injury Guideline (MIG) and Treatment and Assessment Plan (OCF-18) that become effective February 1, 2014.

The revised MIG and OCF-18 reflect the recent change made to the Statutory Accident Benefits Schedule – Effective September 1, 2010 (SABS), outlined in Bulletin A-07/13, to provide that a pre-existing condition referred to in s. 38 (3) (c) (i) (regarding the MIG) must have been documented by a health practitioner prior to the accident.

Health Claims for Auto Insurance

Until the revisions to the OCF‑18 (change to the introductory Note box on page 1 and to the second question in Part 4) are reflected in the electronic Health Claims for Auto Insurance (HCAI) system (expected to occur in the summer of 2014), the revisions are to be read-in to HCAI’s existing electronic version of the OCF-18.

Insurers and health care providers and clinics should visit the HCAI information website [New Window]

(www.hcaiinfo.ca

) to learn more about how the recent SABS amendments change the OCF-18's completion and processes in the HCAI system.

Health care providers are reminded that any attachments to the OCF-18 are to be sent directly to the insurer not to HCAI.

Authority

The revised MIG is issued pursuant to section 268.3 of the Insurance Act (the Act) and is incorporated by reference in the SABS. It is expected to be published in the January 25, 2014 edition of The Ontario Gazette. The revised OCF-18 is issued pursuant to section 66 of the SABS.