Auto Insurance Claims Forms (OCF Forms)

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Below are the current versions of the forms. Also included, are the revised forms to be used on or after June 1, 2016. To find an older version visit the archive section.

OCF-1: Application for Accident Benefits Size: ## kb

Effective June 1, 2016 Size: ## kbPDF
Effective November 1, 2014 Size: ## kbPDF
Effective June 1, 2013 Size: ## kbPDF

OCF-2: Employer's Confirmation Form Size: 92 kb

Effective June 1, 2016 Size: ## kbPDF
Effective as of December 1, 2004 Size: ## kb PDF

OCF-3: Disability Certificate Size: 130 kb

Effective June 1, 2016 Size: ## kbPDF
Effective September 1, 2010 Size: ## kbPDF

OCF-4: Death and Funeral Benefits Application

Size: 81 kb
(Effective March 1, 2006)

OCF-5: Permission to Disclose Health Information

Size: 35 kb
(Effective September 1, 2010)

OCF-6: Expenses Claim Form

Size: 42 kb OFC6

(Effective September 1, 2010)

OCF-9: Explanation of Benefits Payable by Insurance Company

Size: 46 kb
(Effective March 1, 2006)

(Discontinued as of September 1, 2010.)

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

Size: 40 kb
(Effective September 1, 2010)

OCF-12: Activities of Normal Life

Size: 79 kb
(Effective March 1, 2006)

(Discontinued as of September 1, 2010.)

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

Size: 77 kb
(Effective as of December 1, 2004)

(Discontinued as of September 1, 2010.)

OCF-18: Treatment and Assessment Plan Size: 212 kb

Effective October 1, 2016 Size: ## kbPDF
Effective June 1, 2016 Size: ## kbPDF
Effective November 1, 2014 Size: ## kbPDF
Effective February 1, 2014 Size: ## kb PDF | Size: ## kbAccessible document

OCF-19: Application for Determination of Catastrophic Impairment Size: 67 kb

Effective June 1, 2016 Size: ## kbPDF
Effective September 1, 2010 Size: ## kb PDF

OCF-21: Auto Insurance Standard Invoice Size: 371 kb

Effective October 1, 2016 Size: ## kbPDF
Effective June 1, 2016 Size: ## kbPDF
Effective November 1, 2014 Size: ## kbPDF
Note: minor change has been made to the form use date since the original release on August 26, 2014
Effective November 1, 2012 Size: ## kb PDF

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

Size: 111 kb

(Discontinued as of September 1, 2010.)

OCF-23: Treatment Confirmation Form Size: 156 kb

Effective October 1, 2016 Size: ## kbPDF
Effective June 1, 2016 Size: ## kb PDF
Effective November 1, 2014 Size: ## kbPDF
Effective November 1, 2012 Size: ## kbPDF

OCF-24: Minor Injury Treatment Discharge Report Size: 75 kb

Effective June 1, 2016 Size: ## kbPDF
Effective September 1, 2010 Size: ## kbPDF

OCF-25: Notice of Examination

Size: 73 kb
(Effective March 1, 2006)

(Discontinued as of September 1, 2010.)

OCF-26: Voluntary Consent for Pre-Claim Examination

Size: 27 kb
(Effective March 1, 2006)

(Discontinued as of September 1, 2010.)

Settlement Disclosure Notice Size: ## kb

Effective April 1, 2016 Size: ## kbPDF
Effective January 1, 2013 Size: ## kbPDF

Form 1: Assessment of Attendant Care Needs

Size: ## kb Size: 157 Size: ## kb Size: ##Effective October 1, 2016 Size: ## kbPDF
Effective September 1, 2010 Size: ## kbPDF

Statutory Accident Benefits Schedule-Accidents After December 31, 1993 and Before November 1, 1996

Form for Assessment of Attendant Care Needs-Accidents After December 31, 1993 and Before November 1, 1996 - Effective April 1, 2016
PDF | Accessible document

Statutory Accident Benefits Schedule-Accidents Before January 1, 1994

Ontario Automobile Insurance Application for Accident Benefits - Effective April 1, 2016
Size: ## kbPDF | Size: ## kbAccessible document
Ontario Automobile Insurance Application for Additional Accident Benefits - Effective April 1, 2016
Size: ## kbPDF | Size: ## kbAccessible document
Ontario Automobile Insurance Death and Funeral Payment Request - Effective April 1, 2016
Size: ## kb PDF | Size: ## kbAccessible document
Ontario Automobile Insurance Medical or Psychological Report - Effective April 1, 2016
Size: ## kbPDF | Size: ## kbAccessible document