Financial Services Commission of Ontario

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Auto Insurance Claims Forms (OCF Forms)

The OCF forms and Settlement Disclosure Notice form, available for printing or downloading in Adobe Acrobat (.pdf), have been approved by the Superintendent for use in the circumstances described on each form.

The revised Assessment of Attendant Care Needs (Form 1) is also available below.

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.

OCF-1: Accident Benefits Application Package

OCF-2: Employer's Confirmation Form

  • Effective as of December 1, 2004 (PDF)

OCF-3: Disability Certificate

OCF-4: Death and Funeral Benefits Application

OCF-5: Permission to Disclose Health Information

OCF-6: Application for Expenses

  • Effective as of December 1, 2004 (PDF)

OCF-9: Explanation of Benefits Payable by Insurance Company

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

  • Effective as of December 1, 2004 (PDF)

OCF-11: Designated Assessment Centre Referral, Plan and Summary Form

  • No longer in use.

OCF-12: Activities of Normal Life

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

  • Effective as of December 1, 2004 (PDF)

OCF-14: Permission to Disclose Health Information to the Designated Assessment Centre

  • No longer in use.

OCF-17: Notice of Stoppage of Weekly Benefits and Request for Assessment

  • Discontinued as of March 1, 2006.

OCF-18: Treatment Plan

OCF-19: Application for Determination of Catastrophic Impairment

OCF-20: Catastrophic Impairment Determination and Request for Assessment

  • Discontinued as of March 1, 2006.

OCF-21: Auto Insurance Standard Invoice

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

OCF-23: Pre-approved Framework Treatment Confirmation Form

  • Effective as of January 7, 2008 (PDF)
  • Effective as of March 1, 2006 (PDF) (Fillable MS Word)
  • Effective as of December 1, 2004 (PDF)

OCF-24: Pre-approved Framework Discharge & Status Report

  • Effective as of October 1, 2007 (PDF)
  • Effective as of December 1, 2004 (PDF)

OCF-25: Notice of Examination

OCF-26: Voluntary Consent for Pre-Claim Examination

SDN 198: Settlement Disclosure Notice

  • Effective as of October 1, 2003 (PDF)

Form 1: Assessment of Attendant Care Needs

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