Claim forms
Complete this package if you were injured in an accident and:
- have yet to apply for accident benefits; or
- are applying for income replacement benefits.
Even if you were retired or unemployed at the time of the accident, you might qualify for weekly benefits. You must submit the Application for Accident Benefits within 30 days of receiving the package. If you cannot submit it within 30 days, submit it to your insurance company and provide the reason for the late submission. Retain a copy for your records and mail the original application to the insurance company.
You must provide this form to your employer if the insurance company asks you to. Your employer and either you or your representative will complete this form. If you had two or more employers over the previous 52 weeks, each employer needs to complete a separate form. In addition, your insurance company may request other proof of income.
If the insurance company asks you to, complete the first section of this certificate and give it to your health provider (chiropractor, dentist, occupational therapist, nurse provider, optometrist, physician, physiotherapist, speech-language pathologist or psychologist). Your health provider and either you or your representative will complete this certificate.
The auto insurance provider requires the OCF-4 for the deceased individual’s spouse and/or dependant(s) entitled to claim benefits. Individuals claiming this benefit may do so individually or collectively.
Use this form only to claim expenses that your health care provider has not submitted on your behalf. You can apply for necessary and reasonable expenses incurred because of the accident that no other plan covers. Such expenses may include the cost of:
- attendant care;
- caregivers;
- housekeeping services;
- lost educational expenses;
- medical and rehabilitation treatment;
- replacing or repairing lost or damaged clothing, dentures, glasses, prosthetics, and hearing aids;
- transportation expenses;
- visitors’ expenses
Ensure to enclose all bills and receipts.
Even if you qualify for the Income Replacement Benefit, Non-Earner Benefit and/or the Caregiver Benefit, you can receive only one of them. You must choose which one you wish to receive. You cannot change your mind after submitting this form to the insurance company unless the injury is determined to be catastrophic. If you need help deciding on which benefit to choose:
- Contact your insurance company representative right away.
- Send back this form within 30 days of receiving it.
- Print clearly and retain a copy for your records.
Your primary or attending health-care professional (family physician, physiotherapist, psychologist, etc.) will submit your OCF-18, enclosing a treatment plan or regimen including suggested services and products to assist in your treatment and recovery.
If you intend to establish that you have suffered a catastrophic impairment because of your motor vehicle accident, you must complete this application and submit it to your auto insurer. Individuals determined to have a catastrophic impairment are entitled to request attendant care, extended medical and rehabilitation benefits, as well as other expenses. Your insurer may deem you to be catastrophically impaired based on this application.
Seek legal advice when completing these documents.
Your proper completion of these documents is essential. They will constitute your claim, and the defence team and an insurance adjuster will be privy to at least most of your Accident Benefits file.
Additionally, you must complete these documents correctly to access the available benefits.
Legal assistance with Lawyers in Ottawa
If you have a question or need assistance, our team of personal injury lawyers is here to help. We know every personal injury case is unique and we work hard to make sure our clients are fairly compensated.
If you are unable to travel to our downtown Ottawa office, one of our lawyers or paralegals can come to meet you at your home or some other convenient location. During the free consultation, we will get to know you and to understand the nature of your injuries, as well as the impact the accident is having on you and your family. Contact us for a free consultation with a lawyer with complete knowledge about car accident claims. We know it’s personal.
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