If you’ve been seriously injured in a motor vehicle accident in Ontario, one of the first financial challenges you may face is sudden out-of-pocket expenses.
The OCF-6 Expenses Claim Form is a crucial document within Ontario’s Accident Benefits system that allows the injured person and their loved ones to be reimbursed for certain accident-related expenses.
Understanding what is and is not covered as an expense is important at an early stage. Completing the reimbursement form properly the first time can make a significant difference in how quickly you receive reimbursement.
The OCF-6 is used to claim reimbursement for expenses that are already incurred because of the accident. It acts as a record of what, when and why you spent your own money, and how the expenses relates to your injuries or losses.
Your Accident Benefits insurer relies on this form to determine whether you are entitled to be paid back.
Many people are surprised to learn that certain items are covered immediately after an accident, even before any treatment plans are approved. These include:
These are considered reasonable and necessary accident-related losses, and you can (and should) submit them through the OCF-6 with proof of purchase or replacement.
You may also claim other expenses such as transportation to medical appointments, assistive devices, and certain medical supplies, as long as you provide receipts and the expenses are connected to your accident-related needs.
One of the biggest mistakes people can make is thinking that everything can be reimbursed, like their private health insurance. It’s important to understand that treatment services such as: physiotherapy, massage therapy, chiropractic care, psychological counselling, or occupational therapy cannot be incurred and later reimbursed by Accident Benefit insurer. This is very different from private health insurance.
Under the Accident Benefits regime, treatment must be pre-approved by your insurer through a treatment and assessment plan (Form OCF-18).
If you obtain treatment without approval, the insurer is not required to reimburse you.
Fundamental to any insurance claim is evidence. Providing the necessary evidence at first instance makes your claim run much smoother.
To avoid delays or denials:
The Accident Benefits process can feel completely overwhelming, especially when you’re seriously injured. Things like brain injuries, hospital stays, fractures or managing a property damage claim distracts from an already complicated process.
Our firm regularly helps clients complete their forms, gather proper documentation, and makes sure that insurance companies treat you fairly.
If you’ve been seriously hurt in a motor vehicle accident, we’re here to guide you through every step starting with the OCF-6.
Contact Bergeron Clifford LLP today for a free consultation.