No. A-12/03
Property & Casualty
- Auto

Implementing Bill 198: New and Revised Statutory Accident

With this Bulletin, the Financial Services Commission of Ontario (FSCO) is issuing new and revised forms approved by the Superintendent for statutory accident benefits claims. The forms reflect changes to the automobile insurance system brought about in the Keeping the Promise for a Strong Economy Act (Budget Measures) (Bill 198) and the Statutory Accident Benefits Schedule (SABS).

Three forms will apply to accidents occurring on or after October 1, 2003 (“Bill 198 claims”) (these are identified by the designation "/198" after the form code).

In addition, sixteen of the new forms are designed to be used as of October 1, 2003, for claims under both the new Bill 198 and the current Bill 59. Some of these forms continue to be applicable to claims under Bill 164.

For convenience, the attached chart sets out the forms that apply to all existing claims, and those that will apply to Bill 198 claims only. The existence of two sets of forms is an inevitable result of the transition to the new system.

Changes to these forms have been made in consultation with the insurance industry, health professionals and other stakeholders. Revisions also include form improvements requested by these stakeholders.

In addition, FSCO is releasing the revised Settlement Disclosure Notice (SDN-198) that required changes to reflect the Bill 198 reforms. The main change in this Notice involves a prohibition on any cash settlement in the 12 months following an accident (with some exceptions).

The Assessment of Attendant Care Needs (Form 1) was also revised and forms part of Ontario Regulation 403/96, Statutory Accident Benefits Schedule - Accidents on or After November 1, 1996 (as amended by Regulation 281/03). For your convenience, the revised Form 1 is being circulated with this Bulletin.

Use of the Forms

Please note that, effective November 1, 2003, 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.

User Manual

The IBC and health professional associations are developing a user manual to assist in the completion of a number of these forms. The user manual will be available, at a future date, at the IBC’s automobile insurance website: www.autoinsurancereforms.on.ca

How to obtain the revised/new forms

Specimen copies of these revised/new forms are attached to this Bulletin. You can also access the forms at FSCO’s website at: www.fsco.gov.on.ca

Bryan P. Davies
Chief Executive Officer and
Superintendent of Financial Services
August 13, 2003


Attachments (PDF):

• OCF-1 Application for Accident Benefits
• OCF-2 Employer’s Confirmation Form
• OCF-3 Disability Certificate
• OCF-4 Death and Funeral Benefits Application
• OCF-5 Permission to Disclose Health Information
• OCF-6 Application for Expenses
• OCF-9 Explanation of Benefits Payable by Insurance Company
• OCF-10 Election of Income Replacement, Non-Earner or Caregiver Benefit
• OCF-11 Designated Assessment Centre Referral, Plan and Summary Form
• OCF-13 Declaration of Post-Accident Income and Benefits
• OCF-14 Permission to Disclose Health Information to the Designated Assessment Centre
• OCF-17 Notice of Stoppage of Weekly Benefits and Request for Assessment
• OCF-18 Treatment Plan
• OCF-19 Application for Determination of Catastrophic Impairment
• OCF-20 Catastrophic Impairment Determination and Request for Assessment
• OCF-21 Automobile Insurance Standard Invoice
• OCF-22 Application for Approval of an Assessment or Examination
  
  NEW CLAIMS FORMS APPLICABLE TO BILL 198 CLAIMS
  
• OCF-23/198 Pre-approved Framework Treatment Confirmation Form
• OCF-24/198 Pre-approved Framework Discharge Status Report
  
  OTHER FORMS
  
• SDN-198 Settlement Disclosure Notice
• Form 1 Assessment of Attendant Care Need