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What you will Learn in this Guidebook:

 

Disclaimer………………………………………………………………

 

p.4

How this guidebook came to be written………………… p.5
Terms, Definitions and Citations……………………………. p.10
1.   AUTOMOBILE INSURANCE BASICS………………….. p.11
What’s included in a standard automobile

insurance policy?……………………………………………….

 

p.12

What are Statutory Accident Benefits and why are

they important after an accident?……………………….

 

p.14

Important accident reporting deadlines you should

know about……………………………………………………………

 

p.15

Do I really need to upgrade my insurance

coverage?…………………………………………………………

 

p.16

Who can apply for motor vehicle accident

benefits?…………………………………………………………..

 

p.19

Motor Vehicle Accident Claims Fund (MVACF) –

When NO automobile insurance exists…………………..

 

p.20

2.   AN ACCIDENT JUST OCCURRED………………………. p.21
I am at the scene of the accident….What do I do?…. p.22
Everyone has left the scene of the accident – What

next?………………………………………………………………..

 

p.25

·         Obtain medical attention………………………….. p.25
·         Notify your insurer……………………………………. p.26
·         Acquire legal advice………………………………….. p.26
·         Damaged items, receipts and

recordkeeping……………………………………………

 

p.26

Getting your services immediately after an accident

occurs…………………………………………………………………….

 

p.28

Applying for your accident benefits………………….…… p.32
·         Interest on overdue benefits……………………. p.33
·         An insurer may terminate the payment of

benefits; …….…………………….……………………..

 

p.34

Who pays for my therapies and rehabilitation?……. p.34
·         The order of payment……………………………….. p.35

 

Your family is covered for benefits, even if they are not in the accident………………………………………………..  

p.36

A note on communicating with your insurance

adjuster…………………………………………………………………

 

p.36

Potential SABS list of medical benefits…………………… p.37
Potential SABS list of rehabilitation benefits………… p.37
3.   INJURY CATEGORIES and their related Benefits p.38
·    Minor Injury……………………………………………… p.39
·         Non-Catastrophic Injury……………………………. p.46
·         Catastrophic Injury……………………………………. p.54
Claiming visitor/s expenses – Financial support for

family visitation………………………………………………………

 

p.65

Requesting a financial statement…………………………… p.66
My benefits have been denied…The Licence Appeal

Tribunal (2016) “The Dispute Resolution Service”…………………………………………………………………..

 

 

p.67

4.   OCF FORMS – Auto Insurance Claim Forms p.72
OCF-1  Application for Accident Benefits………………. p.73
OCF-2   Employer’s Confirmation Form………………….. p.74
OCF-3   Disability Certificate…………………………………… p.74
OCF-4  Death and Funeral Benefits……………………….. p.75
OCF-5   Permission to Disclose Health Information p.76
OCF-6   Expenses Claim Form…………………………………. p.76
·         Claiming  transportation expenses to and

from medical treatment and rehabilitation sessions…………………………………………………….

 

 

p.78

OCF-10 Election of Income Replacement, Non-

Earner or Caregiver Benefit……………………….

 

p.79

OCF-18 Treatment and Assessment Plan………….……. p.79
·         The   Independent   Medical   Examination

(IME/IE)…………………………………………………….

 

p.80

·         Pro-active steps that you may wish to take

before and after an IME assessment…………

 

p.81

OCF-19 Application for Determination of

Catastrophic Impairment…………………………..

 

p.84

 

OCF-21 Auto Insurance Standard Invoice………………. p.84
OCF-23 Treatment Confirmation Form………………….. p.85
OCF-24 Minor Injury Discharge Report………………….. p.85
Form 1:   Assessment of Attendant Care Needs……. p.85
5.   HEALTH CARE PROVIDERS p.87
Types of Health Care Providers – A brief review……. p.88
·         Health Practitioner…………………………………… p.88
·         Regulated Health Professional………………….. p.88
·         Unregulated Health Professional………………. p.88
·         Supportive Services…………………………………… p.89
The role “Health Practitioners” play in your

recovery…………………………………………………………………

 

p.90

Psychological injury in a MVA………………………………… p.94
·         The Neuropsychologist……………………………… p.97
Insurer’s Preferred Provider Network (PPN); also

known as “Insurance Preferred Health Care Providers”..………………………………………………………….. Regulation and Licensing………………………………………..

 

 

p.98 p.99

·    What is HCAI?……………………………………….. p.99
·         What is the FSCO Service Provider Licence? p.100
A note on Assessments………………………………………….. p.100
6.   A Review of the MINOR INJURY Guideline (post Sept. 1, 2010)………………………………………………….  

p.102

Definition of a Minor Injury…………………………………… p.105
The Minor Injury Guideline (MIG) – Exclusions……… p.107
The Minor Injury Guideline Fee Schedule………………. p.109
Changing Health Practitioners………………………………. p.110
Discharge from the MIG……………………………………….. p.110
The $400.00 for Supplementary Goods and Services

under the MIG Fee Schedule………………………………….

 

p.112

Important points under the MIG…………………………… p.114
7.   LEGAL ACTION……………………………………………….. p.115
Taking legal action in a personal injury lawsuit;

A brief look……………………………………………………………..

 

p.116

 

Understanding the 2 types of Standard Damages you can sue for in a “Tort” claim…………………………….  

p.118

Critical errors that may affect the outcome of your

accident claim/s……………………………………………………..

 

p.121

Out of province claims…………………………………………… p.122
Big changes to accident benefits that affected the

rights of Ontarians, September 1, 2010………………….

 

p.123

Should I borrow money from private lending

Institutions?………………………………………………………

 

p.131

8.   RESOURCES……………………………………………………. p.132
www.mvahealth.ca…………………………………………… p.133
Resource links………………………………………………………… p.134
What is a collision reporting centre (CRC)?…………… p.136
Keep in your glove compartment in case of an

accident………………………………………………………………….

 

p.139

References…………………………………………………………….. p.140
Important contact information………………………………. p.147