Application for Accident Benefits (OCF-2)

What is the Employer's Confirmation Form (OCF-2)?

You may be entitled to income replacement benefits through your automobile insurance provider if you can no longer work because of injuries sustained by a motor vehicle collision. Income replacement benefits should be offered as part of all automobile insurance policies.

The Employer’s Confirmation Form (OCF-2) is a critical document that provides the necessary information to complete an income replacement benefit calculation. The form confirms your work history as completed by employers and includes essential details on when you were employed and how much money was made during those periods; it also notes whether any other sources may be available for income replacement help.

Download your Application for Accident Benefits (OCF-2)

Is the OCF-2 form a multi-section document? Yes it is. 

  • Part 1 - Applicant Information
  • Part 2 - Authorization
  • Part 3 - What Salary Information is Needed
  • Part 4 - Applicant’s Income
  • Part 5 - Other Benefits
  • Part 6 - Employment Details
  • Part 7 - Employer Information
  • Part 8 - Signature

Who should fill out the Employer's Confirmation Form OCF-2 form?  

Parts 1-3: These sections are simple to fill out and can be completed by you, the applicant. 

Part 1: This section basic contact information along with the name of the adjuster/insurance company for accident benefits claim; if unsure how to find these details on their correspondence, then look at the top left corner where there is usually someone's signature (and also match it up accordingly). 

Part 2: This section of the application process, all you need is your name and signature and date it.

Part 3: If you are self-employed or work in a family business, keeping records of your income is essential. The insurance company will require your tax returns and pay stubs to determine how much money was made during each period that qualifies as salary (4 weeks vs 52 weeks). 

Part 4 to 8: The remainder of the OCF-2 is to be completed by your employer and is generally completed by your manager or someone in human resources. Once you are done checking over the form, have your personal injury lawyer make sure there are no errors. It is common for mistakes to be made when filling out these kinds of documents!

Find a Health Professional that works with MVA clients

If you have been hurt in a motor vehicle accident, there are only certain clinics that have registered on Health Claims for Auto Insurance (HCAI), an electronic system for processing auto insurance claims  in order to direct bill motor vehicle accident companies. 

Should I seek help for filling out the form? 

It is essential to seek the advice of someone experienced in the personal injury field, as the forms can be complicated to fill out. If you are not careful with the details, your essential medical and rehabilitation services may be delayed or denied. 

Important Timelines that should be considered: 

The law requires that all car accidents involving bodily injury be reported to the police. In addition, if you want to make a claim for certain accident benefits, you will have 7 days to do so after your accident. Your insurance adjuster will give you more information on how this should happen. 

You have 30 days from receiving this package to return this form or submit an explanation as to why you could not submit it under the timeline. We recommend you keep a copy of the OCF-2 form for your records and return the original document to your insurance company. 

Highlights of the OCF 2 -Employer's Confirmation Form:

  • Section 1 to 3 are be filled out by the person applying for the accident benefits when you are applying for benefits for the first time. If the person applying for accident benefits is unable to fill out the form, is a minor or deceased, the application may be submitted by an assigned representative. 

  • This form requires basic personal information about yourself, details relating to the automobile accident, your insurance policy, form of employment and more, to determine potential entitlement to accident benefits.

  • This form is to be returned 30 days after receiving the package. "If you are unable to return it within 30 days, submit it to your insurance company anyway and explain why you were not able to complete it within the timeframe." SABS, O Regulation 34/10, s.32 (6)
  • Fill out as completely as possible with your signature as missing information will waste time in processing your claim,2 and delay receiving your accident benefits. (SABS, O Regulation 34/10, s.32 (6))

Frequently Asked Questions: 

The IRB is an essential benefit for those who have been injured and need help replacing their lost income. It only applies if you were self-employed or working at least 26 out of 52 weeks before getting hurt.

  • The first thing an insured individual needs to do for themself or their loved one(s) to be eligible for IRBs is to satisfy specific preconditions.
  • Second, the insured individual must satisfy the “substantial inability” test to be eligible for IRBs during their first 104 weeks after the accident. 
  • Third, the insured individual must also satisfy the “complete inability” test to qualify for the IRB after 104 weeks following the accident.   

The insurer will require proof that your accident directly caused your injuries. Documentation such as an OCF-3 Disability Certificate (OCF-3) and other medical evidence will be required before paying any IRB to an individual. 

You can get all of your required supporting documentation by asking the right questions.

The supporting documentation will be crucial for ensuring that the amounts on the OCF 2 have been completed correctly and accurately. This is a critical point if the insured individual was unemployed at the date of the accident, and to determine eligibility, it may be necessary for them to have been employed 26 out of 52 weeks before the accident.


Find a Health Professional that works with MVA clients

If you have been hurt in a motor vehicle accident, there are only certain clinics that have registered on Health Claims for Auto Insurance (HCAI), an electronic system for processing auto insurance claims  in order to direct bill motor vehicle accident companies.