Create and Modify Ontario Claim Forms

This article will help you create, modify, and print Ontario Claim Forms (OCF) available in Universal Office. It covers OCF-1, OCF-2, OCF-5, OCF-6, OCF-19, and OCF-24. The rest of the OCFs available in Universal Office are covered in separate articles.

To perform the following procedures, open a patient MVA case in the Patient Manager, then open the Documents tab.

Claim Form Types

This article covers:

• Application for Accident Benefits (OCF-1)
• Employer’s Confirmation Form (OCF-2)
• Permission to Disclose Health Information (OCF-5)
• Expenses Claim Form (OCF-6)
• Application for Determination of Catastrophic Impairment (OCF-19)
• Minor Injury Treatment Discharge Report (OCF-24)

These other claims forms are covered in separate articles:

• Assessment of Attendant Care Needs (Form 1)
• Disability Formats (OCF-3)
• Treatment & Assessment Plan (OCF-18)
• Auto Insurance Standard Invoice (OCF-21)
• Treatment Confirmation Form (OCF-23)

Create an OCF

1. Click [New Document] on the toolbar, then choose one of the following templates from the Template type drop-down list:
   • OCF-1 (Latest OCF version)
   • OCF-2
   • OCF-5 (Latest OCF version)
   • OCF-6 (Latest OCF version)
   • OCF-19 (Latest OCF version)
   • OCF-24 (Latest OCF version)

   Note: You may want to clone the OCF from a previous OCF (of the same type). To do that, click Previous in the Duplicate From drop-down list, then select one of the previous OCFs.

2. Click Open.
   The OCF Editor opens.
3. Verify the Date of Accident and Document dates.
4. Click the numbered links on the left side of the screen to open, review, and complete each section of the OCF. See more about the available sections for each OCF in respective OCF Sections.
5. Click Save & Close.

Modify an OCF

Note: This can be done only for OCFs with the status of Created.

1. Double-click the Form.
2. Make the necessary changes, then click Save & Close.

Preview and Print an OCF

1. While editing an OCF, click Preview.
   The OCF opens for previewing.
2. Click [Print] on the toolbar.
3. Choose the printer from the list, then click Print.
   Tip: While previewing, you can also export the document to PDF using [Export to PDF] on the toolbar.

Application for Accident Benefits (OCF-1) Sections

• Applicant & Representative
  On this page, you complete parts 1, 2, 10 and 11 of the OCF-1. This page includes information about the applicant and his/her representative.
• Accident Description
  In Part 3 of the OCF-1, specify accident details and health information.
• Details of Automobile Insurance
  In Part 4 of the OCF-1, you may record details of the automobile insurance information. Be sure to complete both pages of Part 4.
• Applicant Status and Student Attending School
  In Parts 5 and 6 of the OCF-1, indicate applicant status and answer questions if applicant is a student.
• Caregiver
  In Part 7 of the OCF-1, answer questions if the claimant was the main caregiver to people living with him/her.
• Income Replacement
  In Part 8 of the OCF-1, specify the details of the claimant’s employment for the past 52 weeks.
• Other Insurance or Collateral Payments
  In Part 9 of the OCF-1, specify other coverage, if any, that the applicant may have.

Employer’s Confirmation Form (OCF-2) Sections

• Applicant, Authorization, and Insurer Information
  The only page in OCF-2; covers Parts 1, 2 and 3.

Permission to Disclose Health Information (OCF-5) Sections

• Applicant, Insurer, and Treating Health Professional Information
  The only page in OCF-5; covers Parts 1, 2, 3, and 4.

Expenses Claim Form (OCF-6) Sections

• Applicant Information
  In Parts 1 & 3 of the OCF-6, specify applicant information.
• Expenses
  List expenses in Part-2 of the OCF-6.

OCF-19 Sections

• Applicant & Insurance information
  On this page, you complete Part 1 of the OCF-19.
• Physician information
  In Parts 2 and 5 of the OCF-19, complete physician’s information.
• Report of Catastrophic Impairment Report & Criteria
  In Parts 3 and 4 of the OCF-19, answer a few questions about the catastrophic impairment report and criteria applicable to the applicant.

OCF-24 Sections

• Insured Person & Insurance Information
  On this page, you complete Parts 1 and 2 of the OCF-24. This page includes applicant, MVA insurer, and adjuster information.
• Signature of Health Practitioner
  In Part 3 of the OCF-24, identify the Health Practitioner.
• Insured Person’s Discharges Status
  In Part 4 of the OCF-24, specify insured person’s status at the time of discharge from MIG.
• Insured Person’s Functional Status at Discharge
  In Part 5 of the OCF-24, specify insured person’s functional status at the time of discharge from MIG.