How to Submit Claims to the Attention of Independent Insurance Adjusters

Are you running into claims handled by independent adjusters? If you haven’t yet, you will: some insurance companies outsource their claims to cut costs and add more flexibility to their claim adjudication process. Find out how to add independent adjusters to patient cases and submit OCFs to their attention.

Add Independent Adjuster to Patient Case

1. Open a patient’s MVA case.
2. From the General Tab, click the […] ellipsis (three dotted) button next to MVA in the Claims section.
3. Select or enter the insurance details, HCAI Insurance Name and HCAI Branch.
4. In the Adjuster Information section, select the name of the independent adjuster company, if applied, then enter the independent adjuster details such as first and last name, email, and phone numbers.
5. Click Save & Close.

Once entered, the system will pre-populate the adjuster and insurance information when creating new OCFs.

Submit OCFs to Attention of Independent Adjuster

1. Open an existing or create a new OCF-18, OCF-21, or OCF-23.
2. Make sure that the HCAI Insurer and HCAI Branch address of the Independent Adjuster are selected in the Auto Insurance section of the OCF.
   Note: If the adjuster is not registered as a branch under the insurer, then simply address it to the insurance company.
3. Make sure the adjuster’s contact details appear in the Adjuster Information section of the claim form.
4. Complete the rest of the claim form, then click Submit & Close.

FSCO provides a full listing of the individual adjusters and adjusting companies on their Individual Adjusters and Adjusting Companies Licensed in Ontario page.