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FSCO updates auto insurance health claim forms


October 11, 2012   by Canadian Underwriter


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The Financial Services Commission of Ontario is about to implement more changes to the Health Claims for Auto Insurance (HCAI) System, with new versions of certain forms mandatory as of next month.

The changes, previously announced in June, will apply to documents delivered on or after Nov. 1, regardless of when the accident occurred.

With the changes, there will be new versions of forms OCF-18 (treatment and assessment plan), OCF-21 (the auto insurance standard invoice) and OCF-23 (treatment confirmation form). The new versions are available on the FSCO website in PDF format.

“Earlier versions of the OCF-18, OCF-21 and OCF-23 are no longer approved for use on or after November 1, 2012,” FSCO stated on its website.

Last June, FSCO released its Health Claims for Auto Insurance (HCAI) July 2012 Guideline – Superintendent’s Guideline No. 02/12, which replaced the previous guideline from December, 2011.

At the time the agency said it identified “gaps” where “additional information is required in order to obtain useful data regarding Minor Injury Guideline (MIG) claims.”

The amended OCF-21C form will include two new mandatory data fields: the date that the MIG treatment block commenced and the profession(s) of the health care provider(s).

The amended OCF-21 form now reflects the requirement to complete the “plan number” field in the manner specified in the HCAI July 2012 guideline. The use of OCF-21C will be mandatory for billing all mounts under MIG and the use of OCF-21B and OCF-18 are no longer approved for use with MIG codes, FSCO says.

OCF-21 has also been revised “to emphasize specific language appearing above the signature boxes in the form through bolding and increased font sizes.”

FSCO stated last summer it made the same changes to forms OCF-18 and OCF-23 but the current wording in those forms has not changed. 

The HCAI data entry centre will not accept any forms between 5:00 p.m. EDT Oct. 31 and 8:00 a.m. the following day. Any forms that are not processed before 5:00 p.m. Oct. 31 will be processed under the new rules, FSCO says.