Ontario Claim Form 21 (OCF-21)
Auto Insurance Standard Invoice

Effective October 1, 2016.

Use this OCF-21 Form for medical and rehabilitation goods and services that are payable by an automobile insurer.

The User Manual for completion of the form and its versions may be found at www.hcaiinfo.ca.

Concerning confidentiality, the collection, use and disclosure of this information are subject to all applicable privacy legislation.

As indicated on the form, all attachments are sent directly to the insurer.

All fields must be completed subject to the following exceptions:

• *required if known;
• **at least one field in this section; and
• ***optional.

Attach Version C, pages 2 and 3 for Minor Injury Guideline for accidents that occurred on or after September 1, 2010.

Attach Version A, page 2, where there is a previously approved treatment or assessment plan.

Version B, pages 2 and 3, must be used for all other goods and services, and may be used for previously approved treatment plans and assessments, at the discretion of the provider.

If you want to learn more about the companion accident benefits claim, and kickstarting the accident benefits application process, then please click the “link” to read my blog entitled “How to Get Your Accident Benefits Application Started”.