Car insurance cases are a lot about paperwork.
Completing the right paperwork. Completing that paperwork the right way, by the right professionals, and completing the paperwork on time. If you’ve done those things, then you are well on your way. While there are no guarantees at success, getting the paperwork done correctly will ensure that your claim doesn’t fail before it even gets started.
Once of the small changes we’ve seen over the past 2 years are the changes to the OCF-1 Application for Accident Benefits.
The OCF-1 Application for Accident Benefits is the FIRST and MOST IMPORTANT form which you can file with your car insurer after a car accident.
If you file this form properly and on time, your accident benefit claim will be live and open. Subsequent forms and documents can be filed afterwards. The OCF-1 Application for Accident Benefits is the form that gets the ball rolling. If you don’t fill out the OCF-1 Application for Accident Benefits, you won’t be able to have an accident benefit case; and it will also have an impact on your tort claim for pain and suffering against the at fault driver. Not to mention that you won’t have any access to medical/rehabilitation benefits to get you better; or access to any attendant care benefits (up to $3,000/month), income replacement benefits (up to $400/week or more if you purchased optional benefits) or non-earner benefits ($185/week).
A few years ago, the OCF-1 Application for Accident Benefit form changed. Those changes were for the better.
The old OCF-1 Application for Accident Benefits form was 8 pages in length.
The newer version of the OCF-1 Application for Accident Benefits form is now just 5 pages in length.
The older version contained a chart which you were required to fill out with the name and address of your previous employers throughout the years. The chart also sought information about your job title, essential duties of the job, hours worked per week, along with the gross income earned during that period of time. It was rather detailed. But, all of the information still needed to be corroborated by employment files, tax returns, and an OCF-2 Employers Confirmation of Income Form. This section always seemed like a big make work assignment in order to frustrate the applicant with redundant forms. The applicant could not rely on what they included in these work charts, and not could an insurer. At the end of the day, the applicant needed to produce another form certified by their employer (the OCF-2 Employers Confirmation of Income Form); along with all of their source documents in order to establish that they were gainfully employed and earned what they said that they were earning. More often than not, the information contained in the chart completed which was by the applicant, did not necessarily exactly match the source information which gets collected. Sometimes there were deliberate attempts to deceive. Other times it was a case a of misremembering, or not having all of the right details at your fingertips at the time of completing the form. More often than not, these were people who just didn’t have all of the details at their disposal and they were trying to complete the form as accurately as possible to the best of their ability. Still, the information needed to be verified and corroborated so it was really a big exercise in duplicity.
The new OCF-1 Application for Accident Benefits form has the very simply statement:
I have missed time from work as a
result of the accident
Yes No N/A
Date returned to work ______
The make work project is no longer. It’s widely understood that the Applicant will need to produce more information in order to accurately establish their employment and earnings.
In the old OCF-1 Application for Accident Benefits, Part 7 of the form was devoted solely to the Caregiver Benefit. It sought questions about the number of people who the applicant was caring for prior to the car accident. This sections stopped making sense after September 1, 2010 when the Caregiver Benefit was completely eliminated for standard, non-catastrophic accident benefit claims. It also didn’t make sense because the Applicant needed to complete an election form to select the Caregiver Benefit. It was not automatically applied. The Applicant had the option of selecting the Income Replacement Benefit, Non Earner Benefit, or the Caregiver Benefit. It was up to the Applicant to decide. Once the Applicant elected the Caregiver benefit, then s/he could inform the insurer about the specific details for those whom they were looking after. But, to have an entire section devoted to the Caregiver Benefit on a standard OCF-1 Application for Accident Benefits long after the Caregiver Benefit had been eliminated for non-catastrophic accident benefit claims made no sense. It simply took up space and made the OCF-1 Application for Accident Benefits longer and more intimidating for claimants than it needed to be.
The newer version of the OCF-1 Application for Accident Benefits completely eliminates Section 7 referring to the Caregiver Benefit. The only mention of a Caregiver Benefit comes in the following context as it relates to the Applicant’s employment status before the car accident:
Were you employed before the Accident?
Were you not empl0yed before the Accident?
Were you a Caregiver before the Accident?
This is a much more simple and straight forward way of getting answers. It would then be up to the insurer to follow up with the Applicant if s/he qualifies for any of the benefits. Unfortunately, this follow up exercise often comes with more forms and more information. But, that’s par for the course and is a large reason as to why people retain personal injury lawyers in order to deal with insurance companies. It’s not fun. It’s a lot of work. And it’s an adversarial process. The insurance company is working in a conflict of interest. They exist to turn a profit and to maximize their profits for their investors/shareholders. Yet, at the same time, they market themselves as caring and compassionate and fair to their insureds. In order to achieve these goals, they need to spend money to pay for the claims of their insureds. But every dollar which they spend on those claims, is a dollar lost in profits. You can see the paradox.