Brain Injury and MVA
After a car accident, the paperwork can feel like a second injury. You may be dealing with anxiety, poor sleep or fear of driving, and at the same time trying to understand claim numbers, adjusters and forms with names like OCF-18. This post walks through how therapy and psychological assessments can be funded through auto insurance accident benefits in Ontario, step by step, and how we help at our North York practice and online.
This is general information, not legal advice. Every claim is different, and your insurer, your adjuster or a personal injury lawyer can tell you how the rules apply to you.
In Ontario, accident benefits usually come from your own auto insurer, whoever was at fault. If you do not have auto insurance, they may come from the insurer of the vehicle you were in or the one that hit you. The rules set short timelines, so it helps to contact the insurer soon after the accident and send in the application forms they give you.
Once your claim is open, you will have a claim number and an adjuster. Keep both handy, because we will need them to bill your insurer.
You do not need to have the paperwork sorted before you reach out. In a free 15-minute car accident consultation, we ask about the accident, what has changed since, and where your claim stands. If therapy or an assessment seems like a good next step, we explain what we will need from you and your insurer.
Many claims start under the Minor Injury Guideline (MIG), which covers injuries such as sprains, strains and whiplash. Treatment under the MIG has a funding limit of $3,500. For some people, especially those with significant anxiety, PTSD symptoms or fear of driving after the accident, that may not be enough.
To be funded outside the MIG, the insurer needs "compelling evidence", usually a treatment plan with supporting information from a health professional. Whether your claim stays in the MIG is decided by your insurer, not by us.
An OCF-18 is the form that asks your insurer to approve and fund specific treatment or an assessment. It sets out what is recommended, why, and what it will cost. We prepare and submit it for you.
Under the rules, your insurer must respond to an OCF-18 within 10 business days. They may approve all of it, part of it, or none of it. If they deny something, they must give reasons, and they may ask you to attend an insurer examination before deciding.
A psychological assessment sets out what has changed since the accident, such as the anxiety, the sleep, the avoidance and the difficulty getting back behind the wheel, and what treatment would help. The report is written so that your insurer, your adjuster, your lawyer and your treating team can all use it.
At our practice, assessments are conducted by our psychologists, Dr. Rex Jose Joseph, Ph.D., C.Psych., and Dr. Sadet Yilmaz, C.Psych., by secure video anywhere in Ontario. Our team arranges each assessment for you. You can read more on our psychological assessments page.
Direct billing to auto insurers. If your accident benefits claim is open, we can submit your treatment and assessment plan to your insurer through HCAI and bill them directly, so you are not paying up front and waiting for reimbursement. Approval and limits are set by your insurer and your claim, not by us.
HCAI (Health Claims for Auto Insurance) is the online system Ontario providers use to send plans and invoices to auto insurers. Our practice is registered with the Financial Services Regulatory Authority of Ontario (FSRA), which allows us to bill auto insurers this way.
Therapy after a car accident often focuses on anxiety, sleep, PTSD symptoms, low mood and getting back to driving. Our posts on PTSD after a car accident and fear of driving after a car accident explain what that work can look like.
A denial is not always the end of the road. Your adjuster can explain the reasons, and sometimes more information or a revised plan is enough. If you still disagree, accident benefits disputes in Ontario go to the Licence Appeal Tribunal. Many people speak with a personal injury lawyer at this point, and some do so from the start. We can work alongside your lawyer and send them what they need, with your consent.
Since July 1, 2026, medical, rehabilitation and attendant care benefits remain a mandatory part of every Ontario auto policy, while most other accident benefits, such as income replacement, are optional. Therapy and psychological assessments fall under medical and rehabilitation benefits. If you are not sure what your policy includes, your broker or insurer can tell you.
If your accident benefits claim is closed, or you would rather not go through your auto insurer, sessions can be covered through extended health benefits or paid privately, with receipts provided. Sessions start from $170 for 50 minutes. You can find more on our fees and insurance page and in our post on whether auto insurance covers therapy after a car accident.
If you do not have some of these yet, that is fine. We can help you work out what is missing.
You do not need to understand the forms before reaching out. A free 15-minute car accident consultation is a chance to talk about what happened, ask questions about your claim and decide on next steps. You can also read more on our therapy after a car accident page. Lawyers and case managers can refer clients through our referral page.
Mindful Connections Therapy
A free 15-minute consultation is a low-key way to see if we are the right fit, no commitment needed.