Health Claims for Auto Insurance (HCAI)
Health Claims for Auto Insurance (HCAI) is Ontario's secure online platform for submitting and managing health benefit claims under the province's Statutory Accident Benefits Schedule (SABS). It is used by regulated health professionals, including audiologists, to submit treatment plans, invoices, and assessments for individuals injured in motor vehicle accidents and covered by Ontario auto insurance.
Under Ontario auto insurance, injured individuals are entitled to statutory accident benefits for rehabilitation and treatment of injuries sustained in a collision. Audiological conditions that can arise from motor vehicle accidents include hearing loss, tinnitus, and vestibular disorders resulting from head and neck trauma. Regulated audiologists participating in the HCAI system can submit treatment and assessment plans (using forms such as the OCF-18) and invoices directly to the insurer through the platform.
HCAI streamlines the claims process and provides insurers with a standardized format for reviewing treatment proposals. Audiologists working with MVA patients should be familiar with the SABS benefit categories, the pre-approval process for treatment plans, and the documentation required to support audiological claims. In Ontario, the Financial Services Regulatory Authority (FSRA) oversees the auto insurance regulatory framework within which HCAI operates.
