Get Auto Insurance Standard Invoice Ocf-21 Effective (2012-11-01). Form Number 1208e.1 - Fsco Gov On

Filling out the Auto Insurance Standard Invoice OCF-21 is essential for ensuring that your medical and rehabilitation services related to automobile accidents are reimbursed effectively. This guide provides detailed, step-by-step instructions to help users complete the form accurately online.

Follow the steps to fill out the form correctly.

1. Press the ‘Get Form’ button to access the invoice form and open it in your preferred editor.
2. In Part 1, provide the applicant information. Fill in the claim number, policy number, date of accident, and the applicant's full name, including last name, first name, and optional middle name. Include the date of birth, gender, and telephone number.
3. In Part 2, enter the insurance information. This includes the adjuster's first and last name, their contact details, and the policy holder's information, ensuring that the policy holder details match the previous section if applicable.
4. Part 3 requires you to complete the invoice information. Indicate the invoice number and whether it is the first or last invoice. If applicable, provide the type of plan, plan date, and plan number, and state whether the previously approved amount has been billed.
5. In Part 4, list the payee information, including the payee's name, address, phone number, fax number, and email address. Make sure to certify that the information provided is true and correct, signing and dating the document.
6. Review all parts of the form to ensure no fields are left incomplete, and that all required information is accurately filled out. Gather any necessary attachments and ensure they are directed to the insurer.
7. Once completed, you can save the form, download it for your records, print it, or share it directly as needed.

Complete your form and submit your documents online to ensure your claims are processed efficiently.