Instructions

You must complete this Claim Form in order to make a claim for money for the time you spent in Administrative Segregation in an Ontario correctional institution during specific time periods.

Completing this Claim Form is only the first step in the claims process. All Claim Forms will be reviewed by an Administrator appointed by the Court. Depending on the information contained in your Claim Form and in your records from your time in an Ontario correctional institution, you might be eligible for a share of money (called Aggregate Damages). You might also be eligible to make a claim for more money later in the claims process.

Once you have completed this Claim Form, you must send it (along with any additional pages) to the Administrator by June 1, 2025. After that date, it will be too late for your Claim Form to be considered.

Keep a copy of your completed Claim Form for your records.

Please read this Claim Form carefully and complete it in full. The sections that you must complete have been marked with an asterisk (*). If you fail to fully complete this Claim Form and/or to sign it, your Claim may be rejected.

You do not need a lawyer to fill out this Claim Form. If you need help completing this Claim Form or have further questions that the Administrator cannot answer, the lawyers at Koskie Minsky LLP are available (at no cost) to help you.

You can contact Koskie Minsky LLP at ontarioadminsegclassaction@kmlaw.ca or by phone 1-844-819-8527 (toll free).

You can also call or email the Administrator for help with this Claim Form at:

Epiq Class Action Services Canada Inc
PO Box 507 STN B
Ottawa, ON K1P 5P6
Toll-Free Telephone: 1-888-290-4730
Email: info@ontarioadministrativesegregation.ca

Read the entire Claim Form before you begin completing it to determine which sections, if any, apply to you.

Who Can Submit a Claim Form?

You can claim if one of the following situations applies to you:

1) You stayed in Administrative Segregation in an Ontario Jail 1 for 15 or more consecutive days AFTER April 20, 2015 and BEFORE August 18, 2021

1 In these lawsuits, an “Ontario Jail” is a correctional institution operated by the Government of Ontario, and does not include the St. Lawrence Valley Correctional and Treatment Centre

OR

2) You stayed in Administrative Segregation in an Ontario Jail for any length of time BETWEEN April 20, 2015 and April 18, 2021 and

3) You were diagnosed by a medical doctor with an eligible mental health disorder and reported that diagnosis to Ontario's agents before or during your segregation placement. A full list of eligible disorders is available at www.ontarioadministrativesegregation.ca
Note: substance abuse disorders and personality disorders (except Borderline Personality Disorder) are not eligible disorders.

The Court decided that anyone placed in Administrative Segregation between January 1, 2009 and April 19, 2015 is barred from pursuing a Claim from this time period, unless you can prove that you could not start a lawsuit before April 20, 2015.

How Do I Submit My Claim Form?

CLAIM ONLINE

Or download and print the Claim Form by going to the website:

Website: https://www.ontarioadministrativesegregation.ca
Email: info@ontarioadministrativesegregation.ca

OR BY MAIL

Ontario Administrative Segregation Class Action Administrator
P.O. Box 507 STN B
Ottawa ON K1P 5P6
Fax: 1-866-262-0816
Toll Free: 1-833-290-4730