Claims Pages
claimspages

Proof Of Loss (Burglary)

A sworn statement by a policyholder on a theft claim which lists the items stolen and their values. Filled out and notarized, this is a formal request by the insured for payment from the insurance company.
  PDF (46KB) Property Forms Property & Casualty

Auto Theft Checklist

Details the steps that an adjuster should take when handling an auto theft claim. It also contains links to other related forms such as a reservation of rights letter, a non-waiver agreement, and an investigating officer statement guideline.
  PDF (12KB) Auto Checklists

Vehicle Inspection Report

Auto Examiner or Adjuster's vehicle inspection report form.
  PDF (22KB) Auto Forms Property & Casualty

Automobile Proof Of Loss

A policyholder must provide this sworn statement in support of an automobile claim. The notarized form documents the date and cause of loss, vehicle identification, settlement amount, and reserves subrogation and other rights of the insurer.
  PDF (46KB) Auto Liability Forms Property & Casualty

Economic Loss Doctrine In All 50 States

The Economic Loss Doctrine explained as it has been applied in all 50 states, an educational reference for subrogation professionals.
  PDF (97KB) Education & Training Liability Ocean Marine Legal Reference

Prescription Abbreviations

A list of medical abbreviations commonly found on prescriptions.
  PDF (20KB) Liability Workers' Compensation Medical Reference

Adjusters Report/Certification

The Adjusters Report/Certification documents the insured property's location, date and type of loss, and summarizes replacement cost and A.C.V. for buildings, structural, contents and additional living expense, with line item detail.
  PDF (47KB) Property Forms Property & Casualty

Release With Medical Agreement

This is a contract that releases an insurer from any legal and financial responsibility for injury and liability claims after a specified time period and medical expense settlement amount is agreed upon.
  PDF (28KB) Liability Forms Property & Casualty

Assignment Sheet

Generic form for assigning an automobile claim to an independent adjuster for investigation and handling. The form lists the insurance company, insured, claimant, endorsements, vehicle details, date and description of loss, and contact information for all parties involved.
  PDF (47KB) Auto Liability Forms Property & Casualty

Claim Register Sheet

Basic registry form for logging when claims are received and closed.
  PDF (83KB) Auto Liability Property Workers' Compensation Forms Property & Casualty

Swimming Pool Injury - Insured

Statement guideline for interviewing an insured in a swimming pool injury claim. Includes initial questions and follow up questions based on responses given.
  PDF (16KB) Liability Statement Guides

No-Fault Automobile Accident Liability States

Currently 12 states and Puerto Rico have no-fault auto insurance laws. Florida, Michigan, New Jersey, New York and Pennsylvania have verbal thresholds. Hawaii, Kansas, Kentucky, Massachusetts, Minnesota, North Dakota and Utah use a monetary threshold.
  PDF (13KB) Liability General Reference

Speed Distance Chart

Chart of feet traveled per second relative to speed (mph).
  PDF (14KB) Auto Liability Subrogation General Reference

Alabama - Uniform Traffic Crash Report: AST-27 (6/08)

The Alabama Traffic Uniform traffic crash report describes the persons, vehicles and circumstances involved, and contains a crash diagram. It includes a code legend and a Truck/Bus Supplement sheet.
  PDF (240KB) Auto Liability Crash Reports
Monty Fire Investigations LLCWeller SalvageKelmar Global