Covenant Not To Sue
Thus is an agreement by an injured party to not pursue a lawsuit against another party in exchange for a settlement.
PDF (21KB)
Liability
Forms Property & Casualty
Automobile Accident Promissory Note (Spanish)
Customized automobile subrogation promissory note which allows the insurance company to notify DMV/BMV in case of default by the tortfeasor.
PDF (56KB)
Auto
Liability
Spanish
Subrogation
Forms Property & Casualty
Pennsylvania WC Forms
A collection of workers' compensation forms which are authorized to be used in the state of Pennsylvania.
PDF (0KB)
Workers' Compensation
Forms Property & Casualty
Release And Trust Agreement (UM/UIM PD)
A release form signed by an insured when making an uninsured motorist or underinsured motorist claim involving property damage.
PDF (24KB)
Auto
Liability
Subrogation
Forms Property & Casualty
Ontario (Canada) - Motor Vehicle Accident Codes
This code sheet is used to decipher the motor vehicle accident report from Ontario, Canada. Codes detail location, roadway surface condition, environmental conditions, traffic control, pre-accident actions, type of accident, safety equipment used, vehicle type, damage, and injuries.
PDF (360KB)
Auto
Liability
Crash Reports
Medical Authorization (HIPAA Compliant) (Spanish)
Authorization form for disclosure of medical records, in compliance with HIPAA requirements.
PDF (76KB)
Liability
Spanish
Workers' Compensation
Forms Property & Casualty
Passengers Statement (Spanish)
A passenger's statement describes persons, vehicles, injuries, driver actions and circumstances of a crash.
PDF (85KB)
Auto
Liability
Spanish
Forms Property & Casualty
Hold Harmless Agreement (Spanish)
This is a contract that releases one party from any legal and financial responsibility for all loss or damage or future claims by the other party in exchange for a settlement.
PDF (82KB)
Auto
Liability
Property
Spanish
Workers' Compensation
Forms Property & Casualty
Vehicle Repair Order
Agreement and authorization between insured and automotive shop to repair a damaged vehicle within the estimated dollar amount.
PDF (15KB)
Auto
Forms Property & Casualty
Non-Waiver Agreement (Spanish)
The non-waiver agreement is signed by the policyholder; its purpose is to protect the insurer. Insurer reserves all of its rights under the policy to investigate and defend a claim without admission of any liability for loss.
PDF (82KB)
Auto
Liability
Property
Forms Property & Casualty
Witness Statement (Spanish)
This written statement is prepared by an accident witness. It documents all details they can recall about the accident scene, including any statements made by parties involved.
PDF (95KB)
Auto
Liability
Forms Property & Casualty
PIP Attending Physician's Report
The attending physician report form is used by an insurer to determine if a person is due benefits under personal injury protection (PIP) law.
PDF (55KB)
Liability
Forms Property & Casualty
