Insurance Claims Documents (Page 46)

Vermont WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of Vermont.

DOC (0KB) Workers' Compensation Forms Property & Casualty

Washington WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of Washington.

PDF (0KB) Workers' Compensation Forms Property & Casualty

Delaware - Uniform Traffic Collision Report: 438 (1-88)

Standard motor vehicle collision report for the state of Delaware provides details of a crash. It includes driver/person and vehicle identification, injury information, and a collision diagram. Codes are used to represent roadway conditions, collision type, traffic control devices, safety equipment, and contributing circumstances.

PDF (160KB) Auto Liability Crash Reports

Statement Of Loss With Enclosures (Spanish)

An adjuster's statement of a loss using Schedules A, B & C, that includes enclosures.

PDF (50KB) Property Spanish Forms Property & Casualty

Insured's Statement In Burglary Loss (Spanish)

A written statement by the insured detailing a burglary loss claim involving a residence or automobile.

PDF (55KB) Auto Property Forms Property & Casualty

Employer Occupational Injury And Disease Report (Spanish)

Basic reporting form used by an employer to record an employee's injury or illness on the job.

PDF (50KB) Spanish Workers' Compensation Forms Property & Casualty

Vehicle Repair Order (Spanish)

Agreement and authorization between insured and automotive shop to repair a damaged vehicle within the estimated dollar amount.

PDF (35KB) Auto Forms Property & Casualty

Statement As To Replacement Cost Coverage (Spanish)

A legal form stating the values used to calculate cost coverage for repair or replacement of a property loss.

PDF (35KB) Property Spanish Forms Property & Casualty

Affidavit-Lightning Losses (Spanish)

This affidavit is filled out by a service provider who inspects a property and certifies lightning damage as the sole source of the loss. A notorized signature and witnesses are required.

PDF (50KB) Auto Property Spanish Forms Property & Casualty

Memorandum For Appraisal (Spanish)

Memorandum for Appraisal is used in property damage situations where insured and insurer disagree on actual cash value, and is binding on the parties as to the amount of loss.

PDF (60KB) Auto Property Spanish Forms Property & Casualty