Claims Pages
claimspages

Request For Contact

Form letter requesting claimant to contact adjuster.
  DOC (17 KB) Letters

Inquiry Form - Index System

This inquiry form requests claim details for a third party using an Index System.
  PDF (16 KB) Forms Property & Casualty

Release & Authorization Of Payment

Used as a general release form which is signed by insureds and specifies payment to settle a claim. The release contains a statement that, as a condition of the settlement, prevents any further claim or legal action against the insurer for the loss event.
  PDF (26 KB) Forms Property & Casualty

Deductible Reimbursement Laws In All 50 States

A summary of the laws and regulations in each state with regard to whether there is a duty or obligation on the part of a subrogated carrier to reimburse any or all of its insured’s deductible to its insured before it can successfully subrogate or seek reimbursement of its claim payments.
  PDF (93 KB) Legal Reference



Inland Marine Proof Of Loss

Inland Marine Proof of Loss form is a legal document to be completed by an insured in support of a claim.
  PDF (33 KB) Forms Property & Casualty


Parent/Guardian Release

This legal form for Parent/Guardian releases an insurer from any liability or indemnity claim for damages or injuries resulting from an accident involving a minor in exchange for a monetary settlement.
  PDF (25 KB) Forms Property & Casualty

Recorded Statement Analysis

A written observation describing behavior of a person making a recorded statement.
  PDF (54 KB) Forms Property & Casualty

Claimant's Report Of Accident

This report form is given to claimants to record the details of an accident. Includes accident location, property damage, vehicle occupants, witnesses and an accident diagram.
  PDF (76 KB) Forms Property & Casualty

Car Evaluation Analysis

Appraisal form used to determine a vehicle's value after a total loss by considering the book value and local market value (dealer quotes). Add or deduct value using a comparable vehicle model, noting trim, paint, glass, tires, power options, mechanical condition and cleanliness.
  PDF (126 KB) Forms Property & Casualty

Digital Photo Sheet 2

Form for digital photo documentation for an adjuster's file.
  DOC (28 KB) Forms Property & Casualty

Dog Bite Injury - Claimant

Statement guideline for interviewing the claimant in a dog bite injury claim. Includes initial questions and follow up questions based on responses given.
  PDF (17 KB) Statement Guides

Memorandum For Appraisal

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 (35 KB) Forms Property & Casualty