Non-Waiver Agreement / Reservation Of Rights
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 (36KB)
Auto
Liability
Property
Workers' Compensation
Forms Property & Casualty
Accident Scene Diagram - T - Intersection
This Microsoft Word template allows users to sketch an accident scene by adding and resizing a variety of objects including roads, vehicles, traffic signs, road signals and other symbols and figures in a T-intersection.
DOC (2286KB)
Auto
Liability
Diagrams
Snow/Ice Slip And Fall - Witness
Statement guideline for interviewing a witness to a slip and fall claim involving snow/ice. Includes initial questions and follow up questions based on responses given.
PDF (16KB)
Liability
Statement Guides
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 (33KB)
Property
Forms Property & Casualty
Staircase Slip And Fall - Insured
Statement guideline for interviewing the insured in a staircase slip and fall claim. Includes initial questions and follow up questions based on responses given.
PDF (15KB)
Liability
Statement Guides
Hold Harmless Agreement
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 (20KB)
Liability
Property
Forms Property & Casualty
Worksheet Contents Personal Property FEMA Form 086-0-6 (4/17)
The adjuster and the policyholder list and assess the inventory of flood-damaged personal property on this form.
PDF (471KB)
Catastrophe
Property
Forms Flood
Release Of All Claims
A full release form which is signed by claimants and releases insureds from bodily injury and property damage liability which arose out of an accident, casualty or event. The release form identifies all parties to a claim, states the date and location of the event, and details the terms of settlement of a claim. The release contains a statement that, as a condition of the settlement, prevents any further claim or legal action against the insurer, or any other parties, for the event.
PDF (28KB)
Liability
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 (126KB)
Auto
Forms Property & Casualty
Notice Of Loss Burglary-Robbery-Theft
A loss report form filled out by an insured when reporting a theft claim to an insurance company. Includes circumstances of the theft, and a list of items claimed as stolen with declared values.
PDF (47KB)
Property
Forms Property & Casualty
Inquiry Form - Index System
This inquiry form requests claim details for a third party using an Index System.
PDF (16KB)
Liability
Forms Property & Casualty
