Auto Insurance Claims Documents (Page 10)

New York City - Police Accident Report (NYC): MV-104AN (7/01)

The New York Police accident report describes the persons, vehicles and circumstances involved, and includes damages, injuries and an accident diagram.

PDF (1640KB) Auto Liability Crash Reports

Notice Under Subrogation Rights (Spanish)

Claim form used to notify an individual of subrogation rights of an insurer for an auto insurance loss.

PDF (31KB) Auto Liability Spanish Subrogation Forms Property & Casualty

Subrogation Receipt (Spanish)

A subrogation receipt is signed by the insured upon payment of a claim, and assigns the insurer to the right to recovery for the loss.

PDF (28KB) Auto Liability Ocean Marine Property Forms Property & Casualty

Reservation Of Rights Letter (Spanish)

The reservation of rights letter notifies the policyholder that the insurer reserves the right to deny coverage of a claim, in whole or part, pending outcome of a claims investigation.

DOC (57KB) Auto Liability Property Spanish Special Investigations Letters

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

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

Denial - No Coverage (Spanish)

This form letter identifies the claimant, insurer, adjuster and date of loss; it is a claim denial for lack of coverage under the insured's policy.

DOC (45KB) Auto Liability Property Spanish Letters

Georgia - Uniform Vehicle Accident Report Overlay: DOT-523 Overlay

Code sheet used to decipher the Vehicle Accident Report for Georgia.

PDF (48KB) Auto Liability Crash Reports

Accident Scene Diagram - Railroad 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 railroad intersection.

DOC (2152KB) Auto Liability Diagrams

Affidavit Of Vehicle Theft (Spanish)

This legal form must be filled out by the insured and notarized. Includes information on vehicle ownership, description & condition, financing, as well as details regarding the theft and police report.

PDF (85KB) Auto Spanish Forms Property & Casualty

Missouri - Uniform Accident Report - Narrative/Statements: SHP-220

Missouri Uniform Crash Report Narrative / Statements Continuation / Supplement (SHP-220) is used when more space is needed to complete Section 11 - Narrative / Statements or when additional narrative information is acquired after the original report has been submitted.

PDF (105KB) Auto Liability Crash Reports

Daily Claims Resources