Claims Pages
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Claim Acknowledgement Letter (Spanish)

A basic MS Word template letter sent as a best practice for the protection of all parties involved. The letter acknowledges receipt of the claim and requests contact with the insured or claimant.
  DOC (51KB) Auto Liability Property Spanish Workers' Compensation Letters

New Hampshire - Uniform Police Traffic Crash Report: DSMV 159 (11/07)

The police traffic accident report used in New Hampshire describes persons, vehicles and circumstances involved, and includes a crash diagram and coding guide.
  PDF (297KB) Auto Liability Crash Reports

North Carolina - Collision Report Form: DMV 349 (10/12)

The North Carolina collision report form describes persons, vehicles and environment involved, including contributing circumstances, crash sequence, crash diagram and narrative.
  PDF (89KB) Auto Liability Crash Reports


Automobile Proof Of Loss (Spanish)

A policyholder must provide this sworn statement in support of an automobile claim. The notarized form documents the date and cause of loss, vehicle identification, settlement amount, and reserves subrogation and other rights of the insurer.
  PDF (86KB) Auto Liability Spanish Forms Property & Casualty

Indiana - Officer's Standard Crash Report: 23558 (2/03)

Standard crash report form for the state of Indiana.
  PDF (416KB) Auto Liability Crash Reports

Iowa - Investigating Officer's Report of Motor Vehicle Accident: 433003 (1/01)

The Iowa traffic accident report includes vehicle and driver information, collision circumstances, a crash diagram and crash narrative.
  PDF (440KB) Auto Liability Crash Reports

Kansas - Motor Vehicle Accident Report - Heavy Vehicle & HAZMAT Supplement: 852 (1/09)

Motor vehicle accident report form used in Kansas when an incident involves heavy vehicles, buses or hazardous materials.
  PDF (483KB) Auto Liability Crash Reports

Louisiana - Uniform Motor Vehicle Traffic Crash Report (1/05)

The uniform motor vehicle crash report for the state of Louisiana includes vehicle and driver identification, collision circumstances, contributing factors, witness/driver statement, a crash diagram and crash narrative. It also contains a railroad grade crossing crash supplement.
  PDF (63KB) Auto Liability Crash Reports

Michigan - Traffic Crash Report Guide (10/15)

Use this code guide to decipher the Michigan traffic crash report.
  PDF (348KB) Auto Liability Crash Reports

Tennessee - Owner/Driver Traffic Crash Report (2/14)

This report must be filed by an owner or driver involved in a crash involving death or injury, or in which damage to property was in excess of four hundred dollars ($400) to any person involved. This report is required regardless of who was at fault and in addition to any report filed by an investigating officer.
  PDF (200KB) Auto Liability Crash Reports

Alaska - Motor Vehicle Crash Form: 12-209

This form is Alaska driver's self-report form for a motor vehicle crash where the damage is less than $500. It describes the persons, vehicles and circumstances involved, and includes a crash diagram.
  PDF (1024KB) Auto Liability Crash Reports

Kansas - Motor Vehicle Accident Report: 850A (1/09)

The motor vehicle accident report used in the state of Kansas provides vehicle and driver identification, and describes the circumstances of a crash.
  PDF (2170KB) Auto Liability Crash Reports

Request For Accident Report (Spanish)

Form letter used by an adjuster requesting an accident report.
  DOC (39KB) Auto Liability Spanish Letters

West Virginia - Uniform Traffic Crash Report (2/07)

The West Virginia traffic crash report describes persons, vehicles and circumstances involved, and includes a crash diagram and narrative. It contains a commercial motor vehicle form.
  PDF (673KB) Auto Liability Crash Reports
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