Arizona - Crash Report: 01-2704 (6/10)
The standard traffic accident report used in Arizona includes vehicle and driver identification, vehicle condition, location, roadway type, traffic control devices, environmental conditions, crash narrative and an accident diagram.
PDF (691KB)
Crash Reports
Arizona - Crash Report Fatal Supplement: 01-2705 (2010)
The supplemental crash report is used for each fatality associated with an Arizona traffic accident, and includes safety device usage or failure, ejection path, tests for alcohol/drugs, and EMS timeline.
PDF (210KB)
Crash Reports
Rhode Island - Uniform Crash Report (12/6)
The Rhode Island Uniform Crash Report form describes persons, vehicles and circumstances involved. It includes a coding guide, crash narrative/diagram and truck/bus supplemental report form.
PDF (480KB)
Crash Reports
Alabama - Uniform Traffic Crash Report - Truck/Bus Supplemental Sheet (6/08)
The Alabama Uniform Traffic Accident Report and the Truck/Bus Supplemental sheet is to be completed when an accident meets both of the following criteria: (1) involves a truck with gross vehicle weight of 10,000 pounds or a Haz/Mat placard, or a vehicle designed to carry 9 or more people, and (2) results in at least one of the following: one or more fatalities, one or more persons injured and taken from the scene for medical attention, or one or more vehicles towed from the scene. Code legend is included.
PDF (420KB)
Crash Reports
Florida - Traffic Crash Report: HSMV-90010S (6/13)
A Long Form report (HSMV 90010S) in its entirety must include a Narrative/Diagram when the following criteria are met:
- Resulted in death of, personal injury to, or any indication of complaints of pain or discomfort by any of the
parties or passengers involved in the crash;
- Leaving the scene involving damage to attended vehicles or property (F.S. 316.061(1));
- Driving while under the influence (F.S. 316.193);
- Rendered a vehicle inoperable to a degree that required a wrecker to remove it from the scene of the crash; or
- Involved a commercial motor vehicle. The Short Form (HSMV 90010S) designation is used to report other types of traffic crashes.
PDF (370KB)
Crash Reports
Power Of Attorney (Auto) (Spanish)
This is a limited power of attorney which grants the insurer permission to transfer title for a specific vehicle on the owner's behalf.
PDF (65KB)
Forms Property & Casualty
Automobile Accident/Loss Notice (Spanish)
A loss report form filled out by insureds and/or agents when reporting an automobile accident. Includes information on occupants, injuries, damages, accident description and witnesses.
PDF (78KB)
Forms Property & Casualty
Non-Waiver Agreement / Reservation Of Rights (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 (65KB)
Forms Property & Casualty
Kentucky - Traffic Collision Report Codes
The code sheet is used to decipher the motor vehicle accident report from the state of Kentucky, and details circumstances and contributing factors.
PDF (245KB)
Crash Reports
Flood Zone Classification Chart
Definitions of flood zone classifications.
PDF (14KB)
General Reference
Reservation Of Rights Agreement (Spanish)
A reservation of insurer's rights to discovery, settlement, or defense in denial of a claim for loss and damages, agreed to by insured.
PDF (92KB)
Forms Property & Casualty
Witness Report Of Accident (Spanish)
Witness statement describing an accident in detail.
PDF (63KB)
Forms Property & Casualty
Guarantee Of Title (Spanish)
For a case involving a total loss or theft of a financed motor vehicle or boat, this is an agreement that the lien holder will provide a lien free Certificate of Title to the insurance company upon receipt of a claim payment.
PDF (20KB)
Forms Property & Casualty
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)
Letters


