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)
Auto
Liability
Spanish
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)
Auto
Liability
Property
Spanish
Workers' Compensation
Forms Property & Casualty
Vermont - Uniform Crash Report (1/08)
The Vermont Uniform Crash Report describes the persons, vehicles and circumstances involved, and includes a code overlay, crash diagram and narrative.
PDF (500KB)
Auto
Liability
Crash Reports
Oregon - Police Traffic Crash Report Addition: 735-46B (9/16)
The Oregon Police Traffic Crash report appendix B lists additional passengers or witnesses, injuries, safety equipment used and contributing factors.
PDF (181KB)
Auto
Liability
Crash Reports
District of Columbia - Traffic Crash Report: PD 10 (12/08)
The traffic crash report for the District of Columbia includes driver/passenger/witness information, location and collision type, vehicle identification, contributing circumstances, injury and damage details, crash diagram and narrative.
PDF (69KB)
Auto
Liability
Crash Reports
Delaware - Uniform Traffic Collision Report: 438 (1-88)
Standard motor vehicle collision report for the state of Delaware provides details of a crash. It includes driver/person and vehicle identification, injury information, and a collision diagram. Codes are used to represent roadway conditions, collision type, traffic control devices, safety equipment, and contributing circumstances.
PDF (160KB)
Auto
Liability
Crash Reports
Minnesota - Motor Vehicle Accident Report: PS 32001-10
Minnesota driver's motor vehicle accident report form, which must be completed for a crash involving $1,000 or more in property damage, or injury or death.
PDF (115KB)
Auto
Liability
Crash Reports
Report Of Public Liability Accident (Spanish)
This report form provides notice and details of a public premise accident.
PDF (70KB)
Auto
Liability
Spanish
Forms Property & Casualty
Kentucky - Civilian Traffic Collision Report: KSP-232 (6/11)
This report form is used when a traffic collision was not investigated by a police officer, and is filed by those involved within ten days of the occurrence.
PDF (29KB)
Auto
Liability
Crash Reports
Pennsylvania - Police Crash Reporting Form - Code Sheet: (2005)
This code sheet is used to decipher the motor vehicle accident report from the state of Pennsylvania.
PDF (52KB)
Auto
Liability
Crash Reports
Tennessee - Electronic Traffic Crash Report (2009)
The Tennessee traffic crash report describes persons, vehicles and circumstances involved, and includes a crash narrative.
PDF (1031KB)
Auto
Liability
Crash Reports
Texas - Driver's Crash Report: CR-2 (4/08)
Texas crash report form CR-2 must be completed by the driver involved when a crash is not investigated by a law enforcement officer.
PDF (20KB)
Auto
Liability
Crash Reports
Ontario Automobile Policy O.A.P. 1 (6/16)
The Ontario Automobile Policy provides liability and property damages coverages for automobile owners. It details liability coverage, accident benefits, uninsured automobile coverage, direct compensation, optional loss or damage coverages, and statutory conditions.
PDF (574KB)
Auto
Liability
Policy Forms
Release & Authorization Of Payment (Spanish)
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 (40KB)
Auto
Liability
Property
Spanish
Workers' Compensation
Forms Property & Casualty
