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New Jersey - Police Accident Report: Code Overlay (4/10)

This code sheet is used to decipher the motor vehicle accident report from the state of New Jersey. These codes are used to represent all circumstances of a traffic incident. Codes detail location, roadway type and surface condition, environmental conditions, traffic control, pre-accident actions, type of accident, safety equipment used, vehicle type, vehicle damage, physical complaints and injuries of driver/pedestrian, physical status, contributing circumstances and county hospitals. It includes crash diagrams and samples of cargo vehicle types.
  PDF (701KB) Auto Liability Crash Reports

Nebraska - Investigator's Motor Vehicle Accident Report: DR Form 40 (1/09)

The motor vehicle accident report used in the state of Nebraska describes persons, vehicles and environment involved in the incident. It includes code overlays, a crash diagram, crash narrative, a continuation form for additional vehicles, and a supplemental truck and bus accident report form.
  PDF (1011KB) Auto Liability Crash Reports

Michigan - Traffic Crash Report: UD-10 (9/15)

The Michigan State Police traffic crash report details driver and vehicle information, injuries, damages, circumstances of the accident, and also includes a crash diagram.
  PDF (170KB) Auto Liability Crash Reports

Minnesota - Accident Report - Law Enforcement Only: PS-32003-10 (1/03)

The traffic accident report form used by Minnesota law enforcement identifies persons, vehicles and environment involved, including contributing circumstances.
  PDF (1040KB) 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

Insured's Release (Spanish)

The release form identifies all parties to a claim, states the date of the occurrence, 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 action against the insurer for the claim event in question.
  PDF (95KB) Auto Property Spanish Forms Property & Casualty

Denial - Less Than Deductible (Spanish)

A denial letter used when the value of a claim submitted is determined to be less than the insured's deductible.
  DOC (55KB) Auto Property Spanish Letters


Release & Subrogation Receipt (Spanish)

A legal form signed by an insured acknowledging receipt of settlement and release of all subrogation rights to the insurer.
  PDF (96KB) Auto Property Spanish Subrogation Forms Property & Casualty

Vehicle Repair Order (Spanish)

Agreement and authorization between insured and automotive shop to repair a damaged vehicle within the estimated dollar amount.
  PDF (35KB) Auto Forms Property & Casualty

Affidavit-Lightning Losses (Spanish)

This affidavit is filled out by a service provider who inspects a property and certifies lightning damage as the sole source of the loss. A notorized signature and witnesses are required.
  PDF (50KB) Auto Property Spanish Forms Property & Casualty

Memorandum For Appraisal (Spanish)

Memorandum for Appraisal is used in property damage situations where insured and insurer disagree on actual cash value, and is binding on the parties as to the amount of loss.
  PDF (60KB) Auto Property Spanish Forms Property & Casualty

Insured's Statement In Burglary Loss (Spanish)

A written statement by the insured detailing a burglary loss claim involving a residence or automobile.
  PDF (55KB) Auto Property Forms Property & Casualty
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