Report Of Public Liability Accident (Spanish)
This report form provides notice and details of a public premise accident.
PDF (70KB)
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)
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)
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)
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)
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)
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)
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)
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)
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)
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)
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)
Forms Property & Casualty
