Subrogation Receipt
A subrogation receipt is signed by the insured upon payment of a claim, and assigns the insurer to the right to recovery for the loss.
PDF (27KB)
Auto
Liability
Ocean Marine
Property
Forms Property & Casualty
Model Minimum Uniform Crash Criteria (MMUCC) - 2012
The Model Minimum Uniform Crash Criteria Guideline (MMUCC) is a minimum, standardized data set for describing motor vehicle crashes and the vehicles, persons and environment involved. The Guideline is designed to generate the information necessary to improve highway safety within each state and nationally.
PDF (523KB)
Auto
Liability
Crash Reports
Acknowledgement Of Assignment
Generic form used by independent adjusters to acknowledge receipt of a property insurance claim, and provide a preliminary report to the insurance company.
PDF (23KB)
Auto
Liability
Property
Workers' Compensation
Forms Property & Casualty
A 14 Point Red Flag Checklist For Staged Collisions
The Red Flag checklist helps determine whether a rear-end collision may have been a staged accident; this maneuver is referred to as a swoop and squat crash by the Coalition Against Insurance Fraud. Claims with numerous red flags may need to be referred to the special investigations unit (SIU).
PDF (58KB)
Auto
Liability
Special Investigations
General Reference
Speed Distance Chart
Chart of feet traveled per second relative to speed (mph).
PDF (14KB)
Auto
Liability
Subrogation
General Reference
Assignment Sheet
Generic form for assigning an automobile claim to an independent adjuster for investigation and handling. The form lists the insurance company, insured, claimant, endorsements, vehicle details, date and description of loss, and contact information for all parties involved.
PDF (47KB)
Auto
Liability
Forms Property & Casualty
Automobile Proof Of Loss
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 (46KB)
Auto
Liability
Forms Property & Casualty
Blood Alcohol Content Chart
Reference chart showing what a person's blood alcohol content may be, based on the number of drinks consumed within an hour. Includes a person's weight as a factor.
PDF (14KB)
Auto
Liability
General Reference
Accident Scene Diagram - Freeway/Highway Onramp
This Microsoft Word template allows users to sketch an accident scene by adding and resizing a variety of objects including roads, vehicles, traffic signs, road signals and other symbols and figures in a freeway/highway onramp.
DOC (2175KB)
Auto
Liability
Diagrams
Auto Repossessions Checklist
List of steps to take when handling a claim that includes automobile repossession by a lienholder who reports damage to the vehicle.
PDF (25KB)
Auto
General Reference
Automobile VIN Decoding Chart
A unique code of numbers and letters comprise a motor vehicle's Vehicle Identification Number. The VIN indicates the country of origin, manufacturer, plant, vehicle type, make and model, year, engine size, overall dimensions, trim package, brakes and tires, warranty and safety restraints.
PDF (16KB)
Auto
General Reference
Accident Scene Diagram - Highway Overpass
This Microsoft Word template allows users to sketch an accident scene by adding and resizing a variety of objects including roads, vehicles, traffic signs, road signals and other symbols and figures in a highway overpass.
DOC (702KB)
Auto
Liability
Diagrams
