Notice Under Subrogation Rights
Claim form used to notify an individual of subrogation rights of an insurer for an auto insurance loss.
PDF (13KB)
Forms Property & Casualty
Accident Scene Diagram - 3-Lane Highway Intersection
This Microsoft Word template allows users to sketch an accident scene by adding and resizing a variety of objects including roadways, vehicles, traffic signs and other symbols in a 3-lane highway intersection.
DOC (221KB)
Diagrams
Auto Theft Loss Checklist
Similar to form number 9221F, this checklist lists the steps that an adjuster should take when handling an auto theft claim.
PDF (25KB)
General Reference
Daily Time Sheet
A daily time sheet to record claims work, hours, mileage and expenses.
PDF (91KB)
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)
General Reference
Automobile Accident Report (Spanish)
Report form that is given to vehicle owners and drivers to capture the details of an accident. Includes occupants, injuries, property damages and witnesses.
PDF (97KB)
Forms Property & Casualty
The Port Authority of NY & NJ - Motor Vehicle Crash Report Code Sheet (08-09)
This code sheet is used to decipher the motor vehicle accident report from the Port Authority of New York and New Jersey.
PDF (140KB)
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)
Forms Property & Casualty
Request For Accident Report
Form letter used by an adjuster requesting an accident report.
DOC (17KB)
Letters
Vehicle Fire - Investigating Officer
Statement guideline for interviewing the investigating officer in a vehicle fire claim. Includes initial questions and follow up questions based on responses given.
PDF (15KB)
Statement Guides
Vehicle Bill Of Sale (Spanish)
The vehicle bill of sale is a document that records transaction between buyer and seller, identified by name and address. Bill of sale includes vehicle type, make, model, year, odometer reading, vehicle identification number (VIN) and purchase price.
PDF (26KB)
Forms Property & Casualty
Vehicle Theft - Investigating Officer
Statement guideline for interviewing the investigating officer in a vehicle theft claim. Includes initial questions and follow up questions based on responses given.
PDF (14KB)
Statement Guides
Event Data Recorders - Vehicle List
This list of vehicles equipped with crash data recorders is current through 2014.
PDF (46KB)
General Reference
