Claims Pages
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Reservation Of Rights Agreement

A reservation of insurer's rights to discovery, settlement, or defense in denial of a claim for loss and damages, agreed to by insured.
  PDF (19KB) Forms Property & Casualty

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 Repair Order

Agreement and authorization between insured and automotive shop to repair a damaged vehicle within the estimated dollar amount.
  PDF (15KB) Forms Property & Casualty

Event Data Recorders - Vehicle List

This list of vehicles equipped with crash data recorders is current through 2014.
  PDF (46KB) General Reference

Texas - Peace Officer's Crash Report: CR-3 (1/12)

The Texas Peace Officer's crash report describes persons, vehicles and circumstances involved, and includes a crash narrative and diagram.
  PDF (212KB) Crash Reports

Release And Trust Agreement (UM/UIM PD)

A release form signed by an insured when making an uninsured motorist or underinsured motorist claim involving property damage.
  PDF (24KB) Forms Property & Casualty

Missouri - Uniform Accident Report: SHP 2Q (1/12)

The Missouri Uniform Crash Report identifies drivers and vehicles involved, and includes all crash circumstances, a collision diagram and crash narrative.
  PDF (340KB) Crash Reports

Missouri - Uniform Accident Report - Narrative/Statements: SHP-220

Missouri Uniform Crash Report Narrative / Statements Continuation / Supplement (SHP-220) is used when more space is needed to complete Section 11 - Narrative / Statements or when additional narrative information is acquired after the original report has been submitted.
  PDF (105KB) Crash Reports

Massachusetts - Motor Vehicle Crash Report Codes

Codes used to decipher the Commonwealth of Massachusetts motor vehicle crash report.
  PDF (488KB) Crash Reports

Drivers Statement (Spanish)

A driver's written statement of sequence of events and collision information.
  PDF (71KB) Forms Property & Casualty

Hold Harmless Agreement (Spanish)

This is a contract that releases one party from any legal and financial responsibility for all loss or damage or future claims by the other party in exchange for a settlement.
  PDF (82KB) Forms Property & Casualty

Release & Trust Agreement (UM/UIM BI) (Spanish)

A release form signed by an insured when making an uninsured motorist or underinsured motorist claim. Requires the insured to cooperate in the recovery of funds from the responsible party.
  PDF (65KB) Forms Property & Casualty

Claimant's Report Of Accident (Spanish)

This report form is given to claimants to record the details of an accident. Includes accident location, property damage, vehicle occupants, witnesses and an accident diagram.
  PDF (87KB) Forms Property & Casualty


Notice Under Subrogation Rights (Spanish)

Claim form used to notify an individual of subrogation rights of an insurer for an auto insurance loss.
  PDF (31KB) Forms Property & Casualty
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