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
Automobile Accident/Loss Notice
A loss report form filled out by insureds and/or agents when reporting an automobile accident. Includes information on occupants, injuries, damages, accident description and witnesses.
PDF (65KB)
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)
Crash Reports
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)
Diagrams
New York - Report Of Motor Vehicle Accident: MV-104 (7/05)
Driver's self-report form for an accident in New York.
PDF (66KB)
Crash Reports
Automobile Turn Signal Diagram
Technical diagram showing the operation of a standard turn signal on an automobile
PDF (21KB)
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)
Diagrams
New York City - Police Accident Report (NYC): MV-104AN (7/01)
The New York Police accident report describes the persons, vehicles and circumstances involved, and includes damages, injuries and an accident diagram.
PDF (1640KB)
Crash Reports
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
Automobile Arbitration Filing Form
An Arbitration Forums, Inc. form which is used by insurance companies when submitting an automobile claim for subrogation. Shows the Applicant and Respondent information, and includes a list of contentions setting forth the legal argument that the claim is owed with supporting evidence.
DOC (91KB)
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
Request For Copy Of Tax Return IRS Form 4506 (7/17)
IRS Form 4506 Request for Copy of Tax Return
PDF (43KB)
Forms Property & Casualty
Adjuster Assignment Form - Fax
Generic fax form sent to an independent adjuster with details of a claim assignment. It allows for a full or limited assignment and lists specific actions required by the adjuster, such as loss verification, photos, scene diagram, statements, subrogation investigation, vehicle appraisals, and settlements.
DOC (33KB)
Forms Property & Casualty
Massachusetts - Motor Vehicle Crash Report Codes
Codes used to decipher the Commonwealth of Massachusetts motor vehicle crash report.
PDF (488KB)
Crash Reports
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
