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 (24 KB)
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 (33 KB)
Forms Property & Casualty
Request For Accident Report
Form letter used by an adjuster requesting an accident report.
DOC (17 KB)
Letters
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 (1640 KB)
Crash Reports
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 (14 KB)
Statement Guides
Event Data Recorders - Vehicle List
This list of vehicles equipped with crash data recorders is current through 2014.
PDF (46 KB)
General Reference
Georgia - Uniform Vehicle Accident Report Overlay: DOT-523 Overlay
Code sheet used to decipher the Vehicle Accident Report for Georgia.
PDF (48 KB)
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 (2175 KB)
Diagrams
Ontario (Canada) - Motor Vehicle Accident Codes
This code sheet is used to decipher the motor vehicle accident report from Ontario, Canada. Codes detail location, roadway surface condition, environmental conditions, traffic control, pre-accident actions, type of accident, safety equipment used, vehicle type, damage, and injuries.
PDF (360 KB)
Crash Reports
Notice Under Subrogation Rights (Spanish)
Claim form used to notify an individual of subrogation rights of an insurer for an auto insurance loss.
PDF (31 KB)
Forms Property & Casualty
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 (702 KB)
Diagrams
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 (105 KB)
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 (19 KB)
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 (15 KB)
Statement Guides
Drivers Statement (Spanish)
A driver's written statement of sequence of events and collision information.
PDF (71 KB)
Forms Property & Casualty
