Subrogation Receipt (Spanish)
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 (28KB)
Forms Property & Casualty
PIP Wage & Salary Verification (Spanish)
This form is used to verify wage and salary information of a person who has applied for personl injury protection (PIP) benefits after an automobile accident.
PDF (35KB)
Forms Property & Casualty
Statement Of Loss With Enclosures (Spanish)
An adjuster's statement of a loss using Schedules A, B & C, that includes enclosures.
PDF (50KB)
Forms Property & Casualty
Insured's Statement In Burglary Loss (Spanish)
A written statement by the insured detailing a burglary loss claim involving a residence or automobile.
PDF (55KB)
Forms Property & Casualty
Employer Occupational Injury And Disease Report (Spanish)
Basic reporting form used by an employer to record an employee's injury or illness on the job.
PDF (50KB)
Forms Property & Casualty
Vehicle Repair Order (Spanish)
Agreement and authorization between insured and automotive shop to repair a damaged vehicle within the estimated dollar amount.
PDF (35KB)
Forms Property & Casualty
Statement As To Replacement Cost Coverage (Spanish)
A legal form stating the values used to calculate cost coverage for repair or replacement of a property loss.
PDF (35KB)
Forms Property & Casualty
Affidavit-Lightning Losses (Spanish)
This affidavit is filled out by a service provider who inspects a property and certifies lightning damage as the sole source of the loss. A notorized signature and witnesses are required.
PDF (50KB)
Forms Property & Casualty
Memorandum For Appraisal (Spanish)
Memorandum for Appraisal is used in property damage situations where insured and insurer disagree on actual cash value, and is binding on the parties as to the amount of loss.
PDF (60KB)
Forms Property & Casualty
Sworn Statement In Proof Of Loss (w/Subrogation) (Spanish)
A notarized statement of the money claimed for a loss under a property coverage policy, which includes giving insurer the right to recovery.
PDF (75KB)
Forms Property & Casualty
Michigan WC Forms
A collection of workers' compensation forms which are authorized to be used in the state of Michigan.
PDF (0KB)
Forms Property & Casualty
Minnesota WC Forms
A collection of workers' compensation forms which are authorized to be used in the state of Minnesota.
PDF (0KB)
Forms Property & Casualty
