Witness Report Of Accident (Spanish)
Witness statement describing an accident in detail.
PDF (63KB)
Forms Property & Casualty
Corporation Release (Spanish)
A release and indemnity agreement for a corporation, which releases insurer from liability which arose out of an accident, casualty or event. The release form identifies all parties to a claim, states the date and location of the event, and details the terms of settlement of a claim. The release contains a statement that, as a condition of the settlement, prevents any further claim or legal action against the insurer.
PDF (45KB)
Forms Property & Casualty
New York WC Forms
A collection of workers' compensation forms which are authorized to be used in the state of New York.
PDF (0KB)
Forms Property & Casualty
Ohio WC Forms
A collection of workers' compensation forms which are authorized to be used in the state of Ohio.
PDF (0KB)
Forms Property & Casualty
Proof Of Loss (Medical Expense)
A declaration by an insured person that he/she was not being transported for a fee at the time of the accident, and otherwise qualifies for medical expense coverage under the policy.
PDF (32KB)
Forms Property & Casualty
Reservation Of Rights Agreement (Spanish)
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 (92KB)
Forms Property & Casualty
Employment, Wage & Med. Authorization (Spanish)
An employee authorization form allowing release of employment, wage and medical information to another party.
PDF (85KB)
Forms Property & Casualty
PIP Attending Physician's Report (Spanish)
The attending physician report form is used by an insurer to determine if a person is due benefits under personal injury protection (PIP) law.
PDF (55KB)
Forms Property & Casualty
Release With Medical Agreement (Spanish)
This is a contract that releases an insurer from any legal and financial responsibility for injury and liability claims after a specified time period and medical expense settlement amount is agreed upon.
PDF (75KB)
Forms Property & Casualty
Guarantee Of Title (Spanish)
For a case involving a total loss or theft of a financed motor vehicle or boat, this is an agreement that the lien holder will provide a lien free Certificate of Title to the insurance company upon receipt of a claim payment.
PDF (20KB)
Forms Property & Casualty
General Release (Husband & Wife) (Spanish)
A legal form that absolves an insurer from any further liability for a claim upon acceptance of a settlement amount by a married couple.
PDF (105KB)
Forms Property & Casualty
Customer's Claim & Affidavit (Spanish)
Damage to customer's property is included under a commercial general liability policy; this form describes items lost, seller, purchase date and depreciation. The claim amount is submitted with signature of customer and adjuster.
PDF (61KB)
Forms Property & Casualty
Attending Physician's Report (Spanish)
A form which is filled out by the attending physician in order to qualify for medical benefits under an automobile insurance policy. (Spanish version of English form 3160F)
PDF (80KB)
Forms Property & Casualty
