Non-Waiver Agreement / Reservation Of Rights (Spanish)
The non-waiver agreement is signed by the policyholder; its purpose is to protect the insurer. Insurer reserves all of its rights under the policy to investigate and defend a claim without admission of any liability for loss.
PDF (65KB)
Auto
Liability
Property
Spanish
Workers' Compensation
Forms Property & Casualty
Maryland WC Forms
A collection of workers' compensation forms which are authorized to be used in the state of Maryland.
PDF (0KB)
Workers' Compensation
Forms Property & Casualty
Attendance Record
Provides a daily record of an employee’s attendance and provides space/codes for noting reasons for any absences.
DOC (78KB)
Management & Underwriting
Forms Property & Casualty
Power Of Attorney (Auto) (Spanish)
This is a limited power of attorney which grants the insurer permission to transfer title for a specific vehicle on the owner's behalf.
PDF (65KB)
Auto
Salvage
Spanish
Forms Property & Casualty
Automobile Accident/Loss Notice (Spanish)
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 (78KB)
Auto
Liability
Spanish
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)
Liability
Spanish
Forms Property & Casualty
Livestock Proof Of Loss
A livestock Proof of Loss and settlement document.
PDF (50KB)
Property
Forms Property & Casualty
Proof Of Loss Medical Payment
A declaration by an insured person that itemizes payments made for medical services after an accident which qualify for medical expense coverage under the policy.
PDF (24KB)
Liability
Forms Property & Casualty
Georgia WC Forms
A collection of workers' compensation forms which are authorized to be used in the state of Georgia.
PDF (0KB)
Workers' Compensation
Forms Property & Casualty
Illinois WC Forms
A collection of workers' compensation forms which are authorized to be used in the state of Illinois.
PDF (0KB)
Workers' Compensation
Forms Property & Casualty
Request For Transcript Of Tax Return IRS Form 4506-T (7/17)
IRS Form 4506-T Request for Transcript of Tax Return
PDF (44KB)
Auto
Liability
Property
Workers' Compensation
Forms Property & Casualty
