Claims Pages
claimspages

Passengers Statement (Spanish)

A passenger's statement describes persons, vehicles, injuries, driver actions and circumstances of a crash.
  PDF (85KB) Forms Property & Casualty

Proof Of Loss (Mobile Home) (Spanish)

A legal form documenting a claimant's property loss involving a mobile home.
  PDF (67KB) Forms Property & Casualty


Notice Of Loss - Inland Marine

The inland marine notice of loss form describes the circumstances and amount of loss, and is prepared by an adjuster and presented to the insurer.
  PDF (25KB) Forms Property & Casualty

Virginia WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of Virginia.
  PDF (0KB) 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

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

Emergency / Temporary Work Repair Summary (Spanish)

An emergency/temporary repair work order, including cost, provided in support of a property claim.
  PDF (35KB) Forms Property & Casualty

Release & Subrogation Receipt (Spanish)

A legal form signed by an insured acknowledging receipt of settlement and release of all subrogation rights to the insurer.
  PDF (96KB) Forms Property & Casualty

Non-Waiver Agreement (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 (82KB) Forms Property & Casualty


Covenant Not To Sue (Spanish)

Thus is an agreement by an injured party to not pursue a lawsuit against another party in exchange for a settlement.
  PDF (40KB) Forms Property & Casualty


Report Of Public Liability Accident (Spanish)

This report form provides notice and details of a public premise accident.
  PDF (70KB) Forms Property & Casualty

Texas WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of Texas.
  PDF (0KB) Forms Property & Casualty
Monty Fire Investigations LLCNationwide OversprayWeller Salvage