Claims Pages
claimspages

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 (50 KB) Forms Property & Casualty

Oklahoma WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of Oklahoma.
  PDF (0 KB) Forms Property & Casualty

South Dakota WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of South Dakota.
  PDF (0 KB) Forms Property & Casualty

Pennsylvania WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of Pennsylvania.
  PDF (0 KB) 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 (35 KB) Forms Property & Casualty

Ohio WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of Ohio.
  PDF (0 KB) Forms Property & Casualty

Passengers Statement (Spanish)

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

Proof Of Loss (Mobile Home) (Spanish)

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

General Authorization (Spanish)

This form authorizes release of information, and requires a notary signature.
  PDF (85 KB) 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 (96 KB) Forms Property & Casualty


Statement Of Loss W/O Enclosures (Spanish)

An adjuster's statement of a loss using Schedules A, B & C.
  PDF (55 KB) Forms Property & Casualty

Notice Of Loss - Inland Marine (Spanish)

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 (35 KB) 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 (50 KB) Forms Property & Casualty