Claims Pages
claimspages

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 (82 KB) Forms Property & Casualty

Witness Statement (Spanish)

This written statement is prepared by an accident witness. It documents all details they can recall about the accident scene, including any statements made by parties involved.
  PDF (95 KB) Forms Property & Casualty

North Dakota WC Forms

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

Washington WC Forms

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

Indiana WC Forms

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

Sworn Statement In Proof Of Loss (No Subrogation) (Spanish)

A notarized statement of the money requested for a loss under a property coverage policy.
  PDF (85 KB) Forms Property & Casualty

Utah WC Forms

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

Livestock Proof Of Loss (Spanish)

A livestock Proof of Loss and settlement document.
  PDF (62 KB) Forms Property & Casualty

Proof Of Loss Medical Payment (Spanish)

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 (34 KB) Forms Property & Casualty

Proof Of Loss (Burglary) (Spanish)

A sworn statement by a policyholder on a theft claim which lists the items stolen and their values. Filled out and notarized, this is a formal request by the insured for payment from the insurance company.
  PDF (94 KB) Forms Property & Casualty

Vermont WC Forms

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

South Carolina WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of South Carolina.
  PDF (0 KB) 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 (80 KB) Forms Property & Casualty