Claims Pages
claimspages

Affidavit-Lightning Losses

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 (26 KB) Forms Property & Casualty

Claimant's Report Of Accident

This report form is given to claimants to record the details of an accident. Includes accident location, property damage, vehicle occupants, witnesses and an accident diagram.
  PDF (76 KB) Forms Property & Casualty

Car Evaluation Analysis

Appraisal form used to determine a vehicle's value after a total loss by considering the book value and local market value (dealer quotes). Add or deduct value using a comparable vehicle model, noting trim, paint, glass, tires, power options, mechanical condition and cleanliness.
  PDF (126 KB) Forms Property & Casualty



Inland Marine Proof Of Loss

Inland Marine Proof of Loss form is a legal document to be completed by an insured in support of a claim.
  PDF (33 KB) Forms Property & Casualty

Inquiry Form - Index System

This inquiry form requests claim details for a third party using an Index System.
  PDF (16 KB) Forms Property & Casualty

Parent/Guardian Release

This legal form for Parent/Guardian releases an insurer from any liability or indemnity claim for damages or injuries resulting from an accident involving a minor in exchange for a monetary settlement.
  PDF (25 KB) Forms Property & Casualty


Digital Photo Sheet 2

Form for digital photo documentation for an adjuster's file.
  DOC (28 KB) Forms Property & Casualty


Release & Authorization Of Payment

Used as a general release form which is signed by insureds and specifies payment to settle a claim. The release contains a statement that, as a condition of the settlement, prevents any further claim or legal action against the insurer for the loss event.
  PDF (26 KB) Forms Property & Casualty

Statement Of Loss W/O Enclosures

An adjuster's statement of a loss using Schedules A, B & C.
  PDF (51 KB) Forms Property & Casualty

Automobile Arbitration Contentions Sheet

An Arbitration Forums, Inc. form which is used by insurance companies when submitting an automobile claim for subrogation. The contentions sheet sets forth the legal argument that the claim is owed, and lists the evidence supporting that argument.
  DOC (28 KB) Forms Property & Casualty

Recorded Statement Analysis

A written observation describing behavior of a person making a recorded statement.
  PDF (54 KB) Forms Property & Casualty