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

Inquiry Form - Index System

This inquiry form requests claim details for a third party using an Index System.
  PDF (16 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

Digital Photo Sheet 2

Form for digital photo documentation for an adjuster's file.
  DOC (28 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



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



Customer's Claim & Affidavit

Damage to customer's property is included under a commercial general liability policy; this form describes items lost, seller, purchase date and depreciation. The claim amount is submitted with signature of customer and adjuster.
  PDF (59 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