Hold Harmless Agreement
This is a contract that releases one party from any legal and financial responsibility for all loss or damage or future claims by the other party in exchange for a settlement.
PDF (20KB)
Liability
Property
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 (33KB)
Property
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 (126KB)
Auto
Forms Property & Casualty
Inquiry Form - Index System
This inquiry form requests claim details for a third party using an Index System.
PDF (16KB)
Liability
Forms Property & Casualty
Notice Of Loss Burglary-Robbery-Theft
A loss report form filled out by an insured when reporting a theft claim to an insurance company. Includes circumstances of the theft, and a list of items claimed as stolen with declared values.
PDF (47KB)
Property
Forms Property & Casualty
Release Of All Claims
A full release form which is signed by claimants and releases insureds from bodily injury and property damage 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, or any other parties, for the event.
PDF (28KB)
Liability
Forms Property & Casualty
Vehicle Inspection Report
Auto Examiner or Adjuster's vehicle inspection report form.
PDF (22KB)
Auto
Forms Property & Casualty
Claim Register Sheet
Basic registry form for logging when claims are received and closed.
PDF (83KB)
Auto
Liability
Property
Workers' Compensation
Forms Property & Casualty
Automobile Accident Promissory Note
Customized automobile subrogation promissory note which allows the insurance company to notify DMV/BMV in case of default by the tortfeasor.
PDF (17KB)
Auto
Liability
Subrogation
Forms Property & Casualty
Adjuster's File Invoice
An invoice form used by independent adjusting firms that lists claims investigation expenses billable to the client insurance company.
PDF (48KB)
Auto
Liability
Property
Workers' Compensation
Forms Property & Casualty
Statement Of Loss With Enclosures
An adjuster's statement of a loss using Schedules A, B & C, that includes enclosures.
PDF (61KB)
Property
Forms Property & Casualty
