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)
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 (59KB)
Forms Property & Casualty
Statement Of Loss W/O Enclosures
An adjuster's statement of a loss using Schedules A, B & C.
PDF (51KB)
Forms Property & Casualty
Witness Report Of Accident
Witness statement describing an accident in detail.
PDF (42KB)
Forms Property & Casualty
Automobile Accident Report
Report form that is given to vehicle owners and drivers to capture the details of an accident. Includes occupants, injuries, property damages and witnesses.
PDF (70KB)
Forms Property & Casualty
Property Arbitration Contentions Sheet
A property subrogation arbitration form.
DOC (28KB)
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)
Forms Property & Casualty
Assignment Sheet
Generic form for assigning an automobile claim to an independent adjuster for investigation and handling. The form lists the insurance company, insured, claimant, endorsements, vehicle details, date and description of loss, and contact information for all parties involved.
PDF (47KB)
Forms Property & Casualty
Non-Waiver Agreement / Reservation Of Rights
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 (36KB)
Forms Property & Casualty
Vehicle Inspection Report
Auto Examiner or Adjuster's vehicle inspection report form.
PDF (22KB)
Forms Property & Casualty
