Arbitration Contentions Sheet

The Arbitration Contentions form lists supporting evidence and damage amount in dispute, and is used by both the filing applicant and the respondent.
  DOC (28KB) Liability Forms Property & Casualty

Medical Authorization (HIPAA Compliant) (Spanish)

Authorization form for disclosure of medical records, in compliance with HIPAA requirements.
  PDF (76KB) Liability Spanish Workers' Compensation Forms Property & Casualty

Attending Physician's Report

A physician treating a person seeking medical benefits under an automobile insurance policy must complete this report.
  PDF (55KB) Liability Workers' Compensation Forms Property & Casualty

Statement As To Replacement Cost Coverage

A legal form stating the values used to calculate cost coverage for repair or replacement of a property loss.
  PDF (26KB) Property Forms Property & Casualty

Proof Of Loss (Mobile Home)

A legal form documenting a claimant's property loss involving a mobile home.
  PDF (50KB) Property Forms Property & Casualty

Daily Time Sheet

A daily time sheet to record claims work, hours, mileage and expenses.
  PDF (91KB) Auto Liability Property Workers' Compensation 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 (28KB) Auto Subrogation Forms Property & Casualty

Release With Medical Agreement

This is a contract that releases an insurer from any legal and financial responsibility for injury and liability claims after a specified time period and medical expense settlement amount is agreed upon.
  PDF (28KB) Liability Forms Property & Casualty

Automobile Accident Report (Spanish)

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 (97KB) Auto Liability Spanish Forms Property & Casualty

Notice Under Subrogation Rights

Claim form used to notify an individual of subrogation rights of an insurer for an auto insurance loss.
  PDF (13KB) Auto Liability Subrogation Forms Property & Casualty

Vehicle Bill Of Sale

The vehicle bill of sale is a document that records transaction between buyer and seller. Bill of sale includes vehicle type, make, year, vehicle identification number (VIN) and purchase price.
  PDF (20KB) Auto Salvage Forms Property & Casualty

PIP Application - Florida No Fault

Application form for Florida personal injury protection (PIP) No Fault benefits.
  PDF (38KB) Liability Forms Property & Casualty

Adjuster's Loss Certification and Apportionment of Claim

This form is used to recommend to the insurer the amount of payment for a loss, and apportionment when a property is covered by two or more insurance companies.
  PDF (21KB) Liability Property Forms Property & Casualty

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