Property Loss Worksheet (Spanish)
Use this worksheet to inventory property and content losses, and obtain an estimate of replacement costs. It contains columns to factor in age, original cost, replacement cost and depreciation to calculate ACV (actual cash value).
PDF (91KB)
Property
Forms Property & Casualty
Automobile Accident/Loss Notice
A loss report form filled out by insureds and/or agents when reporting an automobile accident. Includes information on occupants, injuries, damages, accident description and witnesses.
PDF (65KB)
Auto
Liability
Forms Property & Casualty
Claimant's Report Of Accident (Spanish)
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 (87KB)
Auto
Liability
Spanish
Forms Property & Casualty
Release Of All Claims (Spanish)
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 (80KB)
Liability
Spanish
Forms Property & Casualty
PIP Application - Florida No Fault (Spanish)
Application form for Florida personal injury protection (PIP) No Fault benefits.
PDF (45KB)
Liability
Spanish
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
PIP Application - Florida No Fault
Application form for Florida personal injury protection (PIP) No Fault benefits.
PDF (38KB)
Liability
Forms Property & Casualty
PIP Application For Benefits (Spanish)
This application form to obtain personal injury protection benefits requests information regarding claimant's employment, income, injury, treatment dates and medical bills received, plus any loss of wages due to the accident.
PDF (45KB)
Liability
Spanish
Forms Property & Casualty
Property Arbitration Filing Form
A property subrogation arbitration form.
DOC (55KB)
Property
Subrogation
Forms Property & Casualty
Employment-Wage Authorization
A person uses this form to authorize an employer to release his or her employment and wage records to a third party.
PDF (12KB)
Liability
Workers' Compensation
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
Report Of Public Liability Accident
This report form provides notice and details of a public premise accident.
PDF (40KB)
Auto
Liability
Forms Property & Casualty
