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)
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)
Forms Property & Casualty
PIP Application - Florida No Fault (Spanish)
Application form for Florida personal injury protection (PIP) No Fault benefits.
PDF (45KB)
Forms Property & Casualty
Acknowledgement Of Assignment
Generic form used by independent adjusters to acknowledge receipt of a property insurance claim, and provide a preliminary report to the insurance company.
PDF (23KB)
Forms Property & Casualty
Daily Time Sheet
A daily time sheet to record claims work, hours, mileage and expenses.
PDF (91KB)
Forms Property & Casualty
Property Arbitration Filing Form
A property subrogation arbitration form.
DOC (55KB)
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)
Forms Property & Casualty
Reservation Of Rights Agreement
A reservation of insurer's rights to discovery, settlement, or defense in denial of a claim for loss and damages, agreed to by insured.
PDF (19KB)
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)
Forms Property & Casualty
Vehicle Repair Order
Agreement and authorization between insured and automotive shop to repair a damaged vehicle within the estimated dollar amount.
PDF (15KB)
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)
Forms Property & Casualty
Proof Of Loss (Mobile Home)
A legal form documenting a claimant's property loss involving a mobile home.
PDF (50KB)
Forms Property & Casualty
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)
Forms Property & Casualty
Proof Of Loss Medical Payment (Spanish)
A declaration by an insured person that itemizes payments made for medical services after an accident which qualify for medical expense coverage under the policy.
PDF (34KB)
Forms Property & Casualty
