Release & Trust Agreement (UM/UIM BI) (Spanish)
A release form signed by an insured when making an uninsured motorist or underinsured motorist claim. Requires the insured to cooperate in the recovery of funds from the responsible party.
PDF (65KB)
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)
Forms Property & Casualty
Release And Trust Agreement (UM/UIM PD)
A release form signed by an insured when making an uninsured motorist or underinsured motorist claim involving property damage.
PDF (24KB)
Forms Property & Casualty
Guidelines and Requested Data for Electrical Systems at Fire Scenes
A guide for fire scene investigation of electrical systems.
PDF (21KB)
Forms Property & Casualty
Hold Harmless Agreement (Spanish)
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 (82KB)
Forms Property & Casualty
Drivers Statement (Spanish)
A driver's written statement of sequence of events and collision information.
PDF (71KB)
Forms Property & Casualty
Automobile Accident Report - NY
Report form, customized for New York, that is given to vehicle owners and drivers to capture the details of an accident. Includes occupants, injuries, property damages, crash diagram, driver's account of accident, and witnesses.
PDF (71KB)
Forms Property & Casualty
Notice Under Subrogation Rights (Spanish)
Claim form used to notify an individual of subrogation rights of an insurer for an auto insurance loss.
PDF (31KB)
Forms Property & Casualty
Request For Copy Of Tax Return IRS Form 4506 (7/17)
IRS Form 4506 Request for Copy of Tax Return
PDF (43KB)
Forms Property & Casualty
Adjuster Assignment Form - Fax
Generic fax form sent to an independent adjuster with details of a claim assignment. It allows for a full or limited assignment and lists specific actions required by the adjuster, such as loss verification, photos, scene diagram, statements, subrogation investigation, vehicle appraisals, and settlements.
DOC (33KB)
Forms Property & Casualty
South Carolina - Accident and Insurance Inquiry Forms (Financial Responsibility)
South Carolina Department of Motor Vehicles Accident and Insurance Inquiry forms relating to Financial Responsibility.
PDF (251KB)
Forms Property & Casualty
Automobile Accident Promissory Note (Spanish)
Customized automobile subrogation promissory note which allows the insurance company to notify DMV/BMV in case of default by the tortfeasor.
PDF (56KB)
Forms Property & Casualty
Medical Authorization (HIPAA Compliant) (Spanish)
Authorization form for disclosure of medical records, in compliance with HIPAA requirements.
PDF (76KB)
Forms Property & Casualty
