New York WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of New York.
  PDF (0KB) Workers' Compensation Forms Property & Casualty

Insured's Release (Spanish)

The release form identifies all parties to a claim, states the date of the occurrence, 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 action against the insurer for the claim event in question.
  PDF (95KB) Auto Property Spanish 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) Liability Spanish Forms Property & Casualty

Notice Of Loss Burglary-Robbery-Theft (Spanish)

A loss report form filled out by an insured when reporting a theft claim to and insurance company. Includes circumstances of the theft, and a list of items claimed as stolen with declared values.
  PDF (80KB) Property Spanish Forms Property & Casualty

Power Of Attorney (Auto) (Spanish)

This is a limited power of attorney which grants the insurer permission to transfer title for a specific vehicle on the owner's behalf.
  PDF (65KB) Auto Salvage Spanish Forms Property & Casualty

Receipt & Release Medical Payments Coverage (Spanish)

This form is signed by those who qualify as insureds under a policy when collecting medical payments coverage. Used as both a receipt and a release.
  PDF (25KB) Liability Spanish 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) Auto Liability Forms Property & Casualty

Attendance Record

Provides a daily record of an employee’s attendance and provides space/codes for noting reasons for any absences.
  DOC (78KB) Management & Underwriting Forms Property & Casualty

Vehicle Bill Of Sale (Spanish)

The vehicle bill of sale is a document that records transaction between buyer and seller, identified by name and address. Bill of sale includes vehicle type, make, model, year, odometer reading, vehicle identification number (VIN) and purchase price.
  PDF (26KB) Auto Salvage Forms Property & Casualty

California WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of California.
  PDF (0KB) Workers' Compensation Forms Property & Casualty

Georgia WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of Georgia.
  PDF (0KB) 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

Covenant Not To Sue

Thus is an agreement by an injured party to not pursue a lawsuit against another party in exchange for a settlement.
  PDF (21KB) Liability Forms Property & Casualty

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