Claims Pages
claimspages

Texas Limited POA For Eligible Motor Vehicle Transactions VTR-271 (8/17)

This document gives the insurance company legal authority to transfer title of a vehicle that has been declared a total loss, and sell it for salvage.
  PDF (24KB) Forms Property & Casualty

Uninsured Motorist Arbitration Filing Form

An arbitration request form for a disagreement involving an uninsured motorist that includes allegations, contentions and supporting evidence.
  DOC (37KB) Forms Property & Casualty

Michigan WC Forms

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

Minnesota WC Forms

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


New York WC Forms

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

Pennsylvania WC Forms

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

Proof Of Loss (Medical Expense)

A declaration by an insured person that he/she was not being transported for a fee at the time of the accident, and otherwise qualifies for medical expense coverage under the policy.
  PDF (32KB) Forms Property & Casualty

Inland Marine Proof Of Loss (Spanish)

Inland Marine Proof of Loss form is a legal document to be completed by an insured in support of a claim.
  PDF (50KB) Forms Property & Casualty

Affidavit Of Vehicle Theft (Spanish)

This legal form must be filled out by the insured and notarized. Includes information on vehicle ownership, description & condition, financing, as well as details regarding the theft and police report.
  PDF (85KB) Forms Property & Casualty

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

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

Certificate Of Satisfaction (Spanish)

The insured signs this form which certfies his/her satisfaction with damage repairs performed, directs claim payment to that service provider, and closes the claim.
  PDF (22KB) Forms Property & Casualty
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