Release & Authorization Of Payment (Spanish)
Used as a general release form which is signed by insureds and specifies payment to settle a claim. The release contains a statement that, as a condition of the settlement, prevents any further claim or legal action against the insurer for the loss event.
PDF (40 KB)
Forms Property & Casualty
Kentucky - Civilian Traffic Collision Report: KSP-232 (6/11)
This report form is used when a traffic collision was not investigated by a police officer, and is filed by those involved within ten days of the occurrence.
PDF (29 KB)
Crash Reports
Nebraska - Investigator's Motor Vehicle Accident Report: DR Form 40 (1/09)
The motor vehicle accident report used in the state of Nebraska describes persons, vehicles and environment involved in the incident. It includes code overlays, a crash diagram, crash narrative, a continuation form for additional vehicles, and a supplemental truck and bus accident report form.
PDF (1011 KB)
Crash Reports
Automobile Accident Report - NY (Spanish)
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 (55 KB)
Forms Property & Casualty
Ontario Automobile Policy O.A.P. 1 (6/16)
The Ontario Automobile Policy provides liability and property damages coverages for automobile owners. It details liability coverage, accident benefits, uninsured automobile coverage, direct compensation, optional loss or damage coverages, and statutory conditions.
PDF (574 KB)
Policy Forms
Minnesota - Accident Report - Law Enforcement Only: PS-32003-10 (1/03)
The traffic accident report form used by Minnesota law enforcement identifies persons, vehicles and environment involved, including contributing circumstances.
PDF (1040 KB)
Crash Reports
Parent/Guardian Release (Spanish)
This legal form for Parent/Guardian releases an insurer from any liability or indemnity claim for damages or injuries resulting from an accident involving a minor in exchange for a monetary settlement.
PDF (85 KB)
Forms Property & Casualty
Model Minimum Uniform Crash Criteria (MMUCC) - 2012
The Model Minimum Uniform Crash Criteria Guideline (MMUCC) is a minimum, standardized data set for describing motor vehicle crashes and the vehicles, persons and environment involved. The Guideline is designed to generate the information necessary to improve highway safety within each state and nationally.
PDF (523 KB)
Crash Reports
Employment, Wage & Med. Authorization (Spanish)
An employee authorization form allowing release of employment, wage and medical information to another party.
PDF (85 KB)
Forms Property & Casualty
Florida - Traffic Crash Report: HSMV-90010S (6/13)
A Long Form report (HSMV 90010S) in its entirety must include a Narrative/Diagram when the following criteria are met:
- Resulted in death of, personal injury to, or any indication of complaints of pain or discomfort by any of the
parties or passengers involved in the crash;
- Leaving the scene involving damage to attended vehicles or property (F.S. 316.061(1));
- Driving while under the influence (F.S. 316.193);
- Rendered a vehicle inoperable to a degree that required a wrecker to remove it from the scene of the crash; or
- Involved a commercial motor vehicle. The Short Form (HSMV 90010S) designation is used to report other types of traffic crashes.
PDF (370 KB)
Crash Reports
Non-Waiver Agreement / Reservation Of Rights (Spanish)
The non-waiver agreement is signed by the policyholder; its purpose is to protect the insurer. Insurer reserves all of its rights under the policy to investigate and defend a claim without admission of any liability for loss.
PDF (65 KB)
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 (25 KB)
Forms Property & Casualty
