Acknowledgement Of Representation
This is an MS Word template letter to acknowledge notification of legal representation of a claimant. Most commonly used in PIP or bodily injury claims, where there is a potential for coverage dispute litigation.
DOC (17KB)
Letters
Bodily Injury Reserve Worksheet
A MS Word form to track bodily injury claim reserve modifications by date, showing who authorized each change, is used to project costs associated with claim settlement.
DOC (54KB)
Forms Property & Casualty
Snow/Ice Slip And Fall - Claimant
Statement guideline for interviewing the claimant in a slip and fall claim involving snow/ice. Includes initial questions and follow up questions based on responses given.
PDF (17KB)
Statement Guides
Accident Scene Diagram - 4 Lane Highway
Craft precise accident scene diagrams with our 'Accident Scene Diagram - 4 Lane Highway' template. Designed for Microsoft Word, this tool enables you to visualize and document vehicular accidents with ease. From detailed road layouts to customizable vehicle icons, transform complex scenes into clear, comprehensive diagrams. Ideal for insurance claims, legal cases, and safety assessments, ensure accuracy and clarity in every report. Dive into a user-friendly experience that brings your accident scene analysis to the next level.
DOC (700KB)
Diagrams
Employment, Wage & Med. Authorization
An employee authorization form allowing release of employment, wage and medical information to another party.
PDF (17KB)
Forms Property & Casualty
Staircase Slip And Fall - Claimant
Statement guideline for interviewing a claimant in a staircase slip and fall claim. Includes initial questions and follow up questions based on responses given.
PDF (16KB)
Statement Guides
Driver’s Statement
This form provides all the details of an accident per the driver’s written and signed account of the incident.
PDF (112.742KB)
Forms Property & Casualty
PIP Application For Benefits
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 (33KB)
Forms Property & Casualty
Release & Trust Agreement (UM/UIM BI)
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 (24KB)
Forms Property & Casualty
Subrogation Letter To Individual/Business
A subrogation letter sent to an at-fault party requests reimbursement for automobile losses paid to insured.
DOC (18KB)
Letters
Adjuster Status Report
Short form for reporting the current status of a claim. Typically used by an independent adjuster.
PDF (30KB)
Forms Property & Casualty
Accident Scene Diagram - Parking Lot
This Microsoft Word template allows users to sketch an accident scene by adding and resizing a variety of objects including vehicles, traffic signs, and other symbols and figures in a parking lot.
DOC (186KB)
Diagrams
Digital Photo Sheet 2
Form for digital photo documentation for an adjuster's file.
DOC (28KB)
Forms Property & Casualty
Release & Authorization Of Payment
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 (26KB)
Forms Property & Casualty
Product Liability - Manufacturer/Distributor
Statement guideline for interviewing the manufacturer or distributor in a products liability claim. Includes initial questions and follow up questions based on responses given.
PDF (13KB)
Statement Guides
