Inquiry Form - Index System
This inquiry form requests claim details for a third party using an Index System.
PDF (16KB)
Liability
Forms Property & Casualty
Med Pay / PIP Subrogation in All 50 States
This chart provides an overview of subrogation rights for PIP and/or Med Pay-type benefits paid under the automobile insurance laws of all 50 states.
PDF (40KB)
Liability
Litigation
Ocean Marine
Subrogation
Legal Reference
Reaction And Braking Distance Table
Basic reference table displaying reaction and braking distances for vehicles traveling at a specific speed.
PDF (11KB)
Auto
Liability
General Reference
Snow/Ice Slip And Fall - Witness
Statement guideline for interviewing a witness to a slip and fall claim involving snow/ice. Includes initial questions and follow up questions based on responses given.
PDF (16KB)
Liability
Statement Guides
Claimant's Report Of Accident
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 (76KB)
Auto
Liability
Forms Property & Casualty
Snow/Ice Slip And Fall - Insured
Statement guideline for interviewing the insured in a slip and fall claim on snow/ice. Includes initial questions and follow up questions based on responses given.
PDF (16KB)
Liability
Statement Guides
Release Of All Claims
A full release form which is signed by claimants and releases insureds from bodily injury and property damage liability which arose out of an accident, casualty or event. The release form identifies all parties to a claim, states the date and location of the event, 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 legal action against the insurer, or any other parties, for the event.
PDF (28KB)
Liability
Forms Property & Casualty
Witness Report Of Accident
Witness statement describing an accident in detail.
PDF (42KB)
Auto
Liability
Forms Property & Casualty
Non-Waiver Agreement / Reservation Of Rights
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 (36KB)
Auto
Liability
Property
Workers' Compensation
Forms Property & Casualty
Staircase Slip And Fall - Insured
Statement guideline for interviewing the insured in a staircase slip and fall claim. Includes initial questions and follow up questions based on responses given.
PDF (15KB)
Liability
Statement Guides
Accident Scene Diagram - T - Intersection
This Microsoft Word template allows users to sketch an accident scene by adding and resizing a variety of objects including roads, vehicles, traffic signs, road signals and other symbols and figures in a T-intersection.
DOC (2286KB)
Auto
Liability
Diagrams
Product Liability - Witness
Statement guideline for interviewing a witness to a products liablity claim. Includes initial questions and follow up questions based on responses given.
PDF (15KB)
Liability
Statement Guides
Hold Harmless Agreement
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 (20KB)
Liability
Property
Forms Property & Casualty
