PIP Application - Florida No Fault
Application form for Florida personal injury protection (PIP) No Fault benefits.
PDF (38KB)
Forms Property & Casualty
PIP Wage & Salary Verification
This form is used to verify wage and salary information of a person who has applied for personl injury protection (PIP) benefits after an automobile accident.
PDF (33KB)
Forms Property & Casualty
Blood Alcohol Content Chart
Reference chart showing what a person's blood alcohol content may be, based on the number of drinks consumed within an hour. Includes a person's weight as a factor.
PDF (14KB)
General Reference
New York - Police Accident Report Codes MV-104COV (11/13)
Decipher motor vehicle accident reports in New York with ease using the MV-104COV (11/13) code sheet, a vital resource for claims adjusters and legal professionals. This document lays out crucial codes for assessing accident locations, conditions, vehicle types, damages, and injuries, streamlining the analysis of complex accident reports for efficient claims resolution.
PDF (188KB)
Crash Reports
Notice Under Subrogation Rights
Claim form used to notify an individual of subrogation rights of an insurer for an auto insurance loss.
PDF (13KB)
Forms Property & Casualty
Acknowledgement Of Assignment
Generic form used by independent adjusters to acknowledge receipt of a property insurance claim, and provide a preliminary report to the insurance company.
PDF (23KB)
Forms Property & Casualty
Request For Accident Report
Form letter used by an adjuster requesting an accident report.
DOC (17KB)
Letters
Daily Time Sheet
A daily time sheet to record claims work, hours, mileage and expenses.
PDF (91KB)
Forms Property & Casualty
Employment-Wage Authorization
A person uses this form to authorize an employer to release his or her employment and wage records to a third party.
PDF (12KB)
Forms Property & Casualty
Attending Physician's Report
A physician treating a person seeking medical benefits under an automobile insurance policy must complete this report.
PDF (55KB)
Forms Property & Casualty
Accident Scene Diagram - Freeway/Highway Onramp
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 freeway/highway onramp.
DOC (2175KB)
Diagrams
