A declaration by an insured person that itemizes payments made for medical services after an accident which qualify for medical expense coverage under the policy.
A declaration by an insured person that itemizes payments made for medical services after an accident which qualify for medical expense coverage under the policy.
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.
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.
A policyholder must provide this sworn statement in support of an automobile claim. The notarized form documents the date and cause of loss, vehicle identification, settlement amount, and reserves subrogation and other rights of the insurer.
Inland Marine Proof of Loss form is a legal document to be completed by an insured in support of a claim.
A livestock Proof of Loss and settlement document.