NFIP Adjuster's Final Report FEMA Form 086-0-14 (4/17)
This form is used by adjusters to document the overall flood damages to the insured's property and provide a detailed summary of the claims information.
PDF (512KB)
Catastrophe
Property
Forms Flood
Manufactured (Mobile) Home/Travel Trailer Worksheet FEMA Form 086-0-17 (4/17)
This form is used by the adjuster to record information to determine the replacement cost and actual cash value of a manufactured (mobile) home.
PDF (394KB)
Catastrophe
Property
Forms Flood
Manufactured (Mobile) Home/Travel Trailer Worksheet (Continued) FEMA Form 086-0-18 (4/17)
This form is a continuation of the Manufactured (Mobile) Home/Travel Trailer Worksheet and is used by the adjuster to record information to determine the replacement cost and actual cash value of a manufactured (mobile) home.
PDF (541KB)
Catastrophe
Property
Forms Flood
BEQ-3C (2020) Basic Earthquake Policy - Homeowners Choice
A sample California Earthquake Authority (CEA) policy which provides upgraded earthquake coverage for homeowners. Sold and serviced by participating insurance companies.
PDF (381.473KB)
Catastrophe
Property
Policy Forms
Release & Subrogation Receipt (Spanish)
A legal form signed by an insured acknowledging receipt of settlement and release of all subrogation rights to the insurer.
PDF (96KB)
Auto
Property
Spanish
Subrogation
Forms Property & Casualty
Reservation Of Rights Agreement (Spanish)
A reservation of insurer's rights to discovery, settlement, or defense in denial of a claim for loss and damages, agreed to by insured.
PDF (92KB)
Auto
Liability
Property
Spanish
Special Investigations
Forms Property & Casualty
Certificate Of Satisfaction (Spanish)
The insured signs this form which certfies his/her satisfaction with damage repairs performed, directs claim payment to that service provider, and closes the claim.
PDF (22KB)
Auto
Liability
Property
Spanish
Forms Property & Casualty
BEQ-4B (2020) Basic Earthquake Policy - Renters
A California Earthquake Authority (CEA) sample policy which provides basic earthquake coverage for renters. Sold and serviced by participating insurance companies.
PDF (352.785KB)
Catastrophe
Property
Policy Forms
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 (40KB)
Auto
Liability
Property
Spanish
Workers' Compensation
Forms Property & Casualty
California Earthquake Authority - Claim Manual 08-01-2020
The California Earthquake Authority (CEA) claim manual is designed to assist claim representatives in the investigation and settlement of earthquake claims.
PDF (1839.379KB)
Catastrophe
Property
General Reference
Release And Trust Agreement (UM/UIM PD) (Spanish)
A release form signed by an insured when making an uninsured motorist or underinsured motorist claim involving property damage.
PDF (75KB)
Liability
Property
Spanish
Subrogation
Forms Property & Casualty
Claim Acknowledgement Letter (Spanish)
A basic MS Word template letter sent as a best practice for the protection of all parties involved. The letter acknowledges receipt of the claim and requests contact with the insured or claimant.
DOC (51KB)
Auto
Liability
Property
Spanish
Workers' Compensation
Letters
Property Arbitration Filing Form
A property subrogation arbitration form.
DOC (55KB)
Property
Subrogation
Forms Property & Casualty
