Memorandum For Appraisal (Spanish)
Memorandum for Appraisal is used in property damage situations where insured and insurer disagree on actual cash value, and is binding on the parties as to the amount of loss.
PDF (60 KB)
Forms Property & Casualty
Affidavit-Lightning Losses (Spanish)
This affidavit is filled out by a service provider who inspects a property and certifies lightning damage as the sole source of the loss. A notorized signature and witnesses are required.
PDF (50 KB)
Forms Property & Casualty
Insurance Fraud Legislation Update 2017
Status report on state legislation for insurance fraud bills.
PDF (60 KB)
Legal Reference
Denial - Less Than Deductible (Spanish)
A denial letter used when the value of a claim submitted is determined to be less than the insured's deductible.
DOC (55 KB)
Letters
Subrogation Receipt (Spanish)
A subrogation receipt is signed by the insured upon payment of a claim, and assigns the insurer to the right to recovery for the loss.
PDF (28 KB)
Forms Property & Casualty
Emergency / Temporary Work Repair Summary (Spanish)
An emergency/temporary repair work order, including cost, provided in support of a property claim.
PDF (35 KB)
Forms Property & Casualty
Non-Waiver Agreement / Reservation Of Rights (Spanish)
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 (65 KB)
Forms Property & Casualty
Sworn Statement In Proof Of Loss (w/Subrogation) (Spanish)
A notarized statement of the money claimed for a loss under a property coverage policy, which includes giving insurer the right to recovery.
PDF (75 KB)
Forms Property & Casualty
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 (75 KB)
Forms Property & Casualty
Insured's Release (Spanish)
The release form identifies all parties to a claim, states the date of the occurrence, 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 action against the insurer for the claim event in question.
PDF (95 KB)
Forms Property & Casualty
CEA 04A Endorsement Coverage for Breakables
A sample California Earthquake Authority (CEA) endorsement which provides a optional coverage to forms BEQ-3B, BEQ-3C, BEQ-6B, and BEQ-4B. Sold and serviced by participating insurance companies.
PDF (657.99 KB)
Policy Forms
Worksheet-Building FEMA Form 086-0-7 (4/17)
This form is used by adjusters and policyholders to list and assess the scope of flood damaged building property.
PDF (383 KB)
Forms Flood
