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
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 (96 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
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 (92 KB)
Forms Property & Casualty
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
Statement As To Replacement Cost Coverage (Spanish)
A legal form stating the values used to calculate cost coverage for repair or replacement of a property loss.
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
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
Increased Cost of Compliance Proof of Loss FEMA Form 086-0-10 (4/17)
This form is used by the policyholder to make their statement of the amount for an Increased Cost of Compliance claim with sworn details of loss.
PDF (185 KB)
Forms Flood
Statement Of Loss W/O Enclosures (Spanish)
An adjuster's statement of a loss using Schedules A, B & C.
PDF (55 KB)
Forms Property & Casualty