Claims Pages
claimspages

Statement Of Loss W/O Enclosures

An adjuster's statement of a loss using Schedules A, B & C.
  PDF (51KB) Forms Property & Casualty

Structural Fire - Investigating Officer

Statement guideline for interviewing the investigating officer in a structural fire claim. Includes initial questions and follow up questions based on responses given.
  PDF (17KB) Statement Guides




Customer's Claim & Affidavit

Damage to customer's property is included under a commercial general liability policy; this form describes items lost, seller, purchase date and depreciation. The claim amount is submitted with signature of customer and adjuster.
  PDF (59KB) Forms Property & Casualty

Structural Fire - Witness

Statement guideline for interviewing a witness to a structural fire. Includes initial questions and follow up questions based on responses given.
  PDF (19KB) Statement Guides

Hold Harmless Agreement

This is a contract that releases one party from any legal and financial responsibility for all loss or damage or future claims by the other party in exchange for a settlement.
  PDF (20KB) Forms Property & Casualty

Subrogation Receipt

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 (27KB) Forms Property & Casualty

Statement As To Replacement Cost Coverage

A legal form stating the values used to calculate cost coverage for repair or replacement of a property loss.
  PDF (26KB) Forms Property & Casualty

Non-Waiver Agreement / Reservation Of Rights

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 (36KB) Forms Property & Casualty

Coinsurance Definition And Formula

Coinsurance formula and sample calculation for a property claim where the insured did not maintain the required minimum coverage (usually 80% of value) on a structure.
  PDF (38KB) General Reference

4 Column Adjuster Worksheet

Financial worksheet for calculating a repair estimate, with one column to itemize losses, and 4 columns for replacement cost, quantity or age, depreciation, and actual cash value.
  PDF (79KB) Forms Property & Casualty


Living/Family Room Diagram

This Microsoft Word template allows users to add and resize a variety of objects including walls, windows, couches, chairs, and tables.
  DOC (68KB) Diagrams
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