Daily Time Sheet

A daily time sheet to record claims work, hours, mileage and expenses.
  PDF (91KB) Auto Liability Property Workers' Compensation Forms Property & Casualty

Proof Of Loss (Mobile Home)

A legal form documenting a claimant's property loss involving a mobile home.
  PDF (50KB) Property 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) Property Forms Property & Casualty

Reservation Of Rights Agreement

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 (19KB) Auto Liability Property Special Investigations Workers' Compensation Forms Property & Casualty

Adjuster's Loss Certification and Apportionment of Claim

This form is used to recommend to the insurer the amount of payment for a loss, and apportionment when a property is covered by two or more insurance companies.
  PDF (21KB) Liability Property Forms Property & Casualty

Certificate Of Satisfaction

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 (25KB) Auto Property Forms Property & Casualty

Notice Of Loss - Inland Marine

The inland marine notice of loss form describes the circumstances and amount of loss, and is prepared by an adjuster and presented to the insurer.
  PDF (25KB) Property Forms Property & Casualty

Emergency / Temporary Work Repair Summary

An emergency/temporary repair work order, including cost, provided in support of a property claim.
  PDF (17KB) Property Forms Property & Casualty

Notice Of Loss Burglary-Robbery-Theft (Spanish)

A loss report form filled out by an insured when reporting a theft claim to and insurance company. Includes circumstances of the theft, and a list of items claimed as stolen with declared values.
  PDF (80KB) Property Spanish 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 (95KB) Auto Property Spanish Forms Property & Casualty

Guidelines and Requested Data for Electrical Systems at Fire Scenes

A guide for fire scene investigation of electrical systems.
  PDF (21KB) Property Technology Forms Property & Casualty

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