claims
pages
Toggle dark mode
Account settings
Press
/
to focus
Service Providers
Browse Directory
View Provider Roster
Add Your Business
Daily Claims Resources
Tools & Databases
News Articles
Document Downloads
Event Calendar
Career Listings
Storm Watch
Industry Editorials
Press Releases
Technology
Newsletters
External Resources
Receipt & Release Medical Payments Coverage
Sign-In To Download
PDF (21KB)
Forms Property & Casualty
This form is signed by those who qualify as insureds under a policy when collecting medical payments coverage. Used as both a receipt and a release.
Recent Provider Listings
LT Painting Service, Inc
Serving Hillsborough County
Florida
Painting Contractors
A & A Plumbing, Heating & Cooling
Texas
Air Conditioning Contractors & Systems
Heating & Air Conditioning Contractors
Leak Detection
SOS Ladder Assist
Serving the US
National
Ladder Assist
Roof Measuring & Diagramming Service
Recent Claims News
Rising Distracted Driving Trends: Insights from Arity’s Henry Kowal
Auto
Insurance Industry
Risk Management
Roofing Professionals Discuss Challenges and Solutions for Longer-Lasting Roofs
Catastrophe
Insurance Industry
Property
Florida Insurers Face Legal Challenges for Employing Unlicensed Adjusters After Hurricane Irma
Insurance Industry
Legislation & Regulation
Litigation