Release With Medical Agreement (Spanish)

This is a contract that releases an insurer from any legal and financial responsibility for injury and liability claims after a specified time period and medical expense settlement amount is agreed upon.

BROWSE RELATED DOCUMENT LISTINGS

Release With Medical Agreement

This is a contract that releases an insurer from any legal and financial responsibility for injury and liability claims after a specified time period and medical expense settlement amount is agreed upon.

Receipt & Release Medical Payments Coverage (Spanish)

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.

Release & Trust Agreement (UM/UIM BI) (Spanish)

A release form signed by an insured when making an uninsured motorist or underinsured motorist claim. Requires the insured to cooperate in the recovery of funds from the responsible party.

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.

Employment, Wage & Med. Authorization

An employee authorization form allowing release of employment, wage and medical information to another party.