Complete Release Of All Claims (Spanish)

A full release and indemnity agreement which is signed by claimants and releases insurer from bodily injury and property damage liability which arose out of an accident, casualty or event. The release form identifies all parties to a claim, states the date and location of the event, 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 legal action against the insurer, or any other parties, for the event, and against the release.
  PDF (95KB) Liability Spanish Forms Property & Casualty

Medical Authorization (HIPAA Compliant) (Spanish)

Authorization form for disclosure of medical records, in compliance with HIPAA requirements.
  PDF (76KB) Liability Spanish Workers' Compensation Forms Property & Casualty

Death Claims Investigation Checklist

A checklist helpful for establishing whether an insured is dead or alive, with research techniques to identify motives in possible cases of life insurance fraud.
  PDF (51KB) Life & Health Spanish General Reference

Request For Contact (Spanish)

Form letter requesting claimant to contact adjuster.
  DOC (90KB) Auto Liability Property Spanish Workers' Compensation Letters

Automobile Accident Report (Spanish)

Report form that is given to vehicle owners and drivers to capture the details of an accident. Includes occupants, injuries, property damages and witnesses.
  PDF (97KB) Auto Liability Spanish Forms Property & Casualty

Subrogation Letter To Individual/Business (Spanish)

A subrogation letter sent to an at-fault party requests reimbursement for automobile losses paid to insured.
  DOC (25KB) Auto Liability Ocean Marine Spanish Subrogation Letters

Claimant's Report Of Accident (Spanish)

This report form is given to claimants to record the details of an accident. Includes accident location, property damage, vehicle occupants, witnesses and an accident diagram.
  PDF (87KB) Auto Liability Spanish Forms Property & Casualty

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.
  PDF (65KB) Auto Liability Spanish Subrogation Forms Property & Casualty

Drivers Statement (Spanish)

A driver's written statement of sequence of events and collision information.
  PDF (71KB) Auto Liability Spanish Forms Property & Casualty

Passengers Statement (Spanish)

A passenger's statement describes persons, vehicles, injuries, driver actions and circumstances of a crash.
  PDF (85KB) Auto Liability Spanish Forms Property & Casualty

PIP Application For Benefits (Spanish)

This application form to obtain personal injury protection benefits requests information regarding claimant's employment, income, injury, treatment dates and medical bills received, plus any loss of wages due to the accident.
  PDF (45KB) Liability Spanish 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

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