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

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.
  PDF (75KB) Liability Spanish Forms Property & Casualty

Release & Subrogation Receipt (Spanish)

A legal form signed by an insured acknowledging receipt of settlement and release of all subrogation rights to the insurer.
  PDF (96KB) Auto Property Spanish Subrogation 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

Proof Of Loss Medical Payment (Spanish)

A declaration by an insured person that itemizes payments made for medical services after an accident which qualify for medical expense coverage under the policy.
  PDF (34KB) 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

Reservation Of Rights Letter (Spanish)

The reservation of rights letter notifies the policyholder that the insurer reserves the right to deny coverage of a claim, in whole or part, pending outcome of a claims investigation.
  DOC (57KB) Auto Liability Property Spanish Special Investigations Letters

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.
  PDF (25KB) 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

Request For Accident Report (Spanish)

Form letter used by an adjuster requesting an accident report.
  DOC (39KB) Auto Liability Spanish Letters

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

Non-Auto Liability Accident Notice (Spanish)

Non- auto liability accident notice form details personal injuries and accident circumstances.
  PDF (88KB) Liability Spanish Forms Property & Casualty

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

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