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)
Forms Property & Casualty
Request For Contact (Spanish)
Form letter requesting claimant to contact adjuster.
DOC (90KB)
Letters
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)
Letters
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)
General Reference
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)
Forms Property & Casualty
Release Of All Claims (Spanish)
A full release form which is signed by claimants and releases insureds 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.
PDF (80KB)
Forms Property & Casualty
PIP Application - Florida No Fault (Spanish)
Application form for Florida personal injury protection (PIP) No Fault benefits.
PDF (45KB)
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)
Forms Property & Casualty
Affidavit Of Salvage Retention (Spanish)
Acknowledgment by the current owner that his vehicle has been declared a total loss, and that he/she has elected to retain the salvage for a specific sum of monies. Towing and storage charges are also specified.
PDF (68KB)
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)
Forms Property & Casualty
Hold Harmless Agreement (Spanish)
This is a contract that releases one party from any legal and financial responsibility for all loss or damage or future claims by the other party in exchange for a settlement.
PDF (82KB)
Forms Property & Casualty
Notice Under Subrogation Rights (Spanish)
Claim form used to notify an individual of subrogation rights of an insurer for an auto insurance loss.
PDF (31KB)
Forms Property & Casualty
Drivers Statement (Spanish)
A driver's written statement of sequence of events and collision information.
PDF (71KB)
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)
Forms Property & Casualty
