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

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) Liability Spanish 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

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

Request For Accident Report (Spanish)

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

Affidavit Of Vehicle Theft (Spanish)

This legal form must be filled out by the insured and notarized. Includes information on vehicle ownership, description & condition, financing, as well as details regarding the theft and police report.
  PDF (85KB) Auto Spanish 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) Auto Salvage Spanish Forms Property & Casualty

PIP Application - Florida No Fault (Spanish)

Application form for Florida personal injury protection (PIP) No Fault benefits.
  PDF (45KB) Liability Spanish Forms Property & Casualty

Denial - No Coverage (Spanish)

This form letter identifies the claimant, insurer, adjuster and date of loss; it is a claim denial for lack of coverage under the insured's policy.
  DOC (45KB) Auto Liability Property Spanish Letters

Power Of Attorney (Auto) (Spanish)

This is a limited power of attorney which grants the insurer permission to transfer title for a specific vehicle on the owner's behalf.
  PDF (65KB) Auto Salvage 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

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