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
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
Automobile Accident Promissory Note (Spanish)
Customized automobile subrogation promissory note which allows the insurance company to notify DMV/BMV in case of default by the tortfeasor.
PDF (56KB)
Auto
Liability
Spanish
Subrogation
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
Employment, Wage & Med. Authorization (Spanish)
An employee authorization form allowing release of employment, wage and medical information to another party.
PDF (85KB)
Liability
Spanish
Workers' Compensation
Forms Property & Casualty
Claim Acknowledgement Letter (Spanish)
A basic MS Word template letter sent as a best practice for the protection of all parties involved. The letter acknowledges receipt of the claim and requests contact with the insured or claimant.
DOC (51KB)
Auto
Liability
Property
Spanish
Workers' Compensation
Letters
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.
PDF (75KB)
Liability
Property
Spanish
Subrogation
Forms Property & Casualty
Automobile Proof Of Loss (Spanish)
A policyholder must provide this sworn statement in support of an automobile claim. The notarized form documents the date and cause of loss, vehicle identification, settlement amount, and reserves subrogation and other rights of the insurer.
PDF (86KB)
Auto
Liability
Spanish
Forms Property & Casualty
General Release (Husband & Wife) (Spanish)
A legal form that absolves an insurer from any further liability for a claim upon acceptance of a settlement amount by a married couple.
PDF (105KB)
Liability
Spanish
Forms Property & Casualty
Covenant Not To Sue (Spanish)
Thus is an agreement by an injured party to not pursue a lawsuit against another party in exchange for a settlement.
PDF (40KB)
Liability
Spanish
Forms Property & Casualty
Reservation Of Rights Agreement (Spanish)
A reservation of insurer's rights to discovery, settlement, or defense in denial of a claim for loss and damages, agreed to by insured.
PDF (92KB)
Auto
Liability
Property
Spanish
Special Investigations
Forms Property & Casualty
Certificate Of Satisfaction (Spanish)
The insured signs this form which certfies his/her satisfaction with damage repairs performed, directs claim payment to that service provider, and closes the claim.
PDF (22KB)
Auto
Liability
Property
Spanish
Forms Property & Casualty
Witness Report Of Accident (Spanish)
Witness statement describing an accident in detail.
PDF (63KB)
Auto
Liability
Spanish
Forms Property & Casualty
