Non-Waiver Agreement / Reservation Of Rights (Spanish)
The non-waiver agreement is signed by the policyholder; its purpose is to protect the insurer. Insurer reserves all of its rights under the policy to investigate and defend a claim without admission of any liability for loss.
PDF (65KB)
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)
Forms Property & Casualty
Report Of Public Liability Accident (Spanish)
This report form provides notice and details of a public premise accident.
PDF (70KB)
Forms Property & Casualty
PIP Wage & Salary Verification (Spanish)
This form is used to verify wage and salary information of a person who has applied for personl injury protection (PIP) benefits after an automobile accident.
PDF (35KB)
Forms Property & Casualty
Request For Medical Docs/Bills From Dr. (Spanish)
A form letter requesting medical documents and bills from a physician providing treatment to a claimant, sent with a medical authorization.
DOC (45KB)
Letters
Release & Authorization Of Payment (Spanish)
Used as a general release form which is signed by insureds and specifies payment to settle a claim. The release contains a statement that, as a condition of the settlement, prevents any further claim or legal action against the insurer for the loss event.
PDF (40KB)
Forms Property & Casualty
Parent/Guardian Release (Spanish)
This legal form for Parent/Guardian releases an insurer from any liability or indemnity claim for damages or injuries resulting from an accident involving a minor in exchange for a monetary settlement.
PDF (85KB)
Forms Property & Casualty
Witness Report Of Accident (Spanish)
Witness statement describing an accident in detail.
PDF (63KB)
Forms Property & Casualty
Corporation Release (Spanish)
A release and indemnity agreement for a corporation, which releases insurer from 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.
PDF (45KB)
Forms Property & Casualty
Passengers Statement (Spanish)
A passenger's statement describes persons, vehicles, injuries, driver actions and circumstances of a crash.
PDF (85KB)
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)
Forms Property & Casualty
