Witness Report Of Accident (Spanish)

Witness statement describing an accident in detail.
  PDF (63KB) Auto 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

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

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) Liability Spanish Workers' Compensation Letters

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) Auto Liability Property Spanish Workers' Compensation 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) Liability Spanish 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

PIP Attending Physician's Report (Spanish)

The attending physician report form is used by an insurer to determine if a person is due benefits under personal injury protection (PIP) law.
  PDF (55KB) Liability Spanish Forms Property & Casualty

Guarantee Of Title (Spanish)

For a case involving a total loss or theft of a financed motor vehicle or boat, this is an agreement that the lien holder will provide a lien free Certificate of Title to the insurance company upon receipt of a claim payment.
  PDF (20KB) Auto Liability Spanish Forms Property & Casualty

Employment-Wage Authorization (Spanish)

A person uses this form to authorize an employer to release his or her employment and wage records to a third party.
  PDF (86KB) Liability Spanish Workers' Compensation Forms Property & Casualty

General Authorization (Spanish)

This form authorizes release of information, and requires a notary signature.
  PDF (85KB) Liability Spanish Special Investigations Workers' Compensation Forms Property & Casualty

Attending Physician's Report (Spanish)

A form which is filled out by the attending physician in order to qualify for medical benefits under an automobile insurance policy. (Spanish version of English form 3160F)
  PDF (80KB) Liability Spanish Workers' Compensation Forms Property & Casualty

Memorandum For Appraisal (Spanish)

Memorandum for Appraisal is used in property damage situations where insured and insurer disagree on actual cash value, and is binding on the parties as to the amount of loss.
  PDF (60KB) Auto Property Spanish Forms Property & Casualty

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