Claims Pages
claimspages

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 (45 KB) 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 (105 KB) Forms Property & Casualty

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 (75 KB) Forms Property & Casualty

Report Of Public Liability Accident (Spanish)

This report form provides notice and details of a public premise accident.
  PDF (70 KB) 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 (40 KB) Forms Property & Casualty

Proof Of Loss (Mobile Home) (Spanish)

A legal form documenting a claimant's property loss involving a mobile home.
  PDF (67 KB) Forms Property & Casualty


Passengers Statement (Spanish)

A passenger's statement describes persons, vehicles, injuries, driver actions and circumstances of a crash.
  PDF (85 KB) 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 (45 KB) Letters

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 (86 KB) Forms Property & Casualty

Denial - Less Than Deductible (Spanish)

A denial letter used when the value of a claim submitted is determined to be less than the insured's deductible.
  DOC (55 KB) Letters

Affidavit-Lightning Losses (Spanish)

This affidavit is filled out by a service provider who inspects a property and certifies lightning damage as the sole source of the loss. A notorized signature and witnesses are required.
  PDF (50 KB) Forms Property & Casualty