Statement Of Loss With Enclosures (Spanish)
An adjuster's statement of a loss using Schedules A, B & C, that includes enclosures.
PDF (50KB)
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
Request For Accident Report (Spanish)
Form letter used by an adjuster requesting an accident report.
DOC (39KB)
Letters
General Authorization (Spanish)
This form authorizes release of information, and requires a notary signature.
PDF (85KB)
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)
Forms Property & Casualty
Witness Report Of Accident (Spanish)
Witness statement describing an accident in detail.
PDF (63KB)
Forms Property & Casualty
Livestock Proof Of Loss (Spanish)
A livestock Proof of Loss and settlement document.
PDF (62KB)
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
Notice Of Loss - Inland Marine (Spanish)
The inland marine notice of loss form describes the circumstances and amount of loss, and is prepared by an adjuster and presented to the insurer.
PDF (35KB)
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)
Letters
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)
Forms Property & Casualty
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
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)
Forms Property & Casualty
