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
Statement As To Replacement Cost Coverage (Spanish)
A legal form stating the values used to calculate cost coverage for repair or replacement of a property loss.
PDF (35 KB)
Forms Property & Casualty
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
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
Report Of Public Liability Accident (Spanish)
This report form provides notice and details of a public premise accident.
PDF (70 KB)
Forms Property & Casualty
Notice Of Loss Burglary-Robbery-Theft (Spanish)
A loss report form filled out by an insured when reporting a theft claim to and insurance company. Includes circumstances of the theft, and a list of items claimed as stolen with declared values.
PDF (80 KB)
Forms Property & Casualty
Witness Report Of Accident (Spanish)
Witness statement describing an accident in detail.
PDF (63 KB)
Forms Property & Casualty
Reservation Of Rights Letter (Spanish)
The reservation of rights letter notifies the policyholder that the insurer reserves the right to deny coverage of a claim, in whole or part, pending outcome of a claims investigation.
DOC (57 KB)
Letters
Proof Of Loss Medical Payment (Spanish)
A declaration by an insured person that itemizes payments made for medical services after an accident which qualify for medical expense coverage under the policy.
PDF (34 KB)
Forms Property & Casualty
