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
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 (55 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
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
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
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
Emergency / Temporary Work Repair Summary (Spanish)
An emergency/temporary repair work order, including cost, provided in support of a property claim.
PDF (35 KB)
Forms Property & Casualty
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 (35 KB)
Forms Property & Casualty
Release With Medical Agreement (Spanish)
This is a contract that releases an insurer from any legal and financial responsibility for injury and liability claims after a specified time period and medical expense settlement amount is agreed upon.
PDF (75 KB)
Forms Property & Casualty
Livestock Proof Of Loss (Spanish)
A livestock Proof of Loss and settlement document.
PDF (62 KB)
Forms Property & Casualty
Statement Of Loss W/O Enclosures (Spanish)
An adjuster's statement of a loss using Schedules A, B & C.
PDF (55 KB)
Forms Property & Casualty
Statement Of Loss With Enclosures (Spanish)
An adjuster's statement of a loss using Schedules A, B & C, that includes enclosures.
PDF (50 KB)
Forms Property & Casualty