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
Power Of Attorney (Auto) (Spanish)
This is a limited power of attorney which grants the insurer permission to transfer title for a specific vehicle on the owner's behalf.
PDF (65 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
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
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
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 (80 KB)
Forms Property & Casualty
Proof Of Loss (Burglary) (Spanish)
A sworn statement by a policyholder on a theft claim which lists the items stolen and their values. Filled out and notarized, this is a formal request by the insured for payment from the insurance company.
PDF (94 KB)
Forms Property & Casualty
