Recorded Statement Summary
A summary of a recorded statement.
PDF (22KB)
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Liability
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Workers' Compensation
Forms Property & Casualty
Reservation Of Rights Letter
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 (19KB)
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Liability
Property
Special Investigations
Workers' Compensation
Letters
State Insurance Law Chart
State Insurance Law Chart
PDF (82KB)
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Legislation & Regulation
Liability
Property
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Legal Reference
Adjuster's Log Sheet
Daily log to document adjuster activity on a specific claim.
PDF (26KB)
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Workers' Compensation
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Law Digest Guides
The Insurance Law Digest is a series of PDF files that provide summaries of insurance laws for each U.S. state and the Canadian province.
PDF (KB)
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Legislation & Regulation
Liability
Property
Workers' Compensation
General Reference
Medical Authorization (HIPAA Compliant)
Authorization form for disclosure of medical records, in compliance with HIPAA requirements.
PDF (16KB)
Liability
Workers' Compensation
Forms Property & Casualty
Workers' Compensation Accident - Employee
Statement guideline for interviewing the employee/claimant in a workers' compensation claim. Includes initial questions and follow up questions based on responses given.
PDF (15KB)
Workers' Compensation
Statement Guides
Digital Photo Sheet 1
Form for digital photo documentation for an adjuster's file.
DOC (25KB)
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Request For Medical Docs/Bills From Dr.
A form letter requesting medical documents and bills from a physician providing treatment to a claimant, sent with a medical authorization.
DOC (17KB)
Liability
Workers' Compensation
Letters
Claim Activity Log
This MS Word form is used to document activity on an individual claim.
DOC (39KB)
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Workers' Compensation
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Timeline Template - Horizontal
Create your own time line using this Microsoft Excel template. Just enter dates and labels.
XLS (57KB)
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Liability
Property
Special Investigations
Workers' Compensation
Forms Property & Casualty
Digital Photo Sheet 2
Form for digital photo documentation for an adjuster's file.
DOC (28KB)
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Liability
Property
Workers' Compensation
Forms Property & Casualty
Length Of Injury Table
Estimates of length of disability time for different types of injuries over a range of severities.
PDF (28KB)
Liability
Workers' Compensation
Medical Reference
Adjuster Status Report
Short form for reporting the current status of a claim. Typically used by an independent adjuster.
PDF (30KB)
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