Workers' Compensation Accident - Employer
Statement guideline for interviewing the employer in a claim for workers' compensaton. Includes initial questions and follow up questions based on responses given.
PDF (16KB)
Workers' Compensation
Statement Guides
Workers' Compensation Accident - Witness
Statement guideline for interviewing a witness to a workers' compensaton injury. Includes initial questions and follow up questions based on responses given.
PDF (17KB)
Workers' Compensation
Statement Guides
Acknowledgement Of Assignment
Generic form used by independent adjusters to acknowledge receipt of a property insurance claim, and provide a preliminary report to the insurance company.
PDF (23KB)
Auto
Liability
Property
Workers' Compensation
Forms Property & Casualty
Human Internal Organ Chart
A visual chart showing the placement of the stomach, intestines, lungs, heart, galbladder and other human internal organs.
PDF (290KB)
Liability
Workers' Compensation
Medical Reference
Medical Authorization (HIPAA Compliant) (Spanish)
Authorization form for disclosure of medical records, in compliance with HIPAA requirements.
PDF (76KB)
Liability
Spanish
Workers' Compensation
Forms Property & Casualty
Attending Physician's Report
A physician treating a person seeking medical benefits under an automobile insurance policy must complete this report.
PDF (55KB)
Liability
Workers' Compensation
Forms Property & Casualty
Request For Contact (Spanish)
Form letter requesting claimant to contact adjuster.
DOC (90KB)
Auto
Liability
Property
Spanish
Workers' Compensation
Letters
