Claims Pages
claimspages

Adjuster's File Invoice

An invoice form used by independent adjusting firms that lists claims investigation expenses billable to the client insurance company.
  PDF (48KB) Forms Property & Casualty

Assignment Sheet

Generic form for assigning an automobile claim to an independent adjuster for investigation and handling. The form lists the insurance company, insured, claimant, endorsements, vehicle details, date and description of loss, and contact information for all parties involved.
  PDF (47KB) Forms Property & Casualty

Release With Medical Agreement

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 (28KB) Forms Property & Casualty



Automobile Proof Of Loss

A policyholder must provide this sworn statement in support of an automobile claim. The notarized form documents the date and cause of loss, vehicle identification, settlement amount, and reserves subrogation and other rights of the insurer.
  PDF (46KB) Forms Property & Casualty

Notice Of Loss Burglary-Robbery-Theft

A loss report form filled out by an insured when reporting a theft claim to an insurance company. Includes circumstances of the theft, and a list of items claimed as stolen with declared values.
  PDF (47KB) Forms Property & Casualty

Proof Of Loss (Burglary)

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 (46KB) Forms Property & Casualty


Automobile Arbitration Contentions Sheet

An Arbitration Forums, Inc. form which is used by insurance companies when submitting an automobile claim for subrogation. The contentions sheet sets forth the legal argument that the claim is owed, and lists the evidence supporting that argument.
  DOC (28KB) Forms Property & Casualty

Claim Register Sheet

Basic registry form for logging when claims are received and closed.
  PDF (83KB) Forms Property & Casualty

Property Arbitration Contentions Sheet

A property subrogation arbitration form.
  DOC (28KB) Forms Property & Casualty


Statement Of Loss With Enclosures

An adjuster's statement of a loss using Schedules A, B & C, that includes enclosures.
  PDF (61KB) Forms Property & Casualty

Vehicle Bill Of Sale

The vehicle bill of sale is a document that records transaction between buyer and seller. Bill of sale includes vehicle type, make, year, vehicle identification number (VIN) and purchase price.
  PDF (20KB) Forms Property & Casualty
Monty Fire Investigations LLCHancock Claims ConsultantsNationwide Overspray