Spanish Insurance Claims Documents (Page 4)

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 (55KB) Liability Spanish Forms Property & Casualty

Employment-Wage Authorization (Spanish)

A person uses this form to authorize an employer to release his or her employment and wage records to a third party.

PDF (86KB) Liability Spanish Workers' Compensation Forms Property & Casualty

General Authorization (Spanish)

This form authorizes release of information, and requires a notary signature.

PDF (85KB) Liability Spanish Special Investigations Workers' Compensation Forms Property & Casualty

Automobile Proof Of Loss (Spanish)

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 (86KB) Auto Liability Spanish Forms Property & Casualty

Schedule Of Contents (Spanish)

A contents inventory form, with columns to itemize place and date of purchase, cost, condition, actual value and amount claimed.

PDF (40KB) Property Spanish Forms Property & Casualty

Non-Injury Automobile Statement (Minor) (Spanish)

PDF (60KB) Liability Spanish 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 (80KB) Liability Spanish Workers' Compensation Forms Property & Casualty

General Release (Husband & Wife) (Spanish)

A legal form that absolves an insurer from any further liability for a claim upon acceptance of a settlement amount by a married couple.

PDF (105KB) Liability Spanish Forms Property & Casualty

Guarantee Of Title (Spanish)

For a case involving a total loss or theft of a financed motor vehicle or boat, this is an agreement that the lien holder will provide a lien free Certificate of Title to the insurance company upon receipt of a claim payment.

PDF (20KB) Auto Liability Spanish Forms Property & Casualty

Reservation Of Rights Agreement (Spanish)

A reservation of insurer's rights to discovery, settlement, or defense in denial of a claim for loss and damages, agreed to by insured.

PDF (92KB) Auto Liability Property Spanish Special Investigations Forms Property & Casualty

Corporation Release (Spanish)

A release and indemnity agreement for a corporation, which releases insurer from liability which arose out of an accident, casualty or event. The release form identifies all parties to a claim, states the date and location of the event, and details the terms of settlement of a claim. The release contains a statement that, as a condition of the settlement, prevents any further claim or legal action against the insurer.

PDF (45KB) Liability Spanish Forms Property & Casualty

Release & Authorization Of Payment (Spanish)

Used as a general release form which is signed by insureds and specifies payment to settle a claim. The release contains a statement that, as a condition of the settlement, prevents any further claim or legal action against the insurer for the loss event.

PDF (40KB) Auto Liability Property Spanish Workers' Compensation Forms Property & Casualty