Claims Pages
claimspages

Request For Accident Report (Spanish)

Form letter used by an adjuster requesting an accident report.
  DOC (39KB) Letters


Release And Trust Agreement (UM/UIM PD) (Spanish)

A release form signed by an insured when making an uninsured motorist or underinsured motorist claim involving property damage.
  PDF (75KB) 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) Forms Property & Casualty

Non-Auto Liability Accident Notice (Spanish)

Non- auto liability accident notice form details personal injuries and accident circumstances.
  PDF (88KB) 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) Forms Property & Casualty

General Authorization (Spanish)

This form authorizes release of information, and requires a notary signature.
  PDF (85KB) 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) Forms Property & Casualty

Claim Acknowledgement Letter (Spanish)

A basic MS Word template letter sent as a best practice for the protection of all parties involved. The letter acknowledges receipt of the claim and requests contact with the insured or claimant.
  DOC (51KB) Letters


Denial - Less Than Deductible (Spanish)

A denial letter used when the value of a claim submitted is determined to be less than the insured's deductible.
  DOC (55KB) Letters

Employment, Wage & Med. Authorization (Spanish)

An employee authorization form allowing release of employment, wage and medical information to another party.
  PDF (85KB) 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) Forms Property & Casualty

Passengers Statement (Spanish)

A passenger's statement describes persons, vehicles, injuries, driver actions and circumstances of a crash.
  PDF (85KB) Forms Property & Casualty

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