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)
Liability
Property
Spanish
Subrogation
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
Non-Auto Liability Accident Notice (Spanish)
Non- auto liability accident notice form details personal injuries and accident circumstances.
PDF (88KB)
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
Covenant Not To Sue (Spanish)
Thus is an agreement by an injured party to not pursue a lawsuit against another party in exchange for a settlement.
PDF (40KB)
Liability
Spanish
Forms Property & Casualty
Report Of Public Liability Accident (Spanish)
This report form provides notice and details of a public premise accident.
PDF (70KB)
Auto
Liability
Spanish
Forms Property & Casualty
PIP Wage & Salary Verification (Spanish)
This form is used to verify wage and salary information of a person who has applied for personl injury protection (PIP) benefits after an automobile accident.
PDF (35KB)
Liability
Spanish
Forms Property & Casualty
Request For Medical Docs/Bills From Dr. (Spanish)
A form letter requesting medical documents and bills from a physician providing treatment to a claimant, sent with a medical authorization.
DOC (45KB)
Liability
Spanish
Workers' Compensation
Letters
Parent/Guardian Release (Spanish)
This legal form for Parent/Guardian releases an insurer from any liability or indemnity claim for damages or injuries resulting from an accident involving a minor in exchange for a monetary settlement.
PDF (85KB)
Liability
Spanish
Forms Property & Casualty
Witness Report Of Accident (Spanish)
Witness statement describing an accident in detail.
PDF (63KB)
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
