Claims Pages
claimspages

Vehicle Fire - Insured

Statement guideline for interviewing the insured in a vehicle fire claim. Includes initial questions and follow up questions based on responses given.
  PDF (22KB) Statement Guides

Personal Property Summary Chart

The personal property summary itemizes rooms and areas in a house, with columns to calculate repair cost, actual cash value and replacement cost.
  PDF (79KB) Forms Property & Casualty

Adjuster's Log Sheet

Daily log to document adjuster activity on a specific claim.
  PDF (26KB) Forms Property & Casualty

Homeowner Theft - Insured

Statement guideline for interviewing the insured in a residential theft claim. Includes initial questions and follow up questions based on responses given.
  PDF (17KB) Statement Guides

Subrogation Letter To Insurer

A subrogation letter sent to an at-fault party's insurer requests reimbursement for automobile damages paid to an insured.
  DOC (18KB) Letters

Timeline Template - Horizontal

Create your own time line using this Microsoft Excel template. Just enter dates and labels.
  XLS (57KB) Forms Property & Casualty

Claim Activity Log

This MS Word form is used to document activity on an individual claim.
  DOC (39KB) Forms Property & Casualty

Guarantee Of Title

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 (18KB) Letters

Dog Bite Injury - Insured

Statement guideline for interviewing the insured in a dog bite injury claim. Includes initial questions and follow up questions based on responses given.
  PDF (15KB) Statement Guides

Acknowledgement Of Representation

This is an MS Word template letter to acknowledge notification of legal representation of a claimant. Most commonly used in PIP or bodily injury claims, where there is a potential for coverage dispute litigation.
  DOC (17KB) Letters

Insured's Release

The release form identifies all parties to a claim, states the date of the occurrence, 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 action against the insurer for the claim event in question.
  PDF (23KB) Forms Property & Casualty

Release & Subrogation Receipt

A legal form signed by an insured acknowledging receipt of settlement and release of all subrogation rights to the insurer.
  PDF (29KB) Forms Property & Casualty

Accident Scene Diagram - 4 Lane Highway

Craft precise accident scene diagrams with our 'Accident Scene Diagram - 4 Lane Highway' template. Designed for Microsoft Word, this tool enables you to visualize and document vehicular accidents with ease. From detailed road layouts to customizable vehicle icons, transform complex scenes into clear, comprehensive diagrams. Ideal for insurance claims, legal cases, and safety assessments, ensure accuracy and clarity in every report. Dive into a user-friendly experience that brings your accident scene analysis to the next level.
  DOC (700KB) Diagrams

PIP Application For Benefits

This application form to obtain personal injury protection benefits requests information regarding claimant's employment, income, injury, treatment dates and medical bills received, plus any loss of wages due to the accident.
  PDF (33KB) Forms Property & Casualty

Affidavit-Lightning Losses

This affidavit is filled out by a service provider who inspects a property and certifies lightning damage as the sole source of the loss. A notorized signature and witnesses are required.
  PDF (26KB) Forms Property & Casualty
Monty Fire Investigations LLCU.S. ForensicKelmar Global