Forms and Instructions

Claims

• Incident Report (pdf)
• Liability Loss Notice (pdf) (word)
• Property Loss Report (for Buildings) (pdf)
• Property Loss Report (for Vehicles) (pdf)
• Claim Form (pdf)

Vehicle Accident Kit

• Vehicle Accident Report (pdf)
• Vehicle Accident Instructions (pdf)
• Verification of Auto Insurance (pdf)
• Memo to DMV regarding Proof of Insurance for City Vehicles (pdf)

Claim Response Letters and Releases

• Form 2 - Insufficiency Rejection Notice (pdf) (word)
• Form 3 - Normal Claim Rejection Notice (pdf) (word)
• Form 4 - No Jurisdiction Rejection Letter (pdf) (word)
• Form 5 - Late Claim / 6 Months Rejection Notice (pdf) (word)
• Form 6 - Late Claim / 1 Year Rejection Notice (pdf) (word)
• Form 7 - Reject Late Claim Application Notice (pdf) (word)
• Form 8 - Accept Late Claim Application / Reject Claim (pdf) (word)
• Form 9 - Late Claim Application is Late Notice (pdf) (word)
• Form 10 - Late Claim / Partial Rejection Notice (pdf) (word)
• Form 11 - Claim Rejection Following Insufficiency (pdf) (word)
• Claim Release Form (word)
• Property Release Form (word)
• Minor Release over $5,000 (word)
• Minor Release under $5,000 (word)