National Flood Insurance Program - Adjuster Claims Manual - Part II
NFIP Adjuster Claims Manual Part II
PDF (8908KB)
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National Flood Insurance Program - Adjuster Claims Manual - Part IV
The NFIP Adjuster Claims Manual Part IV contains claims forms.
PDF (4354KB)
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Worksheet Contents Personal Property FEMA Form 086-0-6 (4/17)
The adjuster and the policyholder list and assess the inventory of flood-damaged personal property on this form.
PDF (471KB)
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NFIP Adjuster Certification Application FEMA Form 086-0-21 (4/17)
This form is used to collect information from individuals seeking to become certified flood adjusters.
PDF (453KB)
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Adjuster Preliminary Flood Damage Assessment FEMA Form 086-0-20 (4/17)
This form is used by adjusters to list potentially substantial damaged structures in preparation for possible ICC claims.
PDF (229KB)
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Proof of Loss FEMA Form 086-0-9 (4/17)
A Proof of Loss is a policyholder’s statement of the amount of money being requested, signed to and sworn to by the policyholder with documentation to support the amount requested.
PDF (404KB)
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Statement as to Full Cost of Repair or Replacement FEMA Form 086-0-12 (4/14)
This form is used to document the full repair or replacement cost of an insured property.
PDF (388KB)
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Notice of Loss FEMA Form 086-0-11 (4/17)
This form allows insurance agents or brokers to document damages caused by flood-related hazards to structures covered by the National Flood Insurance Program.
PDF (416KB)
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Cause of Loss and Subrogation Report FEMA Form 086-0-16 (04/17)
The adjuster uses this form to identify potentially responsible third parties and their actions that may have caused worsened flood damage. This includes looking at foundation grading and adequacy of sewer lines.
PDF (475KB)
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Subrogation
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NFIP Adjuster's Final Report FEMA Form 086-0-14 (4/17)
This form is used by adjusters to document the overall flood damages to the insured's property and provide a detailed summary of the claims information.
PDF (512KB)
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Worksheet-Building FEMA Form 086-0-7 (4/17)
This form is used by adjusters and policyholders to list and assess the scope of flood damaged building property.
PDF (383KB)
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Worksheet-Building (Continued) FEMA Form 086-0-8 (4/17)
This form is a continuation sheet used by the adjuster and policyholder to list and assess the amount of building property damage.
PDF (331KB)
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Increased Cost of Compliance Proof of Loss FEMA Form 086-0-10 (4/17)
This form is used by the policyholder to make their statement of the amount for an Increased Cost of Compliance claim with sworn details of loss.
PDF (185KB)
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Increased Cost of Compliance (ICC) Adjusters Report FEMA Form 086-0-19 (4/17)
This form provides FEMA with information regarding substantial damage, mitigation measures, repetitive loss and cost associated with compliance to floodplain management ordinances.
PDF (401KB)
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Manufactured (Mobile) Home/Travel Trailer Worksheet FEMA Form 086-0-17 (4/17)
This form is used by the adjuster to record information to determine the replacement cost and actual cash value of a manufactured (mobile) home.
PDF (394KB)
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