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.

BROWSE RELATED DOCUMENT LISTINGS

Property Loss Notice - (ACORD)

Property Loss Notice form from ACORD.

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.

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.

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.

Automobile Accident/Loss Notice

A loss report form filled out by insureds and/or agents when reporting an automobile accident. Includes information on occupants, injuries, damages, accident description and witnesses.

Automobile Accident/Loss Notice (Spanish)

A loss report form filled out by insureds and/or agents when reporting an automobile accident. Includes information on occupants, injuries, damages, accident description and witnesses.