Claims Pages
claimspages

Adjusters Report/Certification

The Adjusters Report/Certification documents the insured property's location, date and type of loss, and summarizes replacement cost and A.C.V. for buildings, structural, contents and additional living expense, with line item detail.
  PDF (47KB) Forms Property & Casualty

Proof Of Loss (Burglary)

A sworn statement by a policyholder on a theft claim which lists the items stolen and their values. Filled out and notarized, this is a formal request by the insured for payment from the insurance company.
  PDF (46KB) Forms Property & Casualty

Daily Time Sheet

A daily time sheet to record claims work, hours, mileage and expenses.
  PDF (91KB) Forms Property & Casualty

Landlord/Tenant Subrogation in All 50 States (9/16)

The ability of a landlord’s property insurer to subrogate against a tenant for property damage caused by the negligence of the tenant depends on which state the loss occurs in and the nature and language of the lease involved. Understanding when, where, and why such subrogation actions by a landlord’s insurer against a tenant are permitted or prohibited is critical to maximizing property subrogation recoveries and is the focus of this chart.
  PDF (42KB) Legal Reference

Notice Of Loss Burglary-Robbery-Theft

A loss report form filled out by an insured when reporting a theft claim to an insurance company. Includes circumstances of the theft, and a list of items claimed as stolen with declared values.
  PDF (47KB) Forms Property & Casualty

Square Foot Conversion Chart

Table lists square footage calculations based upon linear measurements of up to thirty feet.
  PDF (15KB) General Reference

Acknowledgement Of Assignment

Generic form used by independent adjusters to acknowledge receipt of a property insurance claim, and provide a preliminary report to the insurance company.
  PDF (23KB) Forms Property & Casualty


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) Forms Flood


Statement Of Loss With Enclosures

An adjuster's statement of a loss using Schedules A, B & C, that includes enclosures.
  PDF (61KB) Forms Property & Casualty


Guidelines and Requested Data for Electrical Systems at Fire Scenes

A guide for fire scene investigation of electrical systems.
  PDF (21KB) Forms Property & Casualty

National Flood Insurance Program - Adjuster Claims Manual - Part IV

The NFIP Adjuster Claims Manual Part IV contains claims forms.
  PDF (4354KB) Forms Flood

Emergency / Temporary Work Repair Summary

An emergency/temporary repair work order, including cost, provided in support of a property claim.
  PDF (17KB) Forms Property & Casualty
Monty Fire Investigations LLCHancock Claims ConsultantsU.S. Forensic