Proof of loss: what the form asks for, with a free worksheet

What is a proof of loss?

A proof of loss, or sworn statement in proof of loss, is the formal version of your claim. You state when and how the loss happened, what it would cost to put right, and what you are asking the insurer to pay, and you swear that it is true. Many insurers ask for it to be notarized.

Not every claim needs one. Insurers usually ask for it on larger claims, disputed ones, and flood claims, where FEMA's own form is required. When your insurer asks, it becomes a condition of being paid.

What goes on a proof of loss form?

Forms differ between insurers, but most ask for the same things:

• Your policy number, the claim number and the date of the loss.
• The cause, in a few words: kitchen fire, burst pipe, break-in.
• The full cost of replacement, which is the total of your inventory at today's prices.
• The depreciation taken off, and the actual cash value that leaves.
• Your deductible, and the net amount you are claiming.
• Any other insurance on the same property, and payments you have already received.

Attach your contents list and any estimates. The figures on the form should match them line for line.

Working out the figures

The money lines on the form run in a fixed order. Here is a contents claim worked through:

The depreciation figure usually comes from the insurer's own schedule. Our guide to reading a depreciation schedule explains how it is worked out and how to question a line. The deductible is on your declarations page.

Free proof of loss worksheet

Is there a deadline?

Usually, yes. Many homeowners policies give you 60 days from when the insurer asks for a proof of loss. Flood policies count from the date of the loss instead. Check your policy for the time limit that applies to you, and ask your adjuster to confirm it in writing.

If you can't finish in time, ask for an extension in writing before the deadline passes. Insurers often agree, especially when you are still waiting on estimates, but get the new date confirmed.

What if the numbers change after you sign?

They often do. You remember more items, or a repair estimate comes back higher. Many insurers accept a supplemental proof of loss for the difference. Ask in writing whether yours does, and how long you have to send one.

Read carefully before signing a form the insurer has filled in for you. If it shows their figure rather than yours, signing it can be read as agreeing to that amount. You can fill in your own figures, or add a note that you dispute the amount, and keep a copy of exactly what you signed.

Does it have to be notarized?

Many proof of loss forms have a space for a notary, and some insurers insist on it. Banks, shipping stores and some public libraries offer notary services, often free or for a small fee. Ask your adjuster whether yours must be notarized before you book one, because some insurers now accept an electronic signature instead.

Proof of loss for a flood claim

Flood insurance through the national program has its own rules. The signed proof of loss is usually due within 60 days of the flood, not of the insurer's request, and FEMA sometimes extends that after a large disaster. The adjuster often prepares a draft for you to review. If you disagree with their figures, you can send your own proof of loss with your own numbers and the evidence for them.

Before you sign

• Check every figure against your contents list and estimates.
• Make sure nothing on it is a guess you can't back up. You are swearing it is true.
• Keep a copy of the signed form and everything attached to it.
• Send it in a way you can prove, such as email with a reply, or certified mail.

Where Indemnia helps

Indemnia keeps the contents list behind your proof of loss: every item with today's price, the depreciation for its age, and the actual cash value that leaves. The totals on the form then come straight from a list you can hand the adjuster.