Insurers often require a sworn, notarized proof of loss before paying a property or theft claim. This form states the loss, its cause, and the amount claimed. Describe an insured loss, its cause and the amount claimed.
Describe an insured loss, its cause and the amount claimed.
Insurers often require a sworn, notarized proof of loss before paying a property or theft claim. This form states the loss, its cause, and the amount claimed.
What you'll need
Read this packet and confirm the receiving agency's required form.
Gather the names, dates and supporting records requested in the document.
Bring acceptable identification for any required notarial act.
How to complete it
Fill in the claim details (Page 1) Use your policy and claim numbers. Ask the adjuster if they require their own form instead.
Swear before a notary Sign under oath before the notary with a current, government-issued photo ID.
Send it to the insurer within the time the policy requires, and keep a copy.
Hospitals, clinics, and businesses use this sworn affidavit when producing records for an insurance claim or lawsuit, to confirm the copies are true, complete, and kept in the regular course of business.
A release ends an injury claim in exchange for a settlement payment. Many insurers require the claimant’s signature to be notarized before they issue the check.
These forms are a free convenience, not legal advice. First Choice Mobile Notary & Apostille is not a law firm. Consult an attorney licensed in the relevant state for legal questions.