First-Party Insurance Toolkit: Proof of Loss, Appraisal, Examinations, and Bad Faith Claims

Summary. Letters, logs, and worksheets for documenting, valuing, and fighting a first-party claim.

Tool 1 — Policy and claim file request

To: [Insurer], Claim [ ] Re: Request for policy and claim documentation — insured [ ], date of loss [ ]

Please provide, within [10] days:

1. A complete certified copy of the policy as in effect on the date of loss, including the declarations page, the base form, and all endorsements;
2. A copy of my application and any inspection report obtained at underwriting;
3. Any emergency or catastrophe orders of the [state] Department of Insurance affecting the handling of this claim;
4. The adjuster's estimate and all photographs taken;
5. Any engineering, cause-and-origin, or expert report obtained regarding this loss; and
6. A written statement of the coverage position and the specific policy provisions relied upon.

Please also confirm the deadline for submitting a sworn proof of loss and the policy's suit limitation period.

Tool 2 — Claim diary

Keep it from day one. It is nearly impossible to reconstruct and it is the backbone of any delay or bad faith argument.

Tool 3 — Damage documentation index

Provide this index with the media, on a drive or a link. An adjuster given 400 unlabeled photographs looks at six; one given an index looks at what matters.

Tool 4 — Mitigation and emergency expense log

Request an advance: "I have incurred $[ ] in reasonable emergency mitigation expenses, itemized and documented as attached. I request an advance payment of these expenses under the policy's duties-after-loss provision."

Tool 5 — Estimate comparison worksheet

Cover language: "Attached is a line-item comparison of your estimate to two independent contractor estimates. The following items appear to be omitted or underpriced: [list]. I request a supplement in the amount of $[ ]. Please advise in writing of the basis for any item you decline to include."

Tool 6 — Contents inventory template

Do not skip: linens, towels, cleaning supplies, pantry and freezer contents, tools, sporting goods, holiday decorations, luggage, small kitchen appliances, phone and computer accessories, children's toys, books, and everything in the garage and storage.

Check the sublimits: jewelry · watches · furs · firearms · cash · securities · silverware · business property · electronics.

Tool 7 — Additional living expenses worksheet

Note the limit and the time cap in the policy, and request advances rather than reimbursement.

Tool 8 — Proof of loss extension request

To: [Insurer], Claim [ ] Re: Request for extension of time to submit sworn proof of loss

I received your request for a sworn proof of loss on [date], making it due [date]. I am unable to complete it by that date because [the contents inventory is ongoing / contractor estimates are pending / the scope of damage is still being determined by your own adjuster].

I request an extension to [date]. Please confirm this extension in writing. I am proceeding diligently and will submit as soon as the documentation is complete. Nothing in this request is intended to waive any right under the policy.

Never rely on a verbal extension. Get it in writing or file on time with the numbers you have.

Tool 9 — Sworn proof of loss reservation language

The amounts stated herein are based on the information available to date. The claim is continuing, the scope of damage is still being determined [by the insurer's own adjuster / by ongoing inspection], and the contents inventory remains in progress. I expressly reserve the right to amend and supplement this proof of loss, including for additional damage discovered during repairs, additional contents, additional living expenses incurred after this date, and the withheld depreciation upon completion of repairs.

Have it notarized. Send it certified. Keep the receipt.

Tool 10 — Depreciation holdback demand

Re: Claim [ ] — Demand for withheld depreciation (replacement cost benefits)

The repairs to the insured property have been completed. Enclosed are:

1. Final invoices from [contractors], showing the work performed and the amounts paid;
2. Photographs of the completed work;
3. Proof of payment; and
4. A reconciliation of the completed work against your estimate dated [ ].

Actual cash value previously paid: $[ ]. Total replacement cost incurred: $[ ]. Withheld depreciation now due: $[ ].

Please issue payment within [ ] days. [If applicable: I previously requested and received a written extension of the completion deadline to [date].]

This is the money most insureds never claim.

Tool 11 — Appraisal demand and appraiser engagement

Demand

Pursuant to the appraisal provision of the policy, I demand appraisal of the amount of loss. The parties disagree as to the amount, your estimate being $[ ] and my documented estimate being $[ ].

I appoint [name, address, telephone, credentials] as my appraiser. Please appoint yours within the time provided by the policy and instruct the appraisers to select an umpire. This demand relates to the amount of loss only and is not a waiver of any coverage position or right.

Appraiser engagement points to confirm in writing

• Scope: amount of loss only, itemized by category.
• Experience with this loss type and this construction type.
• Independence: no contingent fee that could be attacked; flat or hourly.
• Availability for the umpire process.
• Deliverable: an itemized award, not a lump sum.

Tool 12 — Examination under oath preparation and objections

Preparation checklist

• Retain counsel; confirm counsel will attend.
• Obtain and re-read: the policy; the proof of loss; the claim diary; every document produced; every recorded statement.
• Reconcile every number you have given the insurer. Inconsistency is the purpose of the exercise.
• Assemble the requested documents; identify anything you do not have and why.
• Confirm the date, time, place, and who will attend.

Production objection language (through counsel)

The insured will produce documents relevant to the loss and to the valuation of the claim as required by the policy's duties-after-loss provision. The insured objects to the request for [five years of personal bank statements / tax returns / phone records] as beyond the scope of the policy condition and not reasonably related to the investigation of this loss. If the insurer contends a specific policy provision requires production of these materials, please identify the provision and the basis, and the insured will respond.

At the examination

• Answer only what is asked. Stop.
• "I don't know" and "I don't recall" are complete answers when true.
• Do not estimate or guess at numbers; say you will provide the document.
• Never state anything you are not certain is accurate — a false statement can void the entire policy.

Tool 13 — Denial response letter

Re: Claim [ ] — Response to denial dated [ ] and request for reconsideration

Your letter denies the claim on the ground that [quote the stated basis] and cites [quote the policy provision, or note that none was identified].

1. The stated basis is contradicted by the evidence. [Point one, with the document attached as Exhibit A.] 2. [Point two, Exhibit B.] 3. Your determination does not address [the insured's expert report / the plumber's opinion on the failure mode / the weather data for the date of loss], which was provided to you on [date]. 4. The provision cited does not apply because [the ensuing loss exception restores coverage / the exclusion addresses a different cause / the grant is all-risk and the burden of proving an exclusion is yours].

I request: (a) written identification of every policy provision relied upon; (b) production of every report, estimate, and photograph on which the denial rests; (c) reconsideration by a supervisor; and (d) a written response within [14] days.

A copy of this letter is being provided to the [State] Department of Insurance.

Tool 14 — Partial payment acceptance language

I acknowledge receipt of $[amount]. I accept this as a partial payment on this claim and not as a full and final settlement. The following items remain unresolved and are supported by the enclosed documentation: [itemized, with amounts]. I request a supplement of $[ ] and I reserve all rights, including my claim to the withheld depreciation upon completion of repairs.

Do not deposit a check tendered as "full and final" until that is resolved in writing.

Tool 15 — Department of insurance complaint outline

Insurer: [ ] Policy: [ ] Claim: [ ] Date of loss: [ ] 1. The loss. [Two sentences.] 2. What I submitted, and when. [Dated list.] 3. What the insurer did, and when. [Dated list, including gaps.] 4. The coverage position taken, and the policy language cited (or the failure to cite any). 5. Why it is wrong. [Short, factual.] 6. Relief requested. [Payment of $__ / a written coverage determination / production of the report relied on.] 7. Exhibits. [Policy, denial letter, estimates, correspondence, claim diary excerpt.]

Note: a complaint does not toll the policy's suit limitation period.

Tool 16 — Bad faith evidence index

Remember the ceiling: punitive damages are constrained by due process, generally to a single-digit ratio to compensatory damages. Build the compensatory case carefully — it sets the ceiling.

Related documents

• First-Party Insurance Claims and Bad Faith
• Filing and Fighting a Property Insurance Claim
• Insurance Claim and Bad Faith Checklist
• Health Insurance Appeal Toolkit
• Residential Real Estate Toolkit
• Auto Purchase and Warranty Toolkit

Templates are starting points, not filings. Insurance is state law and your policy controls. Verify deadlines against your own policy before relying on any of this.