Your claim-history worksheet

Start with the coverage deadline

Use your browser's Print command, or press Ctrl+P on Windows or Command+P on a Mac. Keep the completed worksheet with your policy and repair documents.

Property address:

Current insurer and policy number:

Policy end date and time shown on the notice:

Mortgage or closing deadline, if different:

Make a factual claim timeline

Use the records available to you. Mark an unknown payment amount or claim status as unknown until the insurer confirms it. This worksheet is an organizer, not an insurance application; answer the insurer's actual history questions as written.

Gather the supporting records

• Current declarations page and all cancellation or nonrenewal notices.
• Insurer claim-history statement or loss runs, when available.
• Your consumer loss-history report and any dispute correspondence.
• Paid repair invoices, inspection findings, and permits where required.
• Clear dated photographs of completed work.
• Details of remaining work, open claims, or changes in occupancy.

Questions for the insurance professional

• Which agency and licensed professional will handle the request?
• Which insurers or programs can you approach for this state and property?
• What documents or inspections are still needed?
• What exclusions, settlement terms, deductibles, and fees apply?
• Does the proposed coverage satisfy the lender's requirements?
• Who can bind the policy, and what confirms its effective date?

Keep a record of the next steps

Professional's name and contact:

Documents still needed and agreed next contact date:

When you are ready, request insurance help. Keep the completed worksheet private and ask how to securely supply any requested supporting documents.