Insurance Claim Investigation Questionnaire

I. Claim & Policy Information

Claim Number

Date Claim Reported

Policy Number

Policy Holder Name

Policy Holder Contact

Phone

Email

Type of Loss

Date of Loss

Time of Loss

Location of Loss

Street Address

City

State/Province

Zip/Postal Code

Insured's Deductible/Excess

II. Claimant/Injured Party Information

Note: This section applies if the claimant is not the policyholder (e.g., a third-party liability claim).

Claimant Name

Claimant Contact

Phone

Email

Claimant Address

Street Address

City

State/Province

Zip/Postal Code

Relationship to Policy Holder

Nature of Injury/Damage Claimed

Has a Demand Letter been received?

III. Incident Details - Narrative & Facts

A. Narrative of the Loss

Describe in detail how the loss/incident occurred.

What was the specific cause of the loss? (e.g., Fire, Theft, Collision, Slip and Fall, Storm, Equipment failure, etc.)

Who was present at the time of the incident? (List names and their role/relationship.)

Name

Role/Relationship

A
B
1
 
 
2
 
 
3
 
 
4
 
 
5
 
 

Was the incident reported to any authorities (Police/Fire Dept.)?

If Yes, Agency Name:

Report/Case Number:

Date Reported:

B. Property/Vehicle/Injury Specifics

For Property:

Was the property owned, rented, or leased?

owned

rented

leased

What is the estimated age/condition of the damaged property?

Was any temporary repair or mitigation action taken?

For Vehicle (Auto/Marine):

 

Make, Model, Year of involved vehicle

Vehicle Identification Number/Hull Number

Was the vehicle drivable after the incident?

For Injury/Bodily Harm:

Was medical attention immediately sought?

Name of initial treatment facility/doctor

Date of initial treatment:

Is the claimant currently restricted from work/activity?

IV. Investigation Procedures

When was the Initial Contact with Policy Holder

Please describe in detail the findings or observations.

When was the Site/Scene Inspection

Please describe in detail the findings or observations.

Were photographs or video taken?

Please describe in detail what was captured.

Were witness interviews conducted?

List names/contact info of witnesses

Name

Phone

Email

A
B
C
1
 
 
 
2
 
 
 
3
 
 
 
4
 
 
 
5
 
 
 

How were the statements taken?

Recorded

Written

Other:

Indicate who provided the statements.

What official reports were obtained?

Police

Fire

Weather

Other:

List report numbers obtained.

When was the policy coverage reviewed?

Were the external experts or adjusters engaged?

List firm or individual name and purpose.

V. Witness Information

Name

Contact Number

Relationship to Incident

Statement Taken?

A
B
C
D
1
 
 
 
 
2
 
 
 
 
3
 
 
 
 
4
 
 
 
 
5
 
 
 
 

VI. Adjuster/Investigator Assessment


Is coverage applicable based on initial review?

Yes

No

Undetermined

If No, specify the likely policy exclusion:

Are there any indicators of potential fraud, misrepresentation, or moral hazard?

If Yes, explain the concern:

What is the preliminary estimate of the total loss/claim value?

Are there any other insurance policies/parties that may cover this loss (Subrogation/Contribution potential)?

If Yes, specify the party:

Recommended Next Steps for Resolution:

further interviews

appraisal

request medical records

deny claim

pay claim

Other:

VII. Certification

Investigator Signature

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