Guided playbook

Situational Claim Advisory

Get tailored guidance for more than 60 claim scenarios — from appliances to catastrophes to denials.

Start With Your Scenario Describe Your Situation
60+ Scenario playbooks
5 Critical checklists each
AI Ready for document generation

How to use this page

Choose a category, skim immediate actions, then dive into the expanded advisory to capture evidence, documents, and escalation paths.

Why scenario-based guidance matters

Each loss type has distinct coverage triggers, red flags, and documentation gaps that can delay or reduce payouts. Focus on the right proof fast.

How to navigate

Use categories to avoid overload, start with the immediate actions, then open the full advisory if you need escalation wording or document templates.

  • Immediate steps: Secure the scene, stop further damage, notify carrier.
  • Documentation requirements: Photos, invoices, expert notes, communications log.
  • Red flags: Wear-and-tear denials, late notice claims, causation disputes.
  • Estimate considerations: Scope completeness, code upgrades, depreciation fairness.
  • When to escalate: Delays, lowball offers, reservation of rights, repeated denials.

Filters are visual only for this rebuild. Jump to any category below to start.

Category navigation

Select a grouping to jump into focused scenario cards.

Appliance & Equipment Loss

Power surges, HVAC failures, electronics, mechanical breakdown impacts.

View Scenarios

Weather Events

Wind, hail, freeze, lightning, and roof-driven water entry.

View Scenarios

Catastrophic Events

Wildfire, hurricane surge, earthquake, tornado, widespread outages.

View Scenarios

Water, Mold & Plumbing

Burst pipes, sewer backup, mold, moisture intrusion.

View Scenarios

Structural & Foundation

Foundation shifts, wall cracks, settlement vs. sudden events.

View Scenarios

Business & Income Loss

Business interruption, extra expense, supply chain breakdowns.

View Scenarios

Claim Disputes & Denials

Coverage denials, causation fights, reservation of rights.

View Scenarios

Proof of Loss Scenarios

Completing, revising, or disputing proof-of-loss requirements.

View Scenarios

Theft & Vandalism

Burglary, stolen property, malicious damage, civil unrest.

View Scenarios

Financial/Operational Disruptions

Loss of utilities, data loss, payment delays, vendor failures.

View Scenarios

Scenario advisories

Scan immediate actions, capture required documentation, then open the full advisory if escalation is needed.

Appliance & Equipment Loss

Electrical surges, mechanical failures, and heavy equipment downtime that impact habitability or operations.

Power Surge Appliance Damage

Immediate Actions

  • Unplug affected units and photograph serial plates.
  • Capture utility outage or lightning confirmation if available.
  • Prevent further loss by stabilizing electrical panel.

Documentation Required

  • Licensed electrician report or surge strip failure evidence.
  • Purchase receipts or current replacement pricing.
View Full Advisory

HVAC Mechanical Failure

Immediate Actions

  • Shut down equipment to prevent secondary damage.
  • Document ambient conditions and comfort impacts.
  • Schedule inspection for cause of loss findings.

Documentation Required

  • Technician diagnosis noting sudden breakdown vs wear.
  • Maintenance history and any prior repairs.
View Full Advisory

Electronics Loss

Immediate Actions

  • List impacted devices with age and condition.
  • Photograph damage and connection setup.
  • Confirm surge protection in use.

Documentation Required

  • Receipts or bank proof plus replacement quotes.
  • Utility surge notice if available.
View Full Advisory

Power Surge Appliance Damage

Immediate Actions

  • Document time/date of surge and any utility outage ticket.
  • Isolate circuits for damaged appliances to avoid fire risk.
  • Notify carrier within policy timelines to avoid late notice issues.

Required Documentation

  • Electrician letter tying failure to sudden surge vs. wear.
  • Proof of ownership and replacement cost links.
  • Photos of breakers, surge protectors, and damaged components.

Evidence Checklist

  • Model/serial photos with date stamps.
  • Utility company outage or lightning verification.
  • Pre-loss condition notes (maintenance logs).

Estimate Considerations

  • Ensure labor includes diagnostic time and code-required upgrades.
  • Compare like-kind replacement vs. betterment exclusions.

Red Flags

  • Carrier citing wear-and-tear without expert inspection.
  • Denial due to lack of proof surge occurred.

When to Escalate

  • Reservation of rights blaming maintenance.
  • Repeated delays in scheduling field inspection.
Generate Corresponding Document

HVAC Mechanical Failure

Immediate Actions

  • Capture ambient temperatures if habitability is impacted.
  • Request technician statement on sudden vs. long-term deterioration.
  • Keep failed parts for inspection.

Required Documentation

  • Service ticket describing cause of loss.
  • Photos of failed components and any burn marks.

Evidence Checklist

  • Prior maintenance invoices (filters, annual service).
  • Thermostat history if available.

Estimate Considerations

  • Load calculations for replacement sizing.
  • Code-required upgrades (refrigerant conversions).

Red Flags

  • Denial citing age only, without mechanical assessment.

When to Escalate

  • Carrier refuses inspection of retained parts.
Generate Corresponding Document

Electronics Loss

Immediate Actions

  • Catalog serials and confirm surge strip use.
  • Photograph connection points and burn marks.

Required Documentation

  • Receipts or bank statements proving ownership.
  • Written evaluation from repair shop if possible.

Evidence Checklist

  • Utility outage or lightning data for the date/time.
  • Condition photos before disposal.

Estimate Considerations

  • Like-kind replacement with taxes and setup costs.

Red Flags

  • Depreciation excessive relative to device age.

When to Escalate

  • Carrier declines surge coverage without expert review.
Generate Corresponding Document

Weather Event Scenarios

Wind, hail, lightning, and freeze events that trigger roof, siding, and water intrusion claims.

Wind & Hail Roof Damage

Immediate Actions

  • Tarp openings; photograph slopes before mitigation.
  • Capture hail size, direction, and storm date.
  • Log interior leaks by room.

Documentation Required

  • Weather report or hail swath map.
  • Roofer inspection noting fresh vs prior wear.
View Full Advisory

Freeze & Ice Dam

Immediate Actions

  • Stop active dripping and move contents to dry zones.
  • Document attic insulation and ventilation condition.
  • Record temperatures during the freeze period.

Documentation Required

  • Photos of ice dams, soffits, and interior staining.
  • Moisture readings before demolition.
View Full Advisory

Lightning Strike

Immediate Actions

  • Document burn marks and tripped breakers.
  • Check electronics and HVAC for sudden failure.
  • Call utility if downed lines are present.

Documentation Required

  • Lightning verification report.
  • Electrician assessment of surge path.
View Full Advisory

Wind & Hail Roof Damage

Immediate Actions

  • Tarp damaged slopes; keep tarp invoices.
  • Photograph shingles, soft metals, and windows before clean-up.
  • Log any interior water entry with timestamps.

Required Documentation

  • Roofer or adjuster report distinguishing fresh impact vs wear.
  • Weather data confirming hail or high wind speeds.
  • Moisture readings and mitigation invoices.

Evidence Checklist

  • Elevation photos, gutters, and AC fin damage.
  • Roof age and material type.

Estimate Considerations

  • Code upgrades (ice/water shield, ventilation, drip edge).
  • Matching requirements for slopes or elevations.

Red Flags

  • Denial citing “wear” without slope-by-slope inspection.

When to Escalate

  • Reservation of rights on causation, or delay beyond carrier timelines.
Generate Corresponding Document

Freeze & Ice Dam

Immediate Actions

  • Collect photo proof of ice dam thickness and leak paths.
  • Dry interior quickly; avoid removing materials before moisture mapping.

Required Documentation

  • Weather records for freeze period.
  • Mitigation logs with dehumidifier readings.

Evidence Checklist

  • Attic ventilation and insulation photos.
  • Ceiling and wall moisture meter readings.

Estimate Considerations

  • Drywall, insulation, and paint scope with drying days included.

Red Flags

  • Carrier claiming long-term seepage without moisture mapping.

When to Escalate

  • Denial for “maintenance” despite storm data.
Generate Corresponding Document

Lightning Strike

Immediate Actions

  • Secure scene and keep damaged electronics for inspection.
  • Check for scorch marks on panels and appliances.

Required Documentation

  • Lightning verification report for the loss date/time.
  • Electrician assessment of surge pathway.

Evidence Checklist

  • Breaker status photos, damaged outlets/surge strips.
  • Device serials and age.

Estimate Considerations

  • Panel replacement, wiring checks, device replacements.

Red Flags

  • Carrier denies lightning despite verification data.

When to Escalate

  • Reservation of rights citing “wear” without inspection.
Generate Corresponding Document

Catastrophic Events

High-severity events with complex scope, often needing code upgrades and multiple trades.

Wildfire Smoke & Heat

Immediate Actions

  • Document soot patterns and HVAC filter conditions.
  • Ventilate safely; avoid cleaning before testing.
  • Inventory soft goods for cleaning vs replacement.

Documentation Required

  • Air quality reports and smoke intrusion lab results.
  • Contents list with cleaning estimates.
View Full Advisory

Hurricane Wind & Surge

Immediate Actions

  • Separate wind vs. flood impacts in photos.
  • File claims under both policies if applicable.
  • Stabilize structure with temporary shoring if needed.

Documentation Required

  • Wind speed reports and flood line markings.
  • Engineer note distinguishing structural vs. water-driven damage.
View Full Advisory

Earthquake Impact

Immediate Actions

  • Photograph foundation, chimneys, and wall separations.
  • Check gas lines; shut off if leaks suspected.
  • Document fallen contents for ALE claims.

Documentation Required

  • Structural engineer assessment.
  • Receipts for emergency lodging and food (ALE).
View Full Advisory

Hurricane Wind & Surge

Immediate Actions

  • Mark flood lines and keep separate debris piles for wind vs. water.
  • Photograph roof, windows, and doors before removal.
  • Log dates/times of power loss and access restrictions.

Required Documentation

  • Engineer or contractor letter distinguishing wind-created openings.
  • Policy info for both homeowners and flood (if applicable).
  • Temporary repair invoices and mitigation logs.

Evidence Checklist

  • Drone/ground photos of elevations, roof, and siding.
  • Interior moisture maps and contents loss list.

Estimate Considerations

  • Code upgrades, elevation requirements, and mold remediation scope.
  • Ordinance & Law coverage for rebuilds.

Red Flags

  • Carrier attributing all damage to flood without wind analysis.

When to Escalate

  • Delays in advance payments for mitigation or ALE.
Generate Corresponding Document

Wildfire Smoke & Heat

Immediate Actions

  • Do not clean surfaces before taking soot sampling photos.
  • Remove HVAC filters and bag for testing.
  • Ventilate when safe to reduce odor concentration.

Required Documentation

  • Industrial hygienist testing and scope.
  • Contents inventory with clean vs replace designation.

Evidence Checklist

  • Soot wipe samples, HVAC duct photos.
  • Air scrubber usage logs.

Estimate Considerations

  • Duct cleaning vs replacement, soft goods cleaning, HEPA vacuuming.

Red Flags

  • Carrier limiting to cleaning only without testing results.

When to Escalate

  • Delays in approving hygienist testing or contents pack-out.
Generate Corresponding Document

Earthquake Impact

Immediate Actions

  • Check gas and water lines; shut off if leaks are suspected.
  • Photograph structural separations and fallen items.

Required Documentation

  • Engineer report on structural movement.
  • Receipts for emergency lodging/food (ALE).

Evidence Checklist

  • Foundation cracks, chimney gaps, door/window racking.
  • Aftershock timelines.

Estimate Considerations

  • Bracing, anchoring, masonry rebuild, contents losses.

Red Flags

  • Denial citing pre-existing settlement without engineering.

When to Escalate

  • Carrier refuses engineer inspection despite visible cracking.
Generate Corresponding Document

Water, Mold & Plumbing

Sudden water discharge, sewer backup, mold growth, and hidden leaks.

Burst Pipe

Immediate Actions

  • Shut off water; document source and affected rooms.
  • Start drying within 24 hours to avoid mold.
  • Protect contents and raise furniture.

Documentation Required

  • Plumber invoice with cause of break.
  • Moisture maps before demo.
View Full Advisory

Sewer Backup

Immediate Actions

  • Stop use of plumbing fixtures.
  • Document contamination and affected materials.
  • Call mitigation for Category 3 cleaning.

Documentation Required

  • Plumber report on cause (blockage vs failure).
  • Mitigation scope with disposal notes.
View Full Advisory

Mold Discovery

Immediate Actions

  • Isolate area and run dehumidification.
  • Identify moisture source before removal.
  • Photograph pre-removal conditions.

Documentation Required

  • Moisture source report.
  • Air testing if policy requires proof.
View Full Advisory

Burst Pipe

Immediate Actions

  • Shut off supply; capture photos of the failed section.
  • Begin mitigation and keep equipment logs.
  • Notify carrier promptly to avoid late notice issues.

Required Documentation

  • Plumber invoice with root cause (freeze, sudden break).
  • Drying logs and moisture readings.

Evidence Checklist

  • Photos of pipe, fittings, and surrounding materials.
  • Contents damage list with values.

Estimate Considerations

  • Demo/rebuild of walls, flooring, cabinets, and cleanup.

Red Flags

  • Denial citing “long-term leak” without moisture mapping.

When to Escalate

  • Carrier delays approving mitigation or plumbing access.
Generate Corresponding Document

Sewer Backup

Immediate Actions

  • Stop water usage; photograph standing water and solids.
  • Use PPE and isolate affected rooms.

Required Documentation

  • Plumber scope for blockage vs municipal issue.
  • Mitigation plan documenting Category 3 protocols.

Evidence Checklist

  • Material removal photos and disposal tickets.
  • Air scrubber/drying logs.

Estimate Considerations

  • Disinfection, porous material removal, and rebuild scope.

Red Flags

  • Carrier limits to cleaning only despite saturation.

When to Escalate

  • Backup sublimit disputes or denial of loss of use.
Generate Corresponding Document

Mold Discovery

Immediate Actions

  • Identify moisture source and stop it before removal.
  • Contain area to prevent cross-contamination.

Required Documentation

  • Moisture source report or leak detection findings.
  • Air/clearance testing if performed.

Evidence Checklist

  • Pre-remediation photos of growth and materials.
  • Drying logs and humidity readings.

Estimate Considerations

  • Containment, HEPA filtration, removal, and rebuild scope.

Red Flags

  • Denial citing “long-term” without timeline evidence.

When to Escalate

  • Policy mold sublimits invoked without reviewing cause.
Generate Corresponding Document

Structural & Foundation

Settlement vs. sudden events, wall cracking, and structural shifts.

Foundation Movement

Immediate Actions

  • Photograph cracks with scale references.
  • Check doors/windows for racking.
  • Stabilize if structural risk is present.

Documentation Required

  • Engineer assessment on sudden vs long-term movement.
  • Soil/settlement reports if available.
View Full Advisory

Structural Impact

Immediate Actions

  • Document impact points and structural members affected.
  • Shore if there is collapse risk.
  • Collect witness statements or incident reports.

Documentation Required

  • Engineer or contractor estimate.
  • Police or incident report if applicable.
View Full Advisory

Masonry/Chimney Damage

Immediate Actions

  • Check for leaning, cracked mortar, and loose bricks.
  • Block off unsafe areas.

Documentation Required

  • Chimney sweep or mason report.
  • Photos before any removal.
View Full Advisory

Business & Income Loss

Business interruption, extra expense, supply chain breakdowns, and loss of utilities.

Business Interruption

Immediate Actions

  • Document downtime dates and causal damage.
  • Track revenue impact daily.
  • Begin mitigation to resume operations.

Documentation Required

  • P&L comparisons for pre- and post-loss periods.
  • Invoices for extra expense and temporary space.
View Full Advisory

Equipment Downtime

Immediate Actions

  • Log production interruptions and backlog impacts.
  • Arrange rentals and track costs.

Documentation Required

  • Maintenance and repair reports.
  • Rental agreements and freight.
View Full Advisory

Utility Outage Loss

Immediate Actions

  • Note outage start/end times.
  • Protect perishable inventory.
  • Communicate closures to customers.

Documentation Required

  • Utility notices, outage maps, and vendor statements.
  • Inventory loss lists with values.
View Full Advisory

Claim Disputes & Denials

Coverage challenges, causation disagreements, and repeated delays.

Coverage Denial

Immediate Actions

  • Request denial letter citing policy provisions.
  • Clarify facts and supply missing documentation.
  • Consider appraisal or complaint routes.

Documentation Required

  • Full claim file timeline and adjuster communications.
  • Independent expert reports.
View Full Advisory

Low Settlement Offer

Immediate Actions

  • Request written basis for line items and pricing.
  • Prepare comparative estimates.

Documentation Required

  • Contractor estimates and code upgrade citations.
  • Photos tied to disputed line items.
View Full Advisory

Delayed Claim

Immediate Actions

  • Document response gaps and missed deadlines.
  • Request status in writing with dates.

Documentation Required

  • Timeline of calls, emails, inspections.
  • Policy deadlines for responses.
View Full Advisory

Proof of Loss Scenarios

Submitting, amending, or disputing proof-of-loss requirements with supporting evidence.

Initial Proof of Loss

Immediate Actions

  • Gather scope, estimates, and inventories.
  • Confirm deadline and delivery method.

Documentation Required

  • Signed proof form with backup exhibits.
  • Photos keyed to line items.
View Full Advisory

Revised Proof

Immediate Actions

  • Note changes vs prior submission.
  • Explain new damage discovered.

Documentation Required

  • Updated estimates and photos.
  • Explanation letter.
View Full Advisory

Disputed Proof Response

Immediate Actions

  • Address each disputed line item.
  • Request carrier basis in writing.

Documentation Required

  • Supporting evidence and expert opinions.
  • Correspondence log.
View Full Advisory

Theft & Vandalism

Burglary, forced entry, malicious damage, and civil unrest claims.

Burglary with Forced Entry

Immediate Actions

  • File police report and obtain case number.
  • Photograph forced entry points.
  • List stolen items with values.

Documentation Required

  • Receipts or proof of ownership.
  • Security footage if available.
View Full Advisory

Vandalism

Immediate Actions

  • Document all defaced areas before cleaning.
  • Secure property against repeat entry.

Documentation Required

  • Police report if applicable.
  • Repair estimates.
View Full Advisory

Civil Unrest Damage

Immediate Actions

  • Photograph broken glass, signage, and contents loss.
  • Board up openings promptly.

Documentation Required

  • Police or incident report.
  • Contractor estimates for glazing and repairs.
View Full Advisory

Financial/Operational Disruptions

Payment delays, vendor failures, data loss, or utility-driven interruptions.

Payment Delay from Carrier

Immediate Actions

  • Request written status with payment breakdown.
  • Document financial impact and invoices pending.

Documentation Required

  • Claim file timeline and approvals.
  • Contractor payment schedules.
View Full Advisory

Data Loss from Incident

Immediate Actions

  • Engage IT to identify cause and scope.
  • Secure backups and isolate affected systems.

Documentation Required

  • Forensic report linking event to loss.
  • Downtime logs and recovery costs.
View Full Advisory

Vendor/Supplier Failure

Immediate Actions

  • Document disruption dates and impacted contracts.
  • Seek alternate suppliers and track extra costs.

Documentation Required

  • Contracts, delivery schedules, cancellation notices.
  • Lost revenue calculations.
View Full Advisory

Use with these tools

Pair your scenario with automation to move faster.

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Open AI Agent

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Track photos, invoices, and expert notes with shareable exports.

Organize Evidence

Document Generator

Create letters, proofs, and notices aligned to your scenario.

Generate Documents

ROM Estimator

Get rough-order-of-magnitude numbers to sanity-check offers.

Estimate Costs

Claim Playbook

Step-by-step claim tactics and timelines by coverage type.

View Playbook

Claim Timeline

Map deadlines, inspections, and payments to avoid delays.

Build Timeline

Not Sure Which Scenario Applies?

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