Loss documentation

Statement of Loss

A complete, itemized declaration of damages, valuations, and recoverable amounts — required by insurers for many property claims.

Why this form matters

The Statement of Loss is the insurer-facing, itemized record of every claimed damage, valuation method, and calculation. It aligns your evidence with the carrier’s accounting so payments can be issued without delay.

Insurers require it to validate coverage, calculate depreciation, and reconcile prior payments. Accuracy, clarity, and supporting documentation reduce disputes and speed settlement.

Key financial lines to summarize

  • Total claimed amount
  • Replacement cost values (RCV)
  • Actual cash value (ACV)
  • Depreciation applied
  • Recoverable depreciation
  • Deductible
  • Net claim payable

Structured inputs to capture every value

Use these fields to draft a complete, auditable Statement of Loss.

Property Information

  • Insured name & policy
  • Property type & use
  • Policy form / endorsements
Add Info

Address

  • Site address
  • Unit / building identifiers
  • Mailing details
Add Info

Date of Loss

  • Event date
  • Discovery date
  • Report timing
Add Info

Cause of Loss

  • Peril description
  • Origin & spread
  • Mitigation performed
Add Info

Claim Categories

  • Structural
  • Contents
  • ALE / LOU
  • Other damages
Add Info

Valuation Inputs

  • RCV & ACV per item
  • Depreciation schedules
  • Deductible application
Add Info

Supporting Documentation

  • Photos & videos
  • Estimates & invoices
  • Expert reports
Add Info

Notes & Clarifications

  • Disputed items
  • Missing information
  • Carrier positions
Add Info

Breakdown the insurer will check

Explain every calculation and align it to the carrier’s ledger.

Each line in the Statement of Loss must tie to evidence, valuation method, and policy terms. Document how you derived:

  • Replacement Cost Value (RCV): Full repair or replacement pricing.
  • Actual Cash Value (ACV): RCV minus calculated depreciation.
  • Depreciation: Method, rate, and rationale for each item.
  • Recoverable depreciation: Amount released after proof of repairs.
  • Deductible: Applied once per occurrence per policy terms.
  • Net payment due: ACV plus recoverable depreciation minus prior payments.
  • Total claim: Sum of all categories after adjustments.

Statement of Loss numbers

RCV $0.00
Depreciation ($0.00)
ACV $0.00
Deductible ($0.00)
Recoverable Depreciation $0.00
Total Claim Amount $0.00
Generate Statement of Loss (PDF)

Required Documentation

Attach proof for every number to prevent delays or reductions.

Photos & videos

  • Pre-loss and post-loss visuals
  • Location tags and timestamps
  • Damage progression evidence
Organize in Evidence Tool

Contractor estimates

  • Line-item scope
  • Material and labor rates
  • Code upgrades noted
Organize in Evidence Tool

Xactimate/X1 summaries

  • Category breakdown
  • Pricing versions
  • Applied taxes and O&P
Organize in Evidence Tool

Receipts / invoices

  • Mitigation charges
  • Temporary repairs
  • Replacement purchases
Organize in Evidence Tool

Contents inventory

  • Itemized list with RCV/ACV
  • Age and condition
  • Purchase proof
Organize in Evidence Tool

Expert reports

  • Engineer / roofer findings
  • Mitigation vendor reports
  • Causation and scope support
Organize in Evidence Tool

Proof of repairs

  • Completion photos
  • Certificates and permits
  • Progress billing
Organize in Evidence Tool

Policy excerpts

  • Coverage grants
  • Deductible clauses
  • Depreciation provisions
Organize in Evidence Tool

Common mistakes to avoid

Prevent rejections, underpayments, and avoidable delays.

Understated depreciation

Carrier uses aggressive schedules that reduce ACV without support.

Excluding contents

Leaving personal property off the form lowers the total claim.

Missing ALE

Not documenting temporary housing, meals, or mileage erodes recovery.

Incorrect deductible

Using hurricane/wind deductibles improperly changes the net payment.

Outdated estimates

Old pricing or missing code upgrades understate RCV and holdback.

Missing mitigation costs

Dry-out, tarping, and board-up costs must be itemized to be reimbursed.

Specialty items omitted

Custom finishes, appliances, and antiques need documented valuation.

Wrong ACV/RCV math

Totals must reconcile with depreciation, deductibles, and prior payments.

Pair with the right claim tools

Combine your Statement of Loss with tools that maintain evidence, timelines, and exports.

Evidence Organizer

Centralize photos, invoices, and reports linked to each line item.

Open Evidence Organizer

Claim Journal

Log carrier communications and confirm valuation assumptions.

Open Claim Journal

Document Generator

Create polished Statements of Loss and export ready-to-send PDFs.

Open Document Generator

Claim Timeline

Align loss dates, proof submissions, and payment deadlines.

Open Claim Timeline

Deadline Detector

Keep statutory and policy clocks visible so payments stay on track.

Open Deadline Detector

Claim Playbook

Follow negotiation tactics and documentation checklists per stage.

Open Claim Playbook

Create a Complete, Accurate Statement of Loss

This document is the insurer’s roadmap to payment. Capture valuations, depreciation, and documentation now so funds release without avoidable disputes.