The following are samples of claim and proof of loss forms. You can use them for "dwelling" and "contents" claims. Please refer to our Dwelling Tips, Claim Tips, the Disaster Recovery Handbook, and other United Policyholders' publications for guidance on documenting loss and damage fully and getting fairly, promptly paid on claims.

Sample Letters

Sample Claim Documents

Sworn Statement In Proof of Loss

Dwelling repairs/rebuilding/scope of loss:

See attachments at the bottom of the page for more examples. 

Contents/Personal Property

Inventory/Personal Property Claim Worksheets (Excel doc) - United Policyholders Home Inventory Worksheets for you to complete and save on your computer or recovery flash drive

Example of a completed home inventory - 2003 Cedar Fire Survivor and Disaster Recovery Mentor, Julie Robinson, has donated her contents claim form to United Policyholders

Example of completed home inventory - 2008 Freeway Complex Fire Survivor Laura Hyde has donated her detailed contents inventory form to United Policyholders


Consumer-oriented Guides

Industry Guides

Sample Damage Reports and Documentation

Other types of damage and useful reports may include: cement and asphalt, decks, engineering, fire cause and origin, gutters, insulation, roofs, siding and stucco, and seismic/earthquake.

Please send an email to if you are looking for a type of report you do not see here or would like to contribute a sample report to UP. All samples are redacted for personal information.