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Who is your Homeowners insurance carrier? How long have you been insured with this carrier? Do you have a copy of your policy? Do you have a copy of your application? Do you have a copy of the "Dec Page" and Endorsements?
What are the stated limits in
your policy for the following coverages:
Dwelling/Structure
Other structures
Contents/Personal property
Loss of use
Who was your previous insurance carrier? (if insured by present carrier less than 5 years)
What were the stated limits in
your previous policy for the following coverages:
Dwelling/Structure
Other structures
Contents/Personal property
Loss of use
With respect to the Insured Dwelling/Structure:
What is the exact address of the insured property? Please Describe your property? How long have you owned the property? What type of coverage do you have?
Please Select
Guaranteed Replacement Cost
Extended Replacement Cost
If "Extended", what amount? Do you have "Code Upgrade Coverage"? Do you have exclusion for "Mold"?
With respect to Loss of Use coverage,
which does your policy provide:
Additional living expenses? Fair rental value? Do you have flood insurance? If so, who is your flood insurance carrier? What is your flood insurance policy limit?
With your homeowner's insurance, please
list all payments you have received from the insurance
company under the following coverages:
Dwelling/Structure:
Other structures:
Personal property:
Loss of use:
Who is the adjuster(s) for the insurance company on your claim? Was the adjuster(s) an employee for the insurance company or from an independent adjusting company?
Please Select
Insurance Company Employee
Independent Adjusting Company
Has a Scope of Loss been prepared? If so, by whom? Have you been asked for a personal inventory of items? Were you given a form to fill out regarding these items? Are you currently represented by a public adjuster? If so, who is your public adjuster? What is your public adjusters phone number? Have you signed or been asked to sign a notice of "Intent to Rebuild"? By whom? Have you signed any documents? With respect to your flood insurance, please list any payments you have received thus far: Are you represented by a lawyer? If so, who is your lawyer? What is your lawyers phone number? What is the current status of your claim? What areas of dispute do you currently have with your insurance carrier? Have you tried hired a contractor? What is the name of the contractor? What was the amount? Have you received a bid and when was it provied? Has your insurance company waived the 60 Day Proof of Loss Deadline? If no, what is the date your sworn proof of loss is/was due? Has your insurance company advised you or sent you notification regarding the 180 deadline?
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