Appendix A A Form of Proof of Loss

• Library: The Commercial Property Insurance Policy Deskbook (ABA) (2018 Ed.)

APPENDIX A A Form of Proof of Loss

PROPERTY PROOF OF LOSS

To: __________An insurer (hereinafter called the "Company").

Policy Number: __________ Location of Property: __________

You insure: __________

(Names of all persons insured) (hereinafter called the "Insured").

A __________ loss occurred on the ___ day of ___

(Describe Cause of Loss)

___, 20___about the hour of ___ o'clock ___ m., and was caused by (Origin)

Residence of insured at time of loss: __________

Location of property at the time of loss: __________

The policy insured the Insured against the risk of loss to:

Building(s) up to $ __________ ;

Personal Property/Contents $ __________ ;

Additional Living Expense $ __________ ;

Other coverage(s) described as: __________ for $ __________...