Pro Course 4 of 5 · Core · 15 minutes
Documentation for Insurance Claims
Build a job file an adjuster can follow, from the first call to the last reading, and know the flood claim clock.
What You Will Be Able to Do
- Gather the first call facts the S500 lists
- Photograph and record a loss in an order anyone can follow
- Know the 60 day proof of loss clock on a flood insurance claim
- Point a Nevada customer to the Division of Insurance when a claim stalls
Lesson 1
The First Call Is the First Record
The S500 treats documentation as part of the work, with a whole section on administrative procedures, project documentation and risk management. It also lists what to learn on first contact. That includes the type and use of the building, the source and the date and time the water got in, whether the source is under control, roughly how much is affected, any known or suspected contaminants, earlier water damage, the materials involved, the age of the building and how many people live or work there.
Write those answers down on the call. They shape what you bring, and they become the first page of the claim file.
Key Points
- Ask when the water started and whether it is stopped
- Ask about earlier water damage and contaminants
- Write the answers down on the call
Lesson 2
Photos in an Order Anyone Can Follow
Shoot the outside of the building with the address in frame, then each room wide, then medium, then close. Take the source, such as the failed part, the stain line or the roof opening, before anything moves. Keep failed parts in a labeled bag. Photograph damage that was there before the loss and say so in the notes, since the S500 lists noting it among first visit tasks.
Pair photos with the moisture map and the daily log. A photo shows what it looked like, and the readings show why you did what you did.
Key Points
- Outside with the address, then wide, medium and close
- Keep failed parts in a labeled bag
- Mark damage that was there before
Lesson 3
Scope, Changes and Sign Offs
Write the scope from your findings, with the category and class you chose and why. When the scope changes, such as finding Category 3 water under a floor that looked clean, write down what you found, when, and who you told. Get the owner’s signature on the work authorization before work starts and on any change.
Keep every record dated. Equipment placed and removed, readings, photos and calls with the adjuster all belong in the file with a date and a name.
Key Points
- Write the category and class behind the scope
- Record scope changes with what, when and who
- Date and sign every record
Lesson 4
Flood Claims and Where Customers Turn
Flood damage is usually covered by flood insurance, not a standard home policy. For National Flood Insurance Program claims, FEMA says the signed proof of loss should be submitted within 60 days after the date of loss, with supporting documents like the building damage estimate and a personal property inventory, even if the owner disagrees with the adjuster. A supplemental claim can follow.
Your clean job file is what that estimate stands on. In Nevada, a customer who believes an insurer is mishandling a claim can file a complaint with the Nevada Division of Insurance. Tell them it exists. Do not act as their public adjuster unless you hold that license.
Key Points
- NFIP proof of loss within 60 days of the loss
- Send the estimate and inventory with it
- Nevada customers can complain to the Division of Insurance
Ready for the Exam
10 questions, 8 right to pass. Retake it as often as you like.
Sources
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