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Published February 12, 2026

Proof of Loss: Free PDF Template + Step-by-Step (2026 Guide)

When an insurance carrier or court asks for a proof of loss, they want a sworn summary of what happened, the dollar value of the damage, and the evidence you'll rely on to prove it. Submitting a clear, organized statement keeps the claim moving and protects you if the dispute escalates. This guide explains when to use the document, how to complete every field, and how to generate a polished PDF with CourtPDF's Proof of Loss tool without uploading sensitive files.

When to use it

Insurers rely on proof of loss statements to verify facts before releasing funds. You may also need one for court motions, discovery responses, or settlement negotiations. If you're documenting personal property, business equipment, or vehicle damage, the proof of loss ties the incident narrative to the exact policy that covers it. Submit the statement along with corroborating exhibits and keep a copy for your records.

Common scenarios include severe weather claims, theft investigations, and disputes about repairs. For example, homeowners filing roof damage claims often supplement invoices with a proof of loss and photos to show the carrier the scope of the loss. Businesses can attach equipment inventories using the Incident Report PDF and our Evidence Index generator so adjusters can review the chain of documents quickly. If the insurer questions valuation, create supporting spreadsheets or aProof of Ownership PDF to establish what was lost.

What to include

A complete proof of loss should connect the incident to the policy, summarize damages, and show you swear the statement is accurate. Use the checklist below as you work through the form:

  • Insured: Full legal name of the person or business listed on the policy.
  • Policy No: The policy or certificate number shown on your declarations page.
  • Claim No: The claim number assigned by the insurer once you reported the loss.
  • Incident Date: Exact date (and time if needed) when the damage occurred or was discovered.
  • Location: Address or site description of where the loss happened.
  • Description: A factual narrative explaining what happened, who was involved, and the impact.
  • Estimated Loss: Monetary value, estimates, or invoices showing the amount you seek.
  • Photos / Evidence: A list of attachments such as photos, receipts, or expert reports that support the claim.
  • Signature + Date: Printed name of the signer and the date you executed the statement.

Pair this checklist with receipts or witness statements. The Proof of Payment PDF can demonstrate expenses you already covered, while the Proof of Delivery generator shows when replacement items arrived. Organizing these supporting items keeps reviewers focused on the facts rather than chasing missing paperwork.

How to generate it free

  1. Open the Proof of Loss PDF tool in your browser. The generator runs locally, so none of the policy details or evidence lists leave your device.
  2. Enter the insured's name, policy number, and claim number. Add the incident date and a detailed description. The form accepts paragraph-length narratives, so you can paste notes from adjuster calls or police reports.
  3. List supporting photos or documents, then add the signer's name and today's date. ClickDownload Proof of Loss PDF to generate a clean, court-ready statement.

After downloading, store a copy in your digital case file. Use our Chain of Custody PDF if you need to show who handled physical evidence. You can also merge the statement with exhibits using the built-in Combine PDFs feature inside CourtPDF.

FAQs

Still have questions? These quick answers cover the issues claimants raise most often when preparing a proof of loss.

  • Is this form legally valid? Yes—insurers and courts accept typed statements if they contain accurate policy details and a sworn certification.
  • Do you store my data? No. CourtPDF renders everything locally in your browser, so your information stays on your device.
  • Can I revise it later? Absolutely. Reopen the tool, adjust the details, and download a new copy in seconds.
  • Should I attach receipts? Yes. Include invoices, bids, or proof of purchase documents to show how you calculated the loss amount.
  • What if I lost paperwork? Explain the gap in the narrative and attach affidavits or witness statements that corroborate the missing records.

Disclaimer

CourtPDF is not your attorney and this article is not legal advice. Always review policy requirements and consult a licensed professional if you need personalized guidance for your claim or litigation.