Sedgwick Sworn Statement in Proof of Loss Form

Ensure that you have completed all sections of the form before submitting. You can submit this form via email to your insurance agent or office. Physical submissions can be made directly to your insurance provider's office.

In 2024, the important date remains consistent with prior years. Always check the specific insurance policy details for expiration and renewal dates. Keeping track ensures timely claims processing.

This form is designed to document and prove financial losses incurred in insurance claims. It serves as an official record that captures essential details required by the insurance companies. Accuracy in this form is crucial for swift and fair assessment of claims.

• 1. Policy Number: Identifies the policy associated with the claim.
• 2. Date of Loss: The date when the loss occurred.
• 3. Description of Property: Details about the property involved in the loss.
• 4. Value of Loss: Monetary value attributed to the loss.
• 5. Deductible Amount: Value of the deductible applicable to the claim.

Failing to submit this form can lead to delays or denial of your insurance claim. It is important for all relevant details to be submitted accurately to avoid complications. Missing submissions could result in additional documentation requirements.

• Delayed Claims Processing: Incomplete or missing forms can slow down the review process.
• Claim Denial: Failure to provide necessary information may result in denied claims.
• Additional Documentation Requests: Insurance companies may ask for further proof of loss.

• 1. Accidents: To document vehicle-related accidents and claims.
• 2. Theft: To report losses acquired through theft or burglary.
• 3. Property Damage: For claims related to property damage caused by natural disasters.