Claim Investigation, Damage Assessment, and Documentation
This domain tests whether you can build a record strong enough to support a claim through negotiation, appraisal, and litigation. The insured generally bears the burden of proving a covered loss, so documentation is the claim.
The investigation sequence
- Notice and contact. Document the date the insured learned of the loss and the date the insurer was notified. Delayed notice is a defense only where the insurer was prejudiced.
- Preservation. Send a preservation letter before repairs, disposal, or remediation. Photograph everything in place, including unaffected areas that prove pre-loss condition.
- Cause of loss. Separate cause from damage. Collect the failed component, weather data, and manufacturer or expert input where causation is contested.
- Damage quantification. Use moisture meters, thermal imaging, elevation sketches, and dimensioned photos. Record both the damaged and the matching undamaged materials.
- Pre-loss condition evidence. Dated listing photos, inspection reports, and utility records rebut wear-and-tear and pre-existing damage arguments.
- The sworn package. A proof of loss, contents inventory, receipts, contractor estimates, and expert reports form the submission; keep a date-stamped copy.
Worked example
Hail claim on a twelve-year roof. The insurer asserts the shingles show only granule loss and blistering typical of age. The adjuster's response is a test square on each slope, close-up photographs of fresh impact marks with bruised mat and displaced granules, a date-of-loss weather report showing hail of the relevant size, and a comparison slope not facing the storm. The reasoning is cumulative: a single impact mark proves little, but a pattern consistent with storm direction plus damage concentrated on the exposed slopes supports functional damage.
Traps that cost marks
- Allowing property to be discarded before inspection.
- Documenting the damage but not the pre-loss condition.
- Submitting an undocumented lump-sum demand that cannot survive item-by-item review.
- Confusing causation evidence with damage-severity evidence.