How to Analyze Insurance Documents in a Fire Investigation:
Proof of Loss
VP, Fire Investigation Specialist
American Re-Insurance Co.
The Proof of Loss is the document that reports the official communication
from the insured that an insured property has been damaged. It details the
property involved, the way it was damaged, the amount of damage, and condition
of the property at the time of damage. It can be a valuable tool in establishing
how the insured represented the loss to the insurance company, the entity
that will determine what, if any, financial compensation will come to the
Annotations are found below the form. You may click on any number on
the form to hop directly to its annotation.
1. This section contains all of the information about
the fire loss in the insured's own words: what happened, when it happened
and why it happened. A misstatement here may be admissible evidence of fraud.
2. Information about the use and occupancy of the property
at the time of the fire may be a significant indicator of a motive for the
loss, particularly where a property has become vacant or unoccupied.
3. The legal interest of the insured is a statement of
the insured's legal relationship to the property: ownership, leasehold,
or other. It requires a disclosure of any other persons or entities having
any legal interest in the property.
4. This section requires the disclosure of any changes
in the insured's legal interest in the insurance policy since it was originally
issued and any changes in the nature of the property insured since that
time. This is critical information in considering the issue of motive, especially
when coverage has been increased or the property has been significantly
5. This requires a statement of the total available insurance,
including coverage under any other policies previously disclosed or undisclosed.
It may identify additional evidence of motive, especially in the case
of a property where multiple policies are held that add up to a significant
6. This is the insured's statement of the actual cash
value (market value) of the insured property immediately before the fire
loss. An overstatement of the value may correspond to an attempt to overstate
the loss in a fraudulent claim.
7. This is the insured's statement of the total loss
to the insured property, regardless of the limitations of insurance coverage.
If the claim is fraudulent, the loss will likely be overstated. You may
be able to provide a "reality check" for this figure with the
damage you observed at the scene and the statements the insured made to
8. This represents the insured's definitive statement
of the amount claimed under the policy, subject to any coverage limitations.
If the claim is fraudulently overstated, it will appear here.
9. This paragraph contains a sworn representation by
the insured that nothing about the loss and the resulting insurance cliam
have been fraudulently misstated in any respect. Where the evidence proves
otherwise, this is an admissible statement of the insured at trial.
10. The signature of the insured under oath establishes
the admissibility of the proof of loss as evidence at trial.
11. The requirement that the Proof of Loss be sworn
and notarized is a condition of the policy of insurance and confirms its
admissibility as evidence at trial.
Reprinted with permission from the author.