Insurance Claim Form Template

Collect policy details, incident information, damage estimates, photos, and documents from people filing an insurance claim. Used by insurers, brokers, or claims teams.

Use this template free

When to use it

  • Report damage to a home or business
  • Submit details after a vehicle incident
  • Request reimbursement for damaged belongings
  • Send photos and documents to a claims team

What it asks

  1. Your name
  2. Email address
  3. Phone number
  4. Policy number
  5. Date of incident
  6. What happened?
  7. What was damaged?
  8. Estimated cost of the damage
  9. Upload photos
  10. Upload supporting documents

Why it should be encrypted

Policy numbers, contact details, incident descriptions, and damage evidence can reveal private information. They should be readable only by the people handling the claim—not SealForm or anyone else without a need to review them.

Tips

  • Ask claimants to include the date and location of the incident.
  • Specify which photo angles or supporting documents are most useful.
  • Tell claimants how to label files so your team can match them to a claim.

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