• OUR PUBLIC ADJUSTING PROCESS

A Sworn Proof of Loss: Why Properly Documenting Your Claim Matters

  • An Insurance Estimate Is Not the Same as a Formal Statement of Your Loss.

When property damage occurs, your insurance company will generally investigate the loss and prepare an estimate of what it believes the necessary repairs should cost. But what happens when that estimate doesn't account for the full extent of the damage?

At OUTLX Public Adjusters, we believe policyholders should understand the importance of formally documenting their losses and clearly identifying the amounts they are claiming. 

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WHAT IS A SWORN PROOF OF LOSS?

Understanding What You're Actually Claiming

An insurance company's estimate represents its assessment of the loss. A sworn proof of loss is a formal statement made by the policyholder identifying information about the loss and, typically, the amount being claimed under the insurance policy.

Depending on the policy, it may include information about the property, circumstances of the loss, damaged items, claimed amounts, and other relevant details. The document is generally signed and sworn to by the insured when required by the policy.

A sworn proof of loss does not automatically establish that the insurance company owes the amount requested. However, it formally documents the policyholder's claimed loss.

CONTRACTOR ESTIMATE VS. SWORN PROOF OF LOSS

There Is a Difference Between Estimating Damage and Formally Presenting a Claim

Contractor Estimate

  • Identifies anticipated repair costs
  • Prepared by a contractor or estimator
  • Describes materials, labor, and repairs
  • Can support an insurance claim
  • Generally does not include a sworn declaration
  • Provides supporting valuation evidence

Sworn Proof of Loss

  • Formally states information about the insured's loss and amount claimed
  • Executed by the insured or authorized claimant as required
  • Contains statements required by the applicable policy
  • May satisfy specific proof-of-loss requirements when properly completed
  • Includes sworn certification when required
  • Documents the policyholder's formal claim presentation
WHY THE DOCUMENTATION MATTERS

A Claim Should Be Supported by More Than an Estimated Number

At OUTLX Public Adjusters, we believe a property insurance claim should be built on a thorough investigation of the loss. When a sworn proof of loss is appropriate or required, we assist the insured with preparing the necessary information and organizing the supporting documents.
  • A properly completed sworn proof of loss
  • A detailed repair estimate identifying the scope and amount being claimed
  • Photographs and supporting inspection findings
  • Relevant contractor estimates and restoration reports
  • Personal property inventories and valuations
  • Additional documentation supporting the claimed damages
  • Correspondence identifying the claim, submitted materials, and requested response

“

We submit what we can support.

OUTLX

THE 15-BUSINESS-DAY REQUIREMENT

Understanding the Insurance Company's Obligations

Texas law establishes deadlines governing how insurance companies acknowledge, investigate, and respond to property insurance claims. While the specific requirements depend on the circumstances, the general process includes:

Notice of Claim Submitted

Investigation & Information Requests

All Required Documentation Received

Written Claim Decision

15 Days

Insurer generally must acknowledge receipt of the claim, begin its investigation, and request additional information if needed (§ 542.055).

15 Business Days

Insurer generally must provide written notice accepting or rejecting the claim after receiving all items, statements, and forms required to secure final proof of loss (§ 542.056).

Note: Exceptions and extensions may apply. The specific requirements depend on the type of policy and the circumstances of the claim.

POLICYHOLDER RESPONSIBILITIES

Your Duties After Loss Are Part of the Claims Process

An insurance policy establishes responsibilities for both the insurance company and the policyholder. Following a property loss, the policyholder may be required to:

Provide Timely Notice

Notify the insurance company of the loss as required by your policy.

Protect the Property

Take reasonable steps to prevent additional damage.

Cooperate With the Investigation

Respond to reasonable requests for information and attend inspections when required.

Provide Documentation

Submit a sworn proof of loss when required, along with other requested information.

Proper documentation and compliance with your policy requirements can help establish your position and support a fair evaluation of your claim.
BEFORE THE DISPUTE ESCALATES

Build the Claim Before Escalating the Disagreement

Disagreements with insurance companies can be frustrating, particularly when the amount offered does not reflect what you believe is necessary to complete the repairs. Before a dispute escalates, it is often valuable to ensure that the damages have been properly investigated, the amount being requested has been clearly identified, and the available supporting documentation has been presented.
Can I request appraisal if my insurance company has already issued payment?

Yes. Receiving a payment does not necessarily mean you have accepted the settlement or that the claim is closed. If you believe the payment does not reflect the full amount of loss, you may still be able to invoke the appraisal provision in your policy.

Does appraisal determine whether my claim is covered?

No. Appraisal is generally intended to resolve disputes over the amount of a covered loss. It does not determine whether the insurance policy actually provides coverage for the damage in the first place. Coverage disputes are typically handled separately

Who pays for the appraisal?

Under most policies, each party pays for their own appraiser. The cost of the umpire (if one is needed) is usually split equally between the policyholder and the insurance company.

Will appraisal guarantee additional insurance payment?

No. Appraisal results in an award determining the amount of loss, but it cannot guarantee a specific payment amount. The final payment will depend on the appraisal award, your policy limits, your deductible, and any prior payments made by the insurer.

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Common Questions About Hiring a Public Adjuster

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