Get Automobile Proof Of Loss Sample

This guide aims to assist users in accurately completing the Automobile Proof Of Loss Sample form online. By following these steps, you will ensure that your form is filled out correctly, helping to streamline the claims process.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the form, enabling you to fill it out online.
2. Begin by entering your claim number in the designated field where indicated.
3. Complete the agent/broker section with the relevant information about your insurance agent or broker.
4. Fill in the insurer's details, ensuring the name and contact information of the insurance company are accurate.
5. Provide your information as the insured party, including your name and address, under the insured section.
6. Enter the policy number, and make sure to note the policy's effective date.
7. Describe the vehicle involved in the claim by entering the year, make, and model in the appropriate section.
8. Input the serial number and license plate number along with the province of registration.
9. Document the purchase date and seller's name, along with the purchase price in the respective fields.
10. Indicate the date and time when the loss or damage occurred, precisely filling in those details.
11. Specify the circumstances that caused the loss or damage in the provided area.
12. Note whether the police were notified and include the relevant details regarding the notification.
13. Declare if there has been any other insurance on the vehicle, providing details if necessary.
14. Complete the Harmonized Sales Tax question based on your registration status and provide the necessary percentages.
15. Fill in the total amount of loss or damage, deductibles, and the total amount claimed to the insurer.
16. Confirm that the claim does not include amounts for unreported items or those excluded by willful acts.
17. Authorize payment of the claim by entering the name and details of the person authorized to receive it.
18. Make the solemn declaration regarding the truth of the statements made in the form.
19. Finally, provide the date and sign, and indicate the position or title if the insured is a company or partnership.

Complete your documents online with confidence—start filling out your Automobile Proof Of Loss Sample today.