Scope of Loss Report Template: Free Example + How to Use It
A scope of loss report is the foundational document in any property insurance claim. It is the written record that defines what was damaged, how it was damaged, what it will cost to repair or replace, and why the insurance policy covers it. Without a well-prepared scope of loss, claims are routinely underpaid, delayed, or denied.
This guide provides a free scope of loss report template with every section explained, so you know exactly what to include — and why each element matters to the carrier.
Scope of Loss Report Template: Section by Section
Section 1: Header / Cover Page
The header should include: insured name and contact information, property address, date of loss, cause of loss (wind, water, fire, hail, etc.), claim number, insurance carrier name, policy number, and the name and license number of the public adjuster preparing the report. This information establishes the document's identity and ensures it can be matched to the correct claim file at the carrier.
Section 2: Executive Summary
A 2–3 paragraph summary of the loss event, the extent of damage, and the total estimated cost of repair. The executive summary is what the carrier's desk adjuster reads first — it sets the frame for everything that follows. Lead with the most significant damage items and the total dollar amount.
Section 3: Cause of Loss Narrative
A detailed description of the event that caused the damage: the date and time, the weather conditions (for wind/hail/flood claims), the sequence of events (e.g., wind lifted shingles, allowing water intrusion, which caused ceiling and wall damage), and any relevant documentation (NOAA weather data, fire department reports, police reports). This section establishes coverage under the policy.
Section 4: Room-by-Room / Area-by-Area Damage Description
This is the core of the scope of loss. For each affected area of the property, describe: the specific damage observed, the dimensions of the affected area, the Xactimate line item codes that apply, the unit of measure (SF, LF, EA), the quantity, and the unit price. Include photographs for each area. Be specific: "water staining" is not sufficient — "water staining to 120 SF of drywall ceiling, Category 2 water intrusion, requiring removal and replacement" is what gets paid.
Section 5: Code Upgrade Requirements
Many policies include coverage for code upgrades (also called "ordinance or law" coverage). When damaged components must be replaced to current building code rather than original specification, document the specific code requirement (cite the applicable building code section), the original specification, and the upgraded specification. This is one of the most commonly missed categories in carrier estimates.
Section 6: Mitigation and Emergency Services
Document all emergency mitigation work performed: water extraction, drying equipment, board-up, tarping, debris removal. Include the IICRC standards that apply (S500 for water, S520 for mold, S700 for fire/smoke), the equipment used, the drying logs, and the invoices from the mitigation contractor. Carriers frequently dispute mitigation costs — thorough documentation is essential.
Section 7: Summary Estimate
A line-item summary of all repair costs, organized by category (exterior, interior, mechanical, mitigation, code upgrades). Include the total replacement cost value (RCV), the depreciation applied, and the actual cash value (ACV). If the policy is an RCV policy, note that depreciation is recoverable upon completion of repairs.
Section 8: Supporting Documentation
Attach all supporting documents: photographs (labeled and dated), contractor quotes, weather data, IICRC drying logs, building permits, and any correspondence with the carrier. A scope of loss report without supporting documentation is just an opinion — the documentation is what makes it a claim.
Free Scope of Loss Report Generator
Rather than filling out a template manually, PublicAdjusterTool's Scope of Loss generator produces a complete, professionally formatted scope of loss report from a brief description of the damage. The output includes all eight sections above, Xactimate line item codes, applicable state statutes, and carrier-ready formatting. Try it free — no account required.
See also: How to Write a Scope of Loss Report That Gets Paid, Xactimate Line Items Every Public Adjuster Should Know, Property Damage Claim Documentation Checklist.
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