Windstorm Insurance Claim
Windstorm Insurance Claim
Date: [Date]
Policyholder Information
|
Name |
[Your Name] |
|
Policy Number |
[Policy Number] |
|
Email Address |
[Your Email] |
Description of Incident
|
Date of Windstorm |
July 29, 2050 |
|
Location of Damage |
123 Maple Street, Springfield, IL 62704 |
|
Description |
On July 29, 2050, a severe windstorm caused extensive damage to the property. This included significant roof damage, broken windows, and structural damage to the front porch. Large tree branches also fell on the property, worsening the damage. |
Damage Assessment
|
Item |
Description of Damage |
Estimated Repair Cost |
|---|---|---|
|
Roof |
Approximately 40 shingles are missing, requiring immediate replacement |
$3,500 |
|
Exterior Walls |
Cracks and holes due to debris impact |
$1,200 |
|
Windows |
Three windows shattered |
$600 |
|
Landscaping |
Fallen trees and damaged plants |
$800 |
Total Estimated Cost: $6,100
Supporting Documents
Please find attached the following documents:
-
Photographs of the damage
-
Repair estimates from contractors
-
A copy of the police report
Declaration
I, hereby declare that the information provided in this claim form is accurate and true to the best of my knowledge. I understand that any false statements may result in a denial of the claim.
[Your Name]
