Adjuster report templates
Final Report Template & Example
Last updated 2026-08-03
A final report has one property that distinguishes it from every other report in the file: nothing in it is open. Every figure is final, every item raised in an earlier report is either completed or explicitly transferred somewhere else with a reference, and the reader should be able to close the file without asking a question.
The closing sentence in practitioner use is literally 'This concludes the adjustment of this loss.' It is worth writing exactly, because it is a claim about the file rather than a courtesy. Writing it while a request is outstanding, a payment is unissued or a reserve is still standing is how files get closed and reopened, and a reopened file costs more than the cycle that would have finished it properly.
The structure below is a reconciliation more than a narrative. Its centre is the payment record and the arithmetic that ties gross loss, deductible, payments and reserve disposition together. The worked example closes the fictional water loss used across this library — and it is honest about the one thing that does not close with it, which is the subrogation recovery, transferred to a separate file with its own number rather than pretended into resolution.
Jurisdiction
Written primarily against US first-party property practice. Claim handling is regulated state by state — acknowledgment and response deadlines, prompt-payment requirements, adjuster licensing and unfair claims practices standards all differ — and the policy actually issued governs the claim. Where a page cites a statute, model act or regulation, confirm what applies in the state where the loss occurred. Outside the US, treat the structure as transferable and the legal references as not.
Final Report template
Free Word download, no email required. Or open it in Professional Drafter — it lands in your template library, ready to draft against.
When to use this document
- Every item raised in the file is completed, the last payment has issued, and the reserve is ready to be taken down. If any of those is untrue, the document you need is an [interim report](/adjuster-reports/interim-report/).
- The claim is being closed without payment — a withdrawal, a loss below the deductible, or a claim resolved without indemnity. The final report is still the closing instrument, and the reconciliation section simply reconciles to zero.
- A reopened claim is being reclosed. Reference the original closing report by date and state what reopened it, so the file reads as one sequence rather than two files sharing a number.
Worked example
Fictional scenario: the final report closing the Harbour Lane water loss. The adjustment concludes cleanly, but two things do not resolve with it — the subrogation recovery, transferred to a separate file, and the duration of the leak, which was never determined and is recorded as such rather than tidied away.
Report identification and closing statement
Final report, claim PC-2026-11482, insured D. Okonjo, 118 Harbour Lane. Dated 6 November 2026. Adjuster R. Calloway. Examiner C. Mendez.
Previous report: large loss report no. 5, dated 4 October 2026. Reports 3, 4 and 5 issued on the 30-day cycle on 14 August, 4 September and 4 October.
This concludes the adjustment of this loss.
One matter does not conclude with it and is stated here rather than at the foot of the report: the subrogation recovery against Feldstrom Plumbing has been transferred to recovery file RC-2026-03310 and continues under that reference. The insured's deductible reimbursement position depends on that recovery and is set out in the recovery disposition section below.
Summary of the loss
On or about 11 to 14 July 2026 a braided stainless supply line to the water heater at the risk separated at the crimped fitting, releasing water into the utility closet, hallway, living room and kitchen of a single-family dwelling. The loss was discovered by the insured at approximately 07:15 on 14 July, reported the same day, assigned 15 July and inspected 18 July.
Damage comprised 31 linear feet of drywall wet to 14 inches above slab, concealed saturation of insulation behind 11 linear feet of kitchen cabinetry found at reinspection on 29 July, and water damage to 211 stored volumes in the hallway closet. The detached garage and the bedrooms were unaffected. The dwelling remained habitable throughout and no additional living expense was claimed.
The claim was resolved by agreement. The dwelling was settled on an agreed scope; contents were settled following an independent review of the insured's appraisal. Total indemnity paid $97,530, of which the final two payments, totalling $8,390, issued on 30 October 2026.
Final coverage summary
Policy HO-4471903, term 1 March 2026 to 1 March 2027, in force at the date of loss, premium paid to term.
Limits applied: dwelling $310,000 (not reached); unscheduled personal property $155,000 (not reached); other structures $31,000 (not engaged); additional living expense 12 months actual loss sustained (not claimed). All-peril deductible $2,500, applied once to this occurrence, against the first dwelling payment of 30 July 2026.
Coverage question raised and how it concluded. The policy's exclusion for repeated or continuous seepage or leakage over a period of time was identified in large loss report no. 3 as potentially engaged, its application turning on the duration of the release. Duration was never determined: there was no sub-meter, the municipal supply is billed quarterly, there was no alarm or occupancy log, and Wentmore Plumbing Consultants reported on 11 August that the physical evidence could not narrow the 61-hour window between last occupancy and discovery.
On 26 August 2026 C. Mendez recorded a file decision, made with coverage counsel, that the exclusion would not be pursued and that no reservation of rights would issue. The insured was advised in writing on 28 August that the claim was proceeding without a coverage question. That decision, its author and its date are the record; the reasoning is in the coverage memorandum of 26 August and is not restated here.
Duration of the release remains undetermined as a matter of fact and is recorded that way. It was not necessary to the outcome and was not estimated to make the file tidier.
Final scope and agreed values
Dwelling (Coverage A). Final RCV $47,880. Depreciation $3,140, all recoverable. Final ACV $44,740. Basis: scope agreed with the insured in writing on 14 August 2026 following the 29 July revision; pricing on the carrier's July 2026 price list for the ZIP code. No supplement was requested by the insured or his contractor after agreement.
Recoverable depreciation of $3,140 was released on 30 October 2026 on receipt of the contractor's completion certificate dated 24 October and receipted invoices totalling $48,110, which exceeded the agreed RCV. The excess was not paid; the settlement is capped at the agreed scope.
Unscheduled personal property (Coverage C). Final RCV $52,150. Final ACV $46,900, with a replacement cost benefit of $5,250 released on receipted replacement. Basis: agreed after review. The insured's appraiser, Marren & Doyle, valued 211 volumes at $61,400 replacement value. That appraisal was reviewed by Halstead Rare Books, independently instructed on 21 August, who reported on 18 September at $52,150, the difference arising principally from three individually appraised volumes valued from a pre-loss list that could not be matched to any item recovered from the closet, and from six volumes assessed as restorable rather than total. The insured accepted the reviewed figure on 26 September without appraisal or further dispute.
Other structures (Coverage B). Nil. Detached garage inspected 18 July and 29 July, no intrusion.
Additional living expense (Coverage D). Nil. None claimed; dwelling habitable throughout.
Payment record and reconciliation
30 Jul 2026 — $15,390 — D. Okonjo — Coverage A — ACV on the pre-revision scope ($17,890) less the $2,500 deductible.
21 Aug 2026 — $26,850 — D. Okonjo — Coverage A — supplemental ACV following the agreed revised scope ($44,740 ACV less $17,890 already paid).
2 Oct 2026 — $46,900 — D. Okonjo — Coverage C — contents ACV on the reviewed figure.
30 Oct 2026 — $3,140 — D. Okonjo — Coverage A — recoverable depreciation released on completion evidence.
30 Oct 2026 — $5,250 — D. Okonjo — Coverage C — replacement cost benefit on receipted replacement.
- Gross loss, all coverages, RCV basis:
- $47,880 + $52,150 = $100,030.
- Less deductible, applied once:
- $2,500.
- Net payable:
- $97,530.
- Less total paid:
- $15,390 + $26,850 + $46,900 + $3,140 + $5,250 = $97,530.
- Balance:
- nil.
Reconciliation.
Expense paid: $11,830. Wentmore Plumbing Consultants $2,850; Halstead Rare Books $4,600; independent adjusting fees $3,940; evidence storage and photography $440. No expense invoice is outstanding.
Proof of loss and documentation status
No sworn proof of loss was required on this claim. The dwelling and contents figures were agreed in writing and the file was settled by agreement without a formal proof. C. Mendez confirmed on 26 September 2026 that a proof would not be called for, and that confirmation is in the file.
Recorded here rather than marked 'not applicable' because the requirement and its handling are the sort of thing a reopened file has to establish, and a dated decision by a named person establishes it. Where a proof is called for, the condition and the period for it appear in the standard fire policy language that several states enact verbatim into statute.
Documents in the file at closing: the assignment; the captioned report of 22 July; interim report no. 2 of 4 August; large loss reports 3, 4 and 5; the coverage memorandum of 26 August; scope sheets of 18 and 29 July; estimates of 22 July and 29 July; the Coastline Mitigation drying log and invoice; the Wentmore report of 11 August; the Marren & Doyle appraisal and the Halstead review; the insured's written scope agreement of 14 August and contents acceptance of 26 September; the completion certificate of 24 October and receipted invoices; 118 photographs; five payment advices; and the diary, 214 entries.
Reserve disposition
Indemnity reserve immediately before closing: $98,000. Taken down in full on 6 November 2026. Final indemnity paid $97,530. Variance: $470 favourable, 0.5%.
Expense reserve immediately before closing: $12,000. Taken down in full on 6 November 2026. Final expense paid $11,830. Variance: $170 favourable, 1.4%.
The reserve history and the reason for the variance across the life of the file. The reserve opened at $19,000 on 22 July on the first estimate. It moved to $50,000 on 4 August on the concealed saturation found at reinspection, to $107,000 on 6 August on receipt of the insured's contents appraisal at $61,400, and down to $98,000 on 4 October when the Halstead review returned contents at $52,150.
The $107,000 peak was set deliberately to a defensible worst case rather than to expected outcome, because at that date the only contents valuation in the file was the insured's and reserving below it would have meant reserving to a number nobody had produced. The eventual settlement came in $9,470 below that peak, which is the review doing what it was instructed to do. The useful lesson for the next file is not that the reserve was too high but that the interval between a valuation arriving and a review being instructed — 5 August to 21 August — is the interval worth compressing.
Subrogation, salvage and recovery disposition
Subrogation transferred, not concluded. The water heater was replaced 11 months before the loss by Feldstrom Plumbing under invoice 20941 dated 3 August 2025, and the braided supply line appears to have been supplied and fitted as part of that work. The theory is defective installation of the crimped fitting rather than product failure.
Notice issued to Feldstrom Plumbing on 19 August 2026. Their insurer acknowledged on 3 September and a joint examination of the retained components was held on 14 October, attended by both parties' consultants. No agreement was reached on the failure mode at that examination. The matter transferred to recovery file RC-2026-03310 on 1 November 2026, owner J. Halvorsen.
Evidence retained. Fitting and approximately 18 inches of adjacent line, tagged PC-2026-11482/E1, held in the branch evidence locker, custody with L. Ferris. Retention instruction issued 1 November: hold pending the recovery file, do not release or destructively test without J. Halvorsen's written authority. No expiry set; review diarised for 1 November 2027.
Salvage. None of value. The damaged volumes were retained by the insured at our request during the contents review; that request was released in writing on 2 October and their disposal is a matter for him.
Deductible reimbursement. The insured's $2,500 deductible has not been reimbursed and will be dealt with under the recovery file if and to the extent a recovery is made. He was told this in writing on 30 October and is aware that no reimbursement is promised.
Communication and closing notice to the insured
Last written communication: 30 October 2026, issued with the final two payments. It set out the final agreed figures for both coverages, the full payment history and the reconciliation, confirmed that the claim was being closed on completion of the file review, explained that the subrogation recovery would continue separately under a different file reference and different contact, and gave J. Halvorsen's name and telephone number.
The insured acknowledged by telephone on 3 November, approximately 6 minutes, and raised no further item.
One question was answered late and is recorded rather than omitted. On 29 July the insured asked how long the claim would take and was told a date could not be given until his appraisal arrived. He was not given a completion date until 28 August, four weeks later, when the coverage decision was communicated. A written status letter issued on 7 August, stating what was outstanding and when a decision was expected, but it carried no completion date; the next, on 21 September, did. The interval was longer than it should have been and the cause was the twelve days between the appraisal arriving on 5 August and the review being instructed on 21 August.
No complaint was made, and no department of insurance inquiry was received at any point on this file.
Items completed and items transferred
From the action list in large loss report no. 5 of 4 October 2026:
1. Obtain the insured's acceptance of the reviewed contents figure. Completed 26 September 2026, in writing.
2. Issue the contents ACV payment. Completed 2 October 2026, $46,900.
3. Obtain the contractor's completion certificate and receipted invoices, and release recoverable depreciation. Completed 30 October 2026, $3,140.
4. Obtain receipted replacement evidence for contents and release the replacement cost benefit. Completed 30 October 2026, $5,250.
5. Approve and pay the Halstead Rare Books invoice. Completed 21 October 2026, $4,600.
6. Attend the joint examination of the retained components with Feldstrom's insurer. Completed 14 October 2026. No agreement on failure mode; the point transferred with the recovery file.
7. Issue the closing letter to the insured. Completed 30 October 2026.
8. Conclude the subrogation. Transferred to recovery file RC-2026-03310 on 1 November 2026, owner J. Halvorsen, with the evidence retention instruction at the recovery section above.
9. Obtain a legible copy of Feldstrom invoice 20941. Withdrawn 1 November 2026. Requested from the insured five times between 18 July and 30 August; a legible copy was obtained directly from Feldstrom's insurer on 3 September and is in the file, so the request against the insured is closed as superseded rather than left standing.
No item is carried forward unresolved.
Closing certification
Adjuster: R. Calloway, licence reference held on the branch record and quoted on the assignment. Independent adjuster, instructed by the carrier.
Examiner and file owner: C. Mendez.
Date closed: 6 November 2026.
Retention: the file is retained for the calendar year in which the claim closed plus three years, expiring 31 December 2029, and is held so that the inception, handling and disposition of the claim can be reconstructed from it. Retention of the physical evidence is governed separately by the instruction at the recovery section and is diarised for review on 1 November 2027, which is the later date of the two.
Section-by-section guide
What each section is for, what a good one contains, and where they typically go wrong.
1.Report identification and closing statement
Identify the report as final, state the date, reference the last interim report, and state plainly that this concludes the adjustment. Put the closing sentence here rather than at the end, so a reader knows what kind of document they are holding before they read it. If anything is being transferred rather than completed, name it in this block too — a final report with a surprise at the bottom is not a final report.
2.Summary of the loss
A short, settled account: date and cause of loss, what was damaged, and how the claim was resolved. Past tense throughout. This is the paragraph that gets read when the file is pulled in three years, by someone who will not read the rest, so it should carry the facts a reader would otherwise have to reconstruct. Do not reargue anything and do not introduce a fact that appears nowhere else in the file.
3.Final coverage summary
Policy, term, limits and deductible as applied, plus a statement of any coverage question that arose and how it was concluded in the file. Report the conclusion as a file event with its date and its author — who decided, when, and what was communicated to the insured — rather than restating the reasoning. The final report records that the question was resolved; it is not the place to re-derive the answer.
4.Final scope and agreed values
The final agreed figures by coverage, on both RCV and ACV bases, and how each was arrived at — agreed with the insured, agreed after review, determined by appraisal, or accepted as presented. The basis matters more than the number at closing, because it is what a reopening or a recovery action will be tested against. State whether recoverable depreciation was released and on what evidence.
5.Payment record and reconciliation
Every payment in one table with date, payee, coverage and amount, then the arithmetic: gross loss, less deductible, less payments, balance nil. Show the balance reaching nil rather than asserting that it did. This is the section a reopened file, a recovery action or an audit turns to first, and it is the section most often wrong because advances were issued against one coverage and reconciled against another.
6.Proof of loss and documentation status
Whether a sworn proof of loss was required, requested, received and accepted, with dates. Where none was required, say so and say who waived it and when. The standard fire policy enacted verbatim into several states' statutes sets out the proof-of-loss condition and the period for it, which is why the requirement and its handling are worth recording precisely rather than as 'not applicable'. List the other documents the file closes with.
7.Reserve disposition
Final reserve figures immediately before closing, the amount taken down, and the variance between the last reserve and the final paid, with a reason for the variance. The variance line is the one that gets used, because it is the feedback that makes the next reserve on the next file better. A large variance with a stated cause is more useful to the reader than a small one with none.
8.Subrogation, salvage and recovery disposition
State the disposition, not the intention. Recovery pursued and to what outcome; recovery declined and on what reasoning; recovery transferred, to which unit, under which file reference, on what date. Where evidence is being retained for a recovery that outlives the adjustment, say who has custody, what the retention instruction is, and when it expires. This is the single most common place a final report leaves something genuinely open.
9.Communication and closing notice to the insured
The date and content of the last written communication to the insured, and confirmation that they have been told the claim is being closed. A file that closes without the insured being told is the one that generates a call to the department of insurance. Record any question the insured raised that was answered late or not at all, rather than allowing the file to close as though it had not been asked.
10.Items completed and items transferred
Take the action list from the last interim report and dispose of every line. Completed, with a date. Transferred, with a reference. Withdrawn, with a reason. Nothing carried forward unresolved. This section is what makes the closing sentence true, and it is the cheapest possible check on it: if a line cannot be dispositioned, the file is not ready to close.
11.Closing certification
Adjuster name and licence reference where the state requires it, the examiner or file owner, the closing date, and the retention date. Licensing requirements differ by state and by whether the adjuster is staff, independent or public, so take the requirement from the state's own text rather than from a comparison chart. Record the retention date as a date, not a formula, so nobody has to compute it later.
Common mistakes
The failure modes that show up most often when this document is reviewed later.
Writing 'This concludes the adjustment of this loss' while an item is still outstanding.
The sentence is a factual claim about the file, and the file is the thing that proves or disproves it. A claim closed with a request still standing reopens, and a reopened file costs more than the extra cycle that would have finished it.
Asserting the balance is nil instead of showing the arithmetic.
Gross loss, less deductible, less payments, balance — four lines. Without them, an audit or a recovery action reconstructs the reconciliation from payment records, and the reconstruction is where advances issued against one coverage and reconciled against another surface as an error nobody made deliberately.
Recording subrogation as 'referred to recovery' and closing.
Referred is not disposed. The recovery unit needs the file reference, the custody of the physical evidence, the retention instruction and the deductible reimbursement position, and none of those exist unless the closing report writes them down while the person who knows them is still on the file.
Rearguing a coverage question in the final report.
The final report records that the question was decided, by whom and when, and points at the memorandum. Restating the reasoning creates a second version of it, and when the two versions differ by a word the difference is what gets quoted.
Closing without the reserve variance and its reason.
The variance is the only feedback the reserving process ever gets. Without a stated cause it is a number in a report nobody reads twice; with one, it is the reason the next file's reserve on the same shape of loss is better.
Marking proof of loss 'not applicable' rather than recording the decision.
'Not applicable' has no author and no date. If the file is reopened or the settlement is later questioned, the difference between that and 'waived by C. Mendez on 26 September' is the difference between a record and a gap.
Questions
- Is 'This concludes the adjustment of this loss' the required wording?
- Nothing requires it. It is a practitioner convention and it survives because it is unambiguous — it says the adjustment is over rather than that the report is over, which is the distinction a reader needs. Use it or use something equally plain, but do not use it as a sign-off on a report that still contains an open item.
- How do you close a file when the subrogation is still running?
- The adjustment closes; the recovery does not. Transfer it explicitly, with the receiving file reference, the owner's name, the custody of any retained evidence, the retention instruction and the insured's deductible reimbursement position, and say all of that in the identification block at the top rather than leaving it as a surprise at the foot. The worked example above does exactly this.
- Does a final report need a sworn proof of loss attached?
- It depends on the policy and on whether one was called for; many first-party property claims settle by agreement without one. What the report needs is a dated record of the decision either way — required and received, or not called for and by whom. The proof-of-loss condition itself appears in the standard fire policy language enacted verbatim into several states' statutes, which is the public text worth reading rather than a paraphrase.
- How long does the file have to be kept after closing?
- Retention periods are set by state law and by carrier policy, and they differ. Model 910 §6 recommends the year the claim closed plus three years, and states that adopted it did so at their own citation — check the applicable state's own text rather than assuming the model period. Whatever the answer, write it in the closing certification as a date, because a formula in a closed file is a date nobody computes.
The blank template
Exactly what is in the Word download, so you can see the structure before deciding whether you want it.
Report identification and closing statement
Summary of the loss
Final coverage summary
Final scope and agreed values
Payment record and reconciliation
Proof of loss and documentation status
Reserve disposition
Subrogation, salvage and recovery disposition
Communication and closing notice to the insured
Items completed and items transferred
Closing certification
Download this template
Free Word download, no email required. Or open it in Professional Drafter — it lands in your template library, ready to draft against.
Sources
- NAIC — Market Conduct Record Retention and Production Model Regulation (Model 910, January 2004)
- N.Y. Insurance Law §3404 — standard fire policy (statutory text)
- NAIC — Unfair Property/Casualty Claims Settlement Practices Model Regulation (Model 902, 1991 amendment, July 1997 print)
- NAIC — Market Regulation Handbook: Examination Standards Summary, 2025 Edition
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This page is a documentation aid, not legal advice and not a coverage opinion. Claim-handling requirements vary by state and by policy wording, and a template cannot tell you what your file requires. The worked example describes a fictional loss.