Adjuster report templates
NFIP Preliminary Report Template & Example
Last updated 2026-10-10
Give the NFIP examiner an early account of the inspected damage, the reserve recommendation and any issue needing attention. The June 2025 Claims Manual, Section 1, “Timely Reporting” (Claims Journey–33), makes the Preliminary Report due within 15 calendar days of receipt of the loss assignment. Keep that trigger visible: it is receipt of the assignment, not the date the adjuster finishes the inspection.
Appendix C–2 identifies FEMA's Adjuster's Preliminary Report as FF-206-FY-21-146. The Word download below is a companion drafting worksheet, not that official form. Its headings organize the supporting explanation; they are not a transcription of FEMA's fields. Use the official form from the FEMA directory listed under Sources. Section 1, “Preliminary Report” (Claims Journey–34), says to complete the entire form and highlights reserves, building foundation components and a memorandum for special issues.
The fictional Willow Bend example leaves a prior-repair question open while giving the examiner a usable initial reserve and evidence index. The NFIP narrative report carries the later investigation update; the NFIP final report shows the completed recommendation. This is a separate flood matter from the library's Harbour Lane supply-line loss.
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.
NFIP Preliminary 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
- When preparing the initial NFIP reporting package after inspection, with the assignment-receipt date controlling the preliminary reporting period.
- When an inspection raises an underwriting concern or another special issue that needs a memorandum with the Preliminary Report (Claims Journey–34–35).
- When organizing the initial reserve recommendation and its supporting photographs before the detailed estimate is ready (Claims Journey–34 and 68).
Worked example
Fictional scenario: the Willow Bend flood, claim NF-FICTION-260901, insured M. Reyes, independent adjuster R. Calloway. All people, addresses, dates, identifiers, dollar amounts, measurements, counts and attachment references are fictional. No actual forms or evidence accompany this teaching example. The initial report leaves verification of earlier cabinet repairs unresolved.
Assignment and form record
Companion memorandum for the Preliminary Report on claim NF-FICTION-260901, policy NF-FICTION-2048, M. Reyes, 214 Willow Bend. Assignment received 2 September 2026; policyholder contacted that day; inspection completed 3 September. This package was delivered to the examiner on 10 September.
The package record identifies the completed official Preliminary Report, signed by R. Calloway. The FCN entry was checked in the fictional file; no credential number or signature is reproduced in this example. The inspection notes and delivery receipt are indexed separately so the examiner can distinguish the visit date from the submission date.
Inspection facts and photograph references
M. Reyes reports that water from the overflowing creek reached the dwelling on 1 September and receded the following morning. Reyes supplied photographs showing water across the subject yard and the adjoining property; the accompanying message identifies them as taken during the event. The reported timing is attributed to Reyes, not presented as my observation during the later inspection.
At inspection, debris and staining marked the exterior wall. I measured the highest exterior waterline at 22 inches above the lowest adjacent grade. Interior measurements were 8 inches above the finished living-room floor and 7 inches above the kitchen floor. Images WB-05 through WB-10 show the measurement reference points. The floor plan locates both rooms. Lower wall finishes and the cabinet bases showed wetting and swelling; concealed conditions behind the cabinets were not fully visible. Perimeter images WB-01 through WB-04 and the room images accompany this report.
Initial reserves and their basis
Initial building damage reserve: $24,000. Initial personal property damage reserve: $6,000. These are preliminary damage approximations before a completed estimate, depreciation, deductible and settlement reconciliation. They are not proposed check amounts.
The building figure reflects the inspected lower wall finishes, floor finishes, cabinet bases and associated cleanup work. Measured room notes are attached, but cabinet quantities and the itemized repair submission remain incomplete. The personal property figure reflects the photographed furniture and household items on Reyes's initial list; ages and replacement costs remain to be documented. I will revise each reserve when the missing information establishes a better basis. The cabinet repair history could affect the treatment of those items and is specifically identified below.
Building facts and issues for the examiner
The inspected dwelling has a slab floor at the occupied level. The inspection notes and perimeter images describe the visible foundation and floor configuration; no basement or elevated occupied floor was identified during this visit. No discrepancy with the supplied building description was identified in the areas inspected. These statements record the visit and do not purport to describe concealed construction.
Reyes reports an earlier flood claim involving kitchen cabinets and states that the damaged cabinets were replaced afterward. No invoice was available at inspection. Current photographs establish the condition now visible, but they do not by themselves establish what was replaced after the earlier event. I have brought this issue to the examiner's attention and requested review of the prior loss file.
Outstanding evidence and next report
On 3 September I requested the earlier cabinet replacement invoice and available completion photographs from Reyes. On 4 September I asked the examiner for the prior estimate and photographs. The earlier repair remains unverified as of this submission. The preliminary reserve is subject to that review; it does not resolve the cabinet item.
R. Calloway will follow up on 17 September, compare any received records with the present inspection and report a material change to the examiner. The diary records the 10 September preliminary submission as the reference for the closing or interim reporting interval. The next planned contact is an internal work target, not a new policyholder deadline.
Package check and delivery
The delivery record lists the signed official Preliminary Report, the inspection image index and images, the measured floor plan, the initial personal property list and this reserve and prior-repair memorandum. The examiner can locate the policyholder's event photographs separately from my inspection photographs.
The APDA applicability check is recorded in the inspection file. On this fictional inspection record, the building did not appear potentially substantially damaged; no APDA is listed as enclosed. The earlier cabinet invoice and prior claim file are outstanding requests, not attachments. This submission provides the examiner with the available facts and reserves while keeping that evidence gap visible.
Section-by-section guide
What each section is for, what a good one contains, and where they typically go wrong.
1.Assignment and form record
Use this worksheet alongside FEMA form FF-206-FY-21-146, not as a replacement. Record assignment receipt and report delivery separately. Section 1, “Examination—Reporting Overview” (Claims Journey–68), calls for the Preliminary Report to be signed by the adjuster and include the adjuster's FCN. This example uses an independent adjuster. Keep the transmission chronology in the claim diary.
2.Inspection facts and photograph references
Separate what you observed from what the policyholder reported. Section 1, “Cause of Loss” and “Documenting and Measuring the Waterline” (Claims Journey–11–12), addresses evidence of flood, direct physical loss, source, timing and measured waterlines. “Reporting Overview” (68) calls for perimeter and damage photographs with the Preliminary Report. Identify the images that support each material observation; the photo log can organize the references.
3.Initial reserves and their basis
“Preliminary Report—Reserve Amounts” (Claims Journey–34) describes reserves as the adjuster's best approximation of damage to the insured building and personal property before an estimate is prepared, and calls for updates as the claim progresses. Explain the inspection basis and what remains unpriced. The amounts in this worksheet are initial damage approximations, not a completed settlement calculation.
4.Building facts and issues for the examiner
“Preliminary Report—Building Foundation Components” and “Underwriting Referral” (Claims Journey–34–35) require attention to how the building is constructed and to potential underwriting problems. Refer a potential problem promptly upon discovery, identify the current rating, and supply facts and photographs; disclose uncertainty. “Adjuster Memorandum to the NFIP Insurer” (34) also supports a separate explanation of special issues. This section gathers the facts without reproducing the manual's foundation coverage rules.
5.Outstanding evidence and next report
Record what is missing and the next action. “Prior Loss History and Request” (Claims Journey–49) says to ask about prior flood losses and report the information to the insurer; where repairs cannot be substantiated in the preliminary assessment, recommend review of the prior loss file. “Timely Reporting” (33) calls for a Closing Report within 45 days after the Preliminary Report, or an Interim Report when the claim cannot be concluded, then every 30 days until conclusion or as directed by the examiner. These are report intervals, not substitutes for the policyholder's proof-of-loss requirements.
6.Package check and delivery
List what actually accompanies the form. Claims Journey–68 supports the signed form, FCN, photographs and examiner review of reserves and concerns. “Adjuster Preliminary Damage Assessment” (35) separately addresses the APDA when a building may have suffered substantial damage and says a copy should accompany the Preliminary Report. Check that requirement against the facts; this companion worksheet does not replace either form. Clearly distinguish delivered attachments from documents still requested.
Common mistakes
The failure modes that show up most often when this document is reviewed later.
Starting the preliminary clock at inspection.
Claims Journey–33 uses receipt of the loss assignment as the trigger for the 15-calendar-day period. Recording only the inspection date hides whether the report was timely.
Sending this Word worksheet as if it were FEMA's Preliminary Report form.
Appendix C–2 identifies the official form, and Claims Journey–34 calls for the entire form to be completed. This worksheet supplies supporting prose rather than all of the official form's fields.
Giving a reserve without the inspection basis or known uncertainty.
The reserve is an approximation that must develop with the claim (Claims Journey–34). Explain what informed the amount and which unresolved item could change it.
Treating the policyholder's account of a prior repair as verified replacement.
Claims Journey–49 calls for evaluation of repair evidence and, where it cannot be substantiated, review of the prior file. Attribute the account and retain the unresolved question.
Leaving a discovered underwriting concern for the closing report.
“Underwriting Referral” (Claims Journey–34–35) calls for prompt attention on discovery, with facts and photographs, and resolution before closing. The preliminary reporting date is not a reason to postpone a referral.
Questions
- Which preliminary form does the June 2025 manual identify?
- Appendix C–2 names Adjuster's Preliminary Report, FF-206-FY-21-146. Use the FEMA adjuster forms directory in Sources to obtain the official form. The downloadable Word file on this page is a companion worksheet.
- Does the manual require a completed estimate before the preliminary reserve?
- “Reserve Amounts” (Claims Journey–34) expressly describes an approximation made before an estimate is prepared, based on the initial inspection. State its basis and update it as the claim progresses.
- What if the claim is still open after the Preliminary Report?
- Under “Timely Reporting” and “Status Update” (Claims Journey–33 and 35), submit an Interim Report if adjustment cannot be completed within 45 days after the Preliminary Report, and continue at 30-day intervals until completion; page 33 also recognizes examiner direction. Page 35 calls for an interim update whenever an issue needs the insurer's attention before the final recommendation. The [narrative example](/adjuster-reports/nfip-narrative-report/) shows such an earlier update.
- Must every preliminary package contain an APDA?
- Claims Journey–35 ties the APDA to a building that may have suffered substantial damage. Check that question promptly after inspection and follow the manual's APDA instructions when applicable. A Preliminary Report and an APDA are separate forms; the latter is identified at Appendix C–5.
The blank template
Exactly what is in the Word download, so you can see the structure before deciding whether you want it.
Assignment and form record
Inspection facts and photograph references
Initial reserves and their basis
Building facts and issues for the examiner
Outstanding evidence and next report
Package check and delivery
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
Related templates
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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.