Templates
Public adjuster
The insured-side set: public adjuster contracts, claim process disclosures, letters of representation, rescission notices, supplement requests and appraisal demands.
Public adjusters produce a document set with no carrier equivalent, and most of it is statutorily compelled: the contract title itself is mandated, along with a pre-contract disclosure, a rescission notice with prescribed timing and in some states prescribed type size, and an itemized statement of all compensation.
It is also the most fragmented area in the vertical. The NAIC model act's state adoption chart shows an empty adoption column for every state, which means roughly fifty idiosyncratic statutes and fee caps ranging from a flat 10% to a sliding scale that falls to zero.
11 templates in this section
Public Adjuster Contract Template & Example
A public adjuster contract template with the eleven terms the NAIC model act requires, the four it forbids, and a filled-in example. Free Word download, no signup.
Template + worked example + .docx
Claim Process Disclosure Template & Example (Public Adjuster)
The separate pre-contract disclosure the NAIC model act requires, with the three adjuster definitions and four statements it prescribes, plus a filled-in example.
Template + worked example + .docx
Letter of Representation Template & Example (Public Adjuster to Insurer)
The notification letter the model act requires — signed by the insured, authorising the public adjuster to represent their interest. Template, worked example and free Word download.
Template + worked example + .docx
Public Adjuster Contract Rescission Notice Template & Example
The three-business-day rescission notice: how the window is counted, what has to be returned and when, with a filled-in example and a free Word download.
Template + worked example + .docx
Itemized Statement of Recoveries & Compensation Template
The two itemized statements the model act requires in every public adjuster file — the insured's recoveries and all compensation received from any source — with a worked example.
Template + worked example + .docx
Public Adjuster Estimate Reconciliation Template & Example
How to present a competing scope and estimate to a carrier: a line-by-line reconciliation showing where the two estimates differ, why, and what each difference is worth.
Template + worked example + .docx
Supplemental Claim Request Template & Example
A supplemental claim request with the distinction that decides the deadline: supplement, reopened claim or new claim. Template, worked example and free Word download.
Template + worked example + .docx
Appraisal Demand Letter Template & Example
A written demand for appraisal under the policy's appraisal clause, with the statutory mechanics, the timetable it starts, and what appraisal cannot decide. Free Word download.
Template + worked example + .docx
Department of Insurance Complaint Template & Example
How to file a claim-handling complaint with a state Department of Insurance so it closes as confirmed: what to allege, what to attach, and what the process can and cannot deliver.
Template + worked example + .docx
Public Adjuster Closing Report Template & Example
The closing report to the insured: what was recovered, what it cost, what remains open, and what they must do after the file closes. Template, worked example, free Word download.
Template + worked example + .docx
Property Claim Reconsideration Letter Template & Example
A letter asking a property insurer to reconsider a denial or partial denial, built against the denial's own reasons. Template, worked example, free Word download.
Template + worked example + .docx