How to Fill Out a Home Insurance Proof of Loss Sworn Statement
List your damaged items and losses with costs, sign it, and get it notarized before your insurer's deadline.
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The deadline is strict
Your policy sets a number of days to return the sworn statement after your insurer asks for one, often 60 days. Missing it can give the insurer grounds to deny the claim. Check your policy's proof of loss clause and mark the date as soon as you get the request.
Every item needs a value
List each damaged or lost item with a description, its age, what it cost new, and what you believe it's worth now. Insurers check these numbers against the final payout. Receipts, photos, and any appraisals you have back up what you claim.
Your total sets the ceiling
The dollar amount you swear to becomes the figure the insurer measures your claim against. If the adjuster's estimate or offer comes in lower, the gap between your sworn number and their number is usually where a dispute over the payout starts.
Notarization makes it binding
Signing in front of a notary turns your statement into a sworn legal document. Getting a number wrong, leaving out damaged property, or rounding up isn't a small mistake here. It can be treated as misrepresentation and used to reduce or deny the claim later.
Check your number before you swear to it
The figure on your sworn statement is what the insurer measures their offer against. If it's lower than what rebuilding or replacing actually costs, comparing policies now shows what coverage should have closed that gap.
What if the insurer's estimate comes in lower than your sworn statement
A gap between what you swore to and what the adjuster offers doesn't resolve itself. The insurer's estimate usually comes from their own inspection and their own pricing, which can run lower than what you listed, especially on labor and materials for repairs. Start by asking for the adjuster's full itemized estimate, not just the total. Line it up against your own list item by item and find exactly where the numbers split.
Most differences come from one of three places. The insurer may have used a lower cost per square foot for rebuilding, left out a damaged item entirely, or applied more depreciation than you think is fair for an item's age and condition. Depreciation is the reduction in value for wear and age, and it's where many disputes start. If your policy pays replacement cost rather than actual cash value, you're owed the cost to replace the item new, not its depreciated worth, though you may have to pay out of pocket first and get reimbursed for that difference later. Your declarations page says which one you have.
If the gap doesn't close after talking with the adjuster, ask for a supplemental claim, which is a formal request to reconsider specific items with documentation attached. A contractor's written repair estimate carries more weight than a verbal disagreement. For larger disputes, many policies include an appraisal clause, letting each side hire an independent appraiser and a neutral umpire to settle the amount. This is separate from filing a complaint with your state's insurance department, which looks at whether the insurer followed the law, not whether the dollar amount was fair.
None of this is quick. Supplemental claims and appraisal can take weeks, and in the meantime, a denied or underpaid claim still has a clock running for any legal deadline to dispute it, set by your state. Keep copies of every estimate, email, and photo you send or receive. If the insurer's final position still doesn't cover what the sworn statement laid out, that paper trail is what a public adjuster, attorney, or your state's insurance department will ask for first.
What happens after you submit the sworn statement
Once the notarized statement is in, the insurer reviews it against the adjuster's inspection, your documentation, and the policy's own rules about covered losses. This can take anywhere from a few days to several weeks depending on the size of the claim and how backed up the insurer is. You'll typically get a written response. It might be an acceptance of your figures, a partial payment with an explanation of what was cut, or a request for more information before they'll move forward.
If the insurer asks for more information, they're allowed to. A sworn statement doesn't end their ability to investigate. They can request an examination under oath, which is a separate, more formal interview conducted with a court reporter present, usually reserved for larger or more complicated claims. They can also ask for additional documents, receipts, or access to the property for a second inspection. Responding promptly matters here the same way the original deadline did. Delays on your end can be read the same way a late proof of loss is. Both can be treated as grounds to slow or deny payment.
If new damage turns up after you've already submitted the statement, perhaps a contractor finds rot behind a wall once repairs start, you're not locked out from claiming it. Most policies allow a supplemental or amended proof of loss for damage that wasn't visible or known at the time of the original filing. Document it the same way you did the first time. Take photos, get a contractor's note on when and how the damage was found, and put together an updated cost estimate. Submit it as its own written request rather than folding it into conversations with the adjuster, so there's a clear record of when you reported it and what it covered.
Keep a copy of everything you submitted, including the original sworn statement, for as long as the claim is open and for some time after it closes. If a dispute surfaces months later, the sworn statement becomes the reference point everyone argues from. Having your own signed copy, along with the receipts and photos that backed it up, means you're not relying on the insurer's file alone if the numbers get questioned again.
Before you sign
Pull your policy's proof of loss clause and write down the exact deadline. Match your item list against receipts and photos you already have, so the number you swear to is one you can back up.
