Title Page
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Conducted on
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Inspected by
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PH Name
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Reference Number
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Location
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Peril Type
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Date of Incident
Site Inspection
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The inspection was carried out in the presence of:
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Relation to Claim?
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Area(s) under inspection:
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Items Affected:
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Given Description of Incident
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Report of Damage Inspected
Area
Inspected Areas / Items
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Add Area
Area
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Area Name
Add item
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Item
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Type of Flooring
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Fitting Method
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Description of Flooring
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Age of Item (Years)
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Purchased From?
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Receipt Available?
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Pre-loss Condition
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Ancillaries Fitted
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Type of Underlay
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Type of Gripper
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Types of Doorplate
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Size of Flooring Required
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Ancillaries Required
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Underlay Required M²
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Gripper Required (1.5m length)
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Doorplates Required
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Length of Seam(s)
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Beading required (2.4m length)
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Other ancillaries required
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Services Required
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Reason
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Due to:
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Replacement Cost (£) and items required
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Suggested Outcome
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Type of Furniture
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Age of Item (Years)
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Purchased From?
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Receipt Available?
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Pre-loss Condition
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Size
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Replacement Cost (£)
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Suggested Outcome
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Description of item including sizes and replacement costs
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Age of Item
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Purchased From?
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Pre-loss Condition?
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Receipt Available?
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Suggested Outcome
Concerns
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Are there any concerns over the validity of the claim?