insurance

Insurance Claim

Policyholders report claims in emotional, disorganised narratives that mix critical facts with irrelevant detail. This template extracts the policy number, incident date and location, description of loss, estimated damages, and any third parties involved, creating a structured first notice of loss that adjusters can immediately work with.

See it in action

What users type

I need to file a claim. A tree branch fell on my car during the storm on March 22nd in my driveway. I'm Brian Kessler, policy HO-4482917. The windshield is completely shattered and the roof has a huge dent. I got a preliminary estimate from Caliber Collision for $4,200. No other vehicles or people involved, didn't file a police report since it was weather-related. Email is b.kessler@outlook.com.

What you get

Policyholder Name

Brian Kessler

99%
Policy Number

HO-4482917

99%
Email

b.kessler@outlook.com

99%
Incident Date

2026-03-22

98%
Incident Description

Tree branch fell on car during storm while parked in driveway. Windshield shattered and roof dented.

97%
Estimated Damages

$4,200 (preliminary estimate from Caliber Collision)

98%
Third Parties Involved

None

97%
Police Report Filed

No

98%

Extracted fields

FieldTypeRequired
Policyholder NametextRequired
Policy NumbertextRequired
EmailemailRequired
Incident DatedateRequired
Incident DescriptiontextRequired
Estimated DamagestextOptional
Third Parties InvolvedtextOptional
Police Report FiledbooleanOptional

Use this template

Sign up and select “Insurance Claim” from the template gallery. Customise any field before going live.

Start with this template — free