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Claim forms

The forms, without the fog.

Each form below has been reviewed and cleared for publication. Download the version you need, then check it against your policy, insurer instructions, and applicable state requirements before submitting it.

  • Proof of Loss Form

    Brelly’s two-page, state-neutral sworn statement in proof of loss. The PDF includes interactive fields for digital or printed completion; review every entry, signature, and notary step before use.

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  • Proof of Loss Form (Florida)

    Brelly’s August 2023 Florida-labeled sworn statement in proof of loss. The two-page PDF is printable but not interactively fillable, so it requires manual completion or an external annotation workflow.

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  • Proof of Loss Form (Oklahoma)

    Brelly’s September 2023 Oklahoma-labeled sworn statement in proof of loss. The two-page PDF is printable but not interactively fillable, so it requires manual completion or an external annotation workflow.

    DownloadPDF

  • Notice of Loss Confirmation

    A two-page printable worksheet for recording who you notified, when, and by what method. The PDF is not interactively fillable, so it requires manual completion or an external annotation workflow.

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