Property & Casualty Observation Report

Client Information

Client Name

Assessment Date

Prepared By

Insurance Carrier

Vehicle

Annual Premium ($)

Policy Number

Collision Deductible ($)

Comprehensive Deductible ($)

Bodily Injury Liability

Property Damage Liability

Uninsured Motorist

PIP / Medical Payments

Subjective Auto Coverage Assessment

No Protection Under Protected Optimal Protection

Auto Insurance Notes & Observations

Insurance Carrier

Property Address

Annual Premium ($)

Policy Number

Dwelling Coverage ($)

Personal Property ($)

Liability ($)

Deductible ($)

Hurricane/Wind Deductible

Loss of Use ($)

Subjective Homeowner's Coverage Assessment

No Protection Under Protected Optimal Protection

Homeowner's Insurance Notes & Observations

Check each action item as you complete it during the review process.