Insurance Claims & Coverage Intake Forms: What Defense and Coverage Attorneys Need at Case Intake
Insurance coverage and defense matters arrive with more moving parts than almost any other area of civil practice. You are dealing with a policyholder, a carrier, one or more claimants, potentially multiple policies across different coverage lines, layers of excess and umbrella, and a regulatory framework that varies by state and shifts depending on whether the claim is first-party or third-party. If your intake does not capture the full picture on day one, you will spend the next three weeks chasing policy declarations pages, reservation-of-rights letters, and loss reports that should have been in the file from the start.
Most law firm intake processes collect the client name, the carrier, and a one-line description of the claim. That is not intake — that is a phone message. A real insurance claims and coverage intake form captures the policy architecture, the coverage question, the claims history, and the regulatory exposure before the first substantive call with the adjuster. Here is what that form should include.
Claim type: classifying the matter correctly from the start
Insurance matters are not interchangeable. The coverage analysis, the defense obligations, and the regulatory framework all depend on what kind of claim you are handling. Your intake should classify the matter into one or more of the following categories:
- First-party property damage — the insured is making a claim under their own policy for damage to their own property. Homeowners fire loss, commercial property water damage, business personal property theft. The coverage question centers on the insuring agreement, the cause of loss, and whether any exclusion applies. (On the restoration side, water damage companies have their own intake requirements around IICRC water categories, Xactimate documentation, and insurance billing — see our water damage restoration intake guide.)
- Third-party liability — a claimant is asserting a claim against the insured, and the insured is tendering to the carrier for defense and indemnity. Auto liability, general liability, products liability, professional liability. The carrier's obligations are governed by the duty to defend (broader than the duty to indemnify in most jurisdictions) and the four-corners rule or extrinsic-evidence standard, depending on the state.
- UM/UIM claims — uninsured or underinsured motorist claims. These are hybrid — the insured is making a first-party claim, but the underlying facts involve a tort. Stacking rules, inter-policy exhaustion, and arbitration clauses all come into play.
- Bad faith — first-party bad faith (insurer unreasonably denied or delayed a claim) or third-party bad faith (insurer failed to settle within policy limits, exposing the insured to excess judgment). The distinction matters because the remedies, the burden of proof, and the available damages differ sharply.
- Coverage dispute / declaratory judgment — the carrier and the insured disagree about whether coverage exists. These often run on a parallel track to the underlying litigation, and the intake needs to capture both the DJ action and the underlying claim.
- Subrogation — the carrier has paid a claim and is pursuing the responsible third party to recover. Your intake needs the underlying loss details, the amount paid, and the identity and insurance status of the subrogation target.
Policy identification: the foundation of every coverage question
You cannot analyze coverage without the policy. That sounds obvious, but an alarming number of insurance coverage files are opened with nothing more than a policy number and a vague description of the coverage line. Your intake should capture the full policy architecture:
- Carrier and underwriter — the issuing carrier, the managing general agent (if any), and the surplus lines broker (if non-admitted). For London market placements, capture the lead underwriter and the subscription percentages.
- Policy number and coverage line — CGL, commercial auto, professional liability, D&O, E&O, EPL, inland marine, builder's risk, umbrella, excess. Many claims implicate more than one policy.
- Policy period — effective date, expiration date, and whether the policy is occurrence-based or claims-made. For claims-made policies, capture the retroactive date and extended reporting period (tail) provisions. A claim reported one day after expiration on a claims-made policy with no ERP is a coverage disaster — you need to know this at intake.
- Policy limits — per-occurrence, aggregate, per-person (for BI), and any sublimits. For umbrella and excess layers, capture the attachment point and whether the excess follows form or has its own terms.
- SIR / deductible — amount, whether it applies to defense costs (eroding vs. non-eroding), and whether the SIR must be exhausted before the carrier's duty to defend attaches.
- Key endorsements and exclusions — additional insured endorsements (ISO CG 20 10, CG 20 37, or manuscript), professional services exclusions, pollution exclusions (absolute vs. total vs. limited), assault and battery exclusions, construction defect exclusions. These are the provisions that determine the outcome of the coverage analysis, and you need to know they exist at intake even if the full analysis comes later.
Insured information: who is covered and in what capacity
Insurance policies cover named insureds, but the universe of people and entities with coverage rights extends well beyond the declarations page. Your intake should identify:
- Named insured — the entity or individual on the dec page. For commercial policies, capture all named insureds, including subsidiaries and affiliated entities if the policy has a subsidiary or affiliated-entity endorsement.
- Additional insureds — parties added by endorsement. In construction, the GC is almost always an additional insured on the sub's CGL policy. The endorsement language matters — "arising out of your ongoing operations" is narrower than "arising out of your work."
- Certificate holders — not the same as additional insureds, though they are routinely confused. A certificate of insurance is evidence of coverage, not a grant of coverage. Your intake should note whether a certificate holder is also named as an additional insured on the underlying policy.
- Loss payees and mortgagees — relevant for first-party property claims. The lender's interest in the property creates a separate set of obligations for the carrier under the standard mortgage clause.
Loss details: what happened, when, and where
The loss is the event that triggers the policy. Your intake needs to capture it with enough specificity to begin the coverage analysis and identify the applicable policy period:
- Date of loss — for occurrence policies, this is the date the bodily injury or property damage occurred (which may differ from the date of the negligent act). For claims-made policies, this is the date the claim was first made against the insured.
- Date reported to carrier — late notice is one of the most commonly asserted coverage defenses. The gap between the date of loss and the date reported is a critical data point. In jurisdictions that require prejudice to disclaim on late notice, the length of the delay and the reason for it matter.
- Description of loss — a narrative description of what happened. For property claims: what was damaged, how, and the apparent cause. For liability claims: what the insured allegedly did or failed to do. Keep this factual, not conclusory — "water entered the building through the roof" is useful; "roof leak" is not.
- Location of loss — the specific address or site. For CGL policies with scheduled locations, the loss location determines whether the policy applies. For commercial auto, the state of the accident may affect coverage terms.
- Cause of loss — fire, water, wind, theft, collapse, vehicle impact, slip and fall, defective product, professional error. The cause of loss drives the exclusion analysis. A water damage claim from a burst pipe is covered differently than water damage from surface flooding.
- Police, fire, or incident report numbers — these are independently generated records that corroborate the loss. Capture the report numbers and the issuing agency so you can request copies.
Coverage analysis: framing the question before you answer it
Your intake form is not where you perform the coverage analysis — but it is where you frame the question. Capturing the right data points at intake tells you which provisions to examine first and which defenses are in play:
- Which insuring agreement responds — Coverage A (bodily injury and property damage), Coverage B (personal and advertising injury), or both? For professional liability policies, does the claim fall within the definition of "professional services" or "wrongful act"?
- Applicable exclusions — has the carrier identified specific exclusions in the denial or reservation of rights? If so, list them. If you have the policy, flag the exclusions that are likely to be at issue based on the claim type.
- Conditions precedent — notice, cooperation, voluntary payment, no-action clause. Has the insured complied? If not, what is the nature of the breach and does the jurisdiction require prejudice?
- Late notice defense — if notice was late, how late? What is the insured's explanation? Does the jurisdiction follow the notice-prejudice rule or the strict-compliance rule?
- Cooperation clause issues — has the insured failed to cooperate with the investigation? Refused to submit to an examination under oath? Failed to produce documents? Cooperation breaches can void coverage entirely, but most jurisdictions require the carrier to show substantial prejudice.
Reservation of rights: tracking the carrier's position
The reservation of rights letter is one of the most important documents in an insurance defense file. Your intake should capture its status and substance:
- ROR letter issued — yes or no. If yes, the date it was sent and the date the insured received it.
- Specific reservations — what coverage defenses has the carrier reserved? Late notice, exclusion applicability, policy limits, failure to cooperate, misrepresentation in the application. List each one.
- Independent counsel triggered — in jurisdictions that follow the Cumis rule (California) or the Peppers doctrine, a reservation of rights that creates a conflict between the carrier's interests and the insured's interests triggers the insured's right to select independent counsel at the carrier's expense. Your intake should flag whether this has been triggered, whether independent counsel has been retained, and what billing guidelines apply.
- Coverage litigation pending or anticipated — is the carrier filing a declaratory judgment action? Has the insured threatened bad faith? Is there a parallel track that needs to be managed alongside the underlying defense?
Damages: what is being claimed and what is at stake
The damages picture drives the exposure analysis and determines whether the case is a policy-limits matter or a nuisance claim. Your intake should capture what is known about damages at the outset, even if the numbers are preliminary:
- Property damage — estimates, appraisals, repair vs. replacement value, actual cash value vs. replacement cost. For first-party claims, has the carrier obtained its own estimate? Is there a gap between the carrier's estimate and the insured's contractor estimate?
- Bodily injury — nature and extent of injuries claimed. Hospitalization, surgery, ongoing treatment, permanency allegations. For third-party claims, the BI exposure is often the primary driver of settlement value.
- Loss of use — has the insured or claimant been displaced? Is there additional living expense (ALE) coverage? For commercial claims, has business been interrupted?
- Business interruption and extra expense — period of restoration, actual loss sustained, extended period of indemnity, contingent business interruption. BI claims are document-intensive and require early identification of the accounting records needed to prove or defend the claim.
The damages analysis in insurance matters often overlaps with the work done in commercial litigation intake — particularly when the underlying claim involves business losses, contract disputes, or multi-party contribution. Similarly, insurance defense attorneys handling auto liability claims will find the injury documentation requirements parallel those in personal injury intake, though the analysis runs from the defense side of the caption.
Related claims and litigation: the full picture
Insurance claims rarely exist in isolation. Your intake needs to map the broader landscape:
- Lawsuit filed — has a complaint been served? What is the court, case number, and filing date? Who is plaintiff's counsel? What is the answer deadline? For insurance defense assignments, the answer deadline is often the reason the file is opened in the first place — miss it and you have a default judgment problem on top of the coverage question.
- Related or prior claims — are there other claims arising from the same occurrence? Prior claims on the same policy that affect the aggregate? Claims on other policy years? A single construction defect can generate claims across five policy years with three different carriers and two coverage towers.
- Tender and additional-insured demands — has anyone tendered their defense to your client's carrier? Has your client tendered to another carrier? Track who has tendered to whom, what the response was, and whether the tender was accepted, denied, or is pending.
Stacking and other insurance: who pays and in what order
When multiple policies potentially respond to the same loss, the allocation question can become the most expensive issue in the case. Your intake should identify the other-insurance landscape early:
- Other insurance clause — does the policy contain an other-insurance provision? Is it pro-rata, excess, or escape? How does it interact with the other-insurance clause in the competing policy?
- Primary vs. excess — in multi-carrier disputes, identifying which policy is primary and which is excess often determines who pays defense costs now and who contributes at settlement. For additional-insured claims, the additional-insured endorsement frequently states that coverage is excess over the named insured's own insurance.
- Horizontal vs. vertical exhaustion — for long-tail claims (asbestos, environmental, product liability) spanning multiple policy years, does the jurisdiction require horizontal exhaustion (all primary policies across all years must exhaust before any excess responds) or vertical exhaustion (the insured can exhaust one year's tower before moving to the next)? This is a multi-million-dollar question in legacy claims.
- Stacking — can per-occurrence limits be stacked across policy years? Across multiple policies in the same year? UM/UIM stacking rules vary dramatically by state and are frequently litigated.
Regulatory context: state-specific obligations the carrier must meet
Insurance is one of the most heavily regulated industries in the country, and the regulatory obligations vary by state. Your intake should flag the regulatory considerations that affect how the claim must be handled:
- State DOI complaint — has the insured or claimant filed a complaint with the state Department of Insurance? A DOI complaint creates a parallel regulatory proceeding that the carrier must respond to, typically on a compressed timeline.
- Unfair claims practices — does the state have an Unfair Claims Settlement Practices Act that creates a private right of action? Not all do. In states that allow private suits under the UCSPA, a pattern-and-practice allegation can transform a single denied claim into a class action exposure.
- Prompt-pay statutes — most states require carriers to acknowledge, investigate, and pay or deny claims within specified timeframes. Violations trigger statutory penalties — sometimes substantial ones. A first-party property claim in a prompt-pay jurisdiction needs its deadlines calendared at intake, not discovered when the insured's counsel sends a demand citing the statute.
- Statutory penalties and interest — some states impose penalty interest on late-paid claims, bad-faith damages multipliers, or mandatory attorney's fees for the insured if the carrier's denial is overturned. These potential exposures beyond the policy limits should be identified at intake because they change the carrier's risk calculus.
Building the file right the first time
Insurance coverage and defense work is document-driven in a way that few other practice areas match. The policy, the endorsements, the claim file, the reservation of rights letter, the underlying complaint, the loss reports, the estimates, the prior-claims history — these are not background materials. They are the case. An intake process that captures all of this on day one means the coverage analysis starts from a complete record, not from a series of follow-up requests that take two weeks to fulfill.
If you handle insurance coverage alongside other litigation and need consistent intake documentation across your practice, the Legal Bundle includes insurance claims and coverage alongside 37 other legal practice areas, each with profession-specific intake fields and matching client questionnaires.
Insurance claims & coverage intake forms — $19.99 complete set
Fillable PDF intake form + client questionnaire. Claim type, policy identification, insured information, loss details, coverage analysis, reservation of rights, damages, related litigation, stacking, and regulatory context. Built for insurance defense and coverage attorneys.
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