Describe your insurer's claim type and required information. Makeform creates a claimant statement form for the incident account, loss details, involved parties, uploads, declaration, and signature.
Route statements to email, Google Sheets, Slack, and Zapier.
Sample prompts for the builder
Choose a prompt, tailor it, or send it to the builder. Each example is a starting structure, not a completed statement.
Audience
Policyholders reporting property damage
Format
Guided narrative with loss details
Prompt size
307 chars
Example form structure
Guided narrative with loss details
Claimant, policy, and claim details
Loss discovery time and place
Chronological incident account
Upload photos, receipts, or estimates
Review declaration and signature
Suggested routing tags
New statement
Needs documents
Adjuster review
Separate firsthand observations from information received from other people so reviewers can identify each source.
Step 1
Identify
claimant, policy, claim, and contact details
Step 2
Describe
time, place, sequence, observations, and actions
Step 3
Document
loss items, parties, references, and supporting files
Step 4
Review
declaration acknowledged and statement signed
Clearer claim intake
A blank text box often produces a short summary with missing dates, unclear sequences, and unidentified attachments. A guided claimant statement form gathers the narrative and the facts an adjuster needs to understand it.
Separate prompts for before, during, and after the incident help the claimant reconstruct events in order while details are still available.
Policy number, claim number, incident type, and claimant role travel with the account instead of being copied from an email thread.
Place upload fields beside loss items, report references, or expense questions so reviewers can tell what each document supports.
Built around the loss
Start with the claim type closest to your intake workflow, then edit the questions, explanations, and routing details in the builder.
Capture discovery time, affected areas, damaged items, mitigation steps, contractors contacted, and photos organized around the property.
Collect road conditions, direction of travel, event sequence, points of impact, other parties, witness details, and scene files.
Record last-known location, access, discovery, report references, and a repeatable inventory with ownership documents.
Guide the claimant through location, observations, people notified, reported symptoms, care, expenses, and effects on usual activities.
Statement workflow
Give Makeform the questions and claim context, refine the generated structure, and share one consistent intake path with claimants.
Name the loss type, intended claimant, identifiers, narrative prompts, item details, supporting files, and internal routing information.
Replace generic labels with your terminology, mark essential fields required, add helper text, and show follow-up questions only when relevant.
Complete a sample submission on phone and desktop, checking long answers, repeated loss items, uploads, confirmation wording, and signature placement.
Send the public form link to the claimant and direct submissions or notifications to the team that performs the next review.
Form vs document vs email
The claimant still supplies the account. The difference is whether your team receives a loose narrative or a statement organized around the claim facts it must review.
Field guide
Use these six sections as an intake checklist, then adapt them to the loss and information already collected.
Identity and role
Collect enough information to match the submission. Record the claimant’s role because each participant may observe different parts of an event.
Incident coordinates
Date, time, and location frame the narrative. Let claimants mark an unknown time as approximate instead of requiring false precision.
Chronological account
Use one long-answer prompt per stage. Ask for observations, actions, conversations, and timing, with other sources identified separately.
Loss details
Use a repeating group for loss items and conditional sections for property, vehicle, injury, or other relevant follow-ups.
People and documents
Record each person’s role and contact details. Label uploads by purpose so documents arrive with useful context.
Review and declaration
Show your declaration above the acknowledgment and signature. Let the claimant correct mistakes and identify estimates before submitting.
Related tools
Use related Makeform generators for the first report, other firsthand accounts, business claim intake, and supporting loss workflows.
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Open toolFAQ
Practical answers for claims teams replacing emailed narratives and static statement documents.
A claimant statement form asks a person making a claim to provide their written account of an incident and resulting loss. It commonly connects the account to a policy or claim number, captures dates and locations, guides the claimant through the event sequence, records damaged or missing property and other involved people, accepts supporting files, and ends with a review acknowledgment or signature. The exact questions depend on the claim type and the insurer’s intake process.
Start with claimant identity, contact details, role, policy number, and claim number. Then ask when and where the incident happened or was discovered; what the claimant personally observed before, during, and after it; what property, vehicle, expense, or injury is being reported; what immediate actions were taken; and who else was involved or notified. Add report references and labeled uploads, then let the claimant review their answers before acknowledging your declaration and signing.
Use several focused long-answer prompts instead of one request to describe everything. Ask about the period immediately before the event, the event itself, and actions afterward. Request approximate times, locations, movements, observations, and conversations where relevant. Include a separate question for facts learned from other people, and let the claimant flag uncertainty. This structure preserves the claimant’s own wording while making the sequence easier for a reviewer to follow.
Yes. Add file-upload fields for scene and damage photos, receipts, estimates, inventory lists, diagrams, correspondence, and available reports. Label each upload prompt clearly and place it near the question it supports. For multiple damaged or missing items, repeat an item block with its own upload field so the reviewer does not need to guess which receipt or image belongs to which item.
Yes. Begin with a loss-type choice and use conditional sections for property damage, vehicle incidents, theft, injury, or another workflow. A property branch might ask about affected rooms and mitigation; a vehicle branch might ask about direction of travel and point of impact; a theft branch might open an itemized inventory. Shared identity, narrative, declaration, and routing fields can remain consistent across every branch.
It can. Use declaration wording approved by your organization, show it directly above the acknowledgment, and let the claimant review and correct their account before signing. Include the signing date and, if someone is completing the statement as a representative, ask them to state that capacity. Makeform provides the form fields and submission workflow; your organization remains responsible for deciding what wording and review process fit the claim.
Yes. Makeform supports unlimited free forms and responses, so you can generate, edit, publish, and collect claimant statement submissions without a form or response cap. The paid tier removes the Makeform badge. You can still revise the questions, share the form by link, and test the claimant experience before using it in your intake workflow.
Route each statement with its claim number, loss type, claimant role, and a consistent status such as new statement, needs documents, or adjuster review. Check that the account identifies its time and location, separates firsthand observations from other information, lists the reported loss, names relevant parties, and explains each upload. If something is missing, follow up on the specific gap rather than asking the claimant to rewrite the entire statement.
Collect the account and loss details in one flow.
