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Insurance Flood Statement of Values

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INSURANCE FLOOD STATEMENT OF VALUES

Effective Date:   Policy Number:

Applicant / Insured Information

Policy Details

Policy Type: Dwelling Commercial Condominium Mobile Home Other:

Property Locations and Itemized Values

Provide each insured location on a separate line. Include building and contents values for each location.

Year Built:   Square Footage:   Building Limit:   Contents Limit:

Occupancy:   Number of Stories:   Basement: Yes No

Year Built:   Square Footage:   Building Limit:   Contents Limit:

Year Built:   Building Limit:   Contents Limit:

Year Built:   Building Limit:   Contents Limit:

Flood Exposure & Elevation Data

For each location listed above, provide known flood-elevation related information. If not known, indicate N/A and attach supporting documentation.

Lowest Floor Elevation (feet, NAVD88 or local datum if known):   Lowest Adjacent Grade:   Base Flood Elevation (BFE):

FEMA / Local Flood Zone:   Community / Jurisdiction:

Pile / Pier Slab-on-Grade Basement Elevated on Fill / Other

Values Summary

Aggregate Total Insured Value:

Coverage Options & Limits

Building Property Coverage Personal Property / Contents Other Structures Increased Cost of Compliance Loss of Use / Additional Living Expense

Exclusions and Notices

The following exclusions apply unless a specific endorsement is obtained: losses due to earth movement not caused by flood, contamination or pollution, loss resulting from lack of maintenance, and losses excluded by the policy's standard flood provisions. This Statement of Values does not amend, extend or alter the terms and conditions of any insurance policy. Values reported herein are subject to audit and adjustment by the insurer.

Supporting Documentation Checklist

Please attach copies of available documents. Check all that apply.

Elevation Certificate

Recent Photographs of Property

Inventory of Contents / Values

Building Plans / Appraisal / Purchase Documentation

Repair or Replacement Estimates

Beneficiary / Payee Designation

If flood proceeds are to be paid in whole or in part to a third party (mortgagee, loss payee, or other beneficiary), provide details below.

Declaration and Certification

I certify that the values, elevations and other information provided in this Statement of Values are true, accurate and complete to the best of my knowledge. I understand that any material misrepresentation or omission may result in denial of coverage or rescission of the policy. I authorize the insurer to verify information, audit values, and request additional documentation as necessary to establish correct premium and coverage. I understand that coverage is effective only upon issuance of a policy and acceptance by the insurer.

Fraud Warning: Any person who knowingly submits false or misleading information for the purpose of obtaining insurance may be subject to civil and criminal penalties under applicable law.

Applicant / Insured:

Signature:

Date:

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What the Insurance Flood Statement of Values Is

An Insurance Flood Statement of Values is a formal document listing insured property, buildings, and contents values for flood coverage. It summarizes replacement or actual cash values, building square footage, construction type, elevation data when available, and occupancy details. Insurers use the statement to set premium, determine coverage limits and to assess risk before issuing or renewing flood insurance. The document may be required by mortgage lenders, flood programs, or underwriting teams and is typically updated at policy renewal or when property values change materially.

Why a Clear Statement of Values Matters

A precise Statement of Values ensures accurate premiums, appropriate limits, and smoother claims handling. It reduces underwriting questions and the chance of coverage gaps by matching declared values to replacement cost and exposure.

Why a Clear Statement of Values Matters

Who Completes the Statement and Who Reviews It

Final signed statement should be retained by both the insured and the insurer for policy records and future audits.

  • Insurance Agent: Prepares and reviews values, confirms policy limits, and routes to underwriting.
  • Property Owner / Manager: Supplies inventories, recent appraisals, and building details for accuracy.
  • Underwriting Department: Validates values, applies flood zone data, and issues premium and conditions.

Core Elements of a Professional Statement of Values

A complete Statement of Values presents property and contents in a standardized, auditable format so carriers can underwrite flood exposure reliably and consistently across portfolios.

Property Inventory

Itemized list of buildings and structures with unique identifiers, addresses, and usage descriptions to map coverage to physical assets and avoid duplication during underwriting and claims.

Building Values

Declared replacement cost or agreed value for each structure, including construction type and square footage to align limits with likely reconstruction expenses.

Contents Values

Aggregate or room-by-room contents totals where required, with separate values for business property, tenant improvements, and personal property to clarify coverage subsets.

Elevation and Flood Zone

Provided elevation certificate reference or flood zone designation (FEMA panel) when available, which materially affects rating, mitigation credits, and coverage eligibility.

Policy Limits

Requested limits, deductibles, and coinsurance terms per location so the underwriter and insured agree on coverage scope and financial responsibilities.

Supporting Notes

Explanatory remarks for atypical items, recent renovations, mitigation measures, or valuation methods used to justify declared amounts and speed review.

Required Fields to Include

Insured Name: Full legal name
Property Address: Street, city, state, ZIP
Building ID: Unit or structure number
Replacement Value: Dollar amount
Flood Zone: FEMA zone code
Effective Date: MM/DD/YYYY

Step-by-Step: Completing and Submitting the Statement

Follow these steps in order to prepare a complete Statement of Values for flood insurance submission.

  • 01
    Gather Documents: Collect appraisal, floor plans, and elevation data.
  • 02
    Populate Fields: Enter addresses, values, and zone codes accurately.
  • 03
    Attach Evidence: Upload supporting inventories and certificates.
  • 04
    Sign and Submit: Apply authorized signature and send to the insurer.

Configuring an Online Submission Workflow

Set up a digital routing flow to collect values, attachments, and signatures in a repeatable, auditable process.

Field Configuration
Owner Details Required text field, validation on name format
Value Fields Numeric fields with currency formatting
Attachments Allow PDF, DOCX, JPEG uploads
Signature E-signature field with date stamp

Digital Submission and Integration Considerations

Align platform settings with insurer requirements and retain signed records in secure storage for audits and claims.

  • File Types: PDF, DOCX, JPEG supported
  • Authentication: Email or SMS code options
  • Integrations: CRM and document storage links

Where to Send a Completed Statement

Typical delivery paths depend on the insurer and whether the account is brokered or direct; choose the route that matches your policy servicing arrangement.

  • Agent Portal: Upload via broker or agency system
  • Underwriter Email: Send to assigned underwriting contact
  • Carrier Portal: Submit through insurer web portal
  • Program Admin: Route to flood program administrator

Key Timing Considerations and Deadlines

Be aware of policy renewal windows and any insurer-requested deadlines to prevent coverage lapse or rating based on prior values.

Policy Renewal:

Submit updated statement before renewal effective date

Insurer Request:

Provide requested values within 30 days when asked

Post-Build Completion:

Update values within 60 days of major renovation

Claim Timeframe:

Ensure original values are retained for claims review

Mortgage Requirement:

Deliver to lender when requested for escrow purposes

Penalties and Risks for Incorrect or Incomplete Statements

Claim Denial: Possible denial
Premium Adjustment: Retroactive increase
Policy Cancellation: Nonrenewal risk
Legal Exposure: Potential litigation
Mortgage Issues: Escrow disputes
Fraud Consequences: Civil or criminal penalties

Common Preparation Errors to Avoid

  • Underestimating replacement cost without supporting estimates leads to inadequate limits and disputes during claims; always attach appraisal or contractor estimates when using RCV.
  • Entering inconsistent addresses or unit identifiers across schedules creates mapping errors that delay underwriting and can result in duplicate coverage or omitted locations.
  • Using rounded or vague values (for example 'approx. 100k') increases insurer requests for clarification; provide precise dollar amounts and note the valuation method.
  • Failing to sign with authorized representative information and title can make the statement invalid for underwriting or lender requirements; ensure signature authority is documented.

Practical Tips for Accurate, Efficient Completion

Adopt consistent templates and validation checks to improve accuracy and reduce follow-ups from insurers and lenders.

Use Standardized Templates
Create a single template with validated fields and required attachments. Standardization reduces data-entry errors and speeds batch processing across multiple properties and renewal cycles.
Attach Supporting Evidence
Always include recent appraisals, elevation certificates, and photographs where value or flood exposure is material. Supporting evidence shortens underwriting review cycles and reduces requests for clarification.
Record Signatory Authority
Document and store proof of authority for signers (board resolution, power of attorney). This prevents disputes when values are updated or when lenders require confirmation.
Automate Validation
Use basic validation rules (numeric currency, mandatory address fields, FEMA zone lookup) to catch obvious errors before submission and to produce audit logs for compliance.

Real-World Examples of Statement Use

These two anonymized scenarios show how Statements of Values support underwriting and claims readiness across property types.

Apartment Portfolio

A property manager consolidated values across ten buildings to standardize flood limits and loss histories.

  • The manager included elevation certificates for coastal locations.
  • As a result, the underwriting review completed in one cycle, premiums aligned to risk, and mortgagee reporting was simplified for escrow reconciliation.

Retail Center

A mall owner updated building and contents values following a major renovation to merchandising spaces.

  • The owner supplied contractor estimates and itemized tenant improvements.
  • Underwriters adjusted limits accordingly, preventing underinsurance and ensuring faster claims processing after localized flooding affected several storefronts.

Who Can Sign and Commit Values

Authorized Agent

A licensed insurance agent or broker with documented authority may prepare and sign the statement on behalf of the insured when the carrier accepts agent-certified values.

Owner or Officer

An insured owner, corporate officer, or other authorized representative must sign to attest to the accuracy of declared values and to bind the information to the policy application.

Key Processing Milestones from Preparation to File

Track these sequential milestones to ensure timely submission and insurer acceptance of the Statement of Values.

01

Preparation Complete

Document values and attachments ready for review.

02

Internal Approval

Authorized signatory reviews and signs.

03

Submission

File with insurer or agent via chosen channel.

04

Underwriter Decision

Carrier validates and returns premium or conditions.

eSignature Pricing Comparison for Submitting Statements

Comparison of common eSignature vendors and core plan features relevant to electronic submission and signing of Insurance Flood Statements of Values.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies Varies Varies Varies
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Frequently Asked Questions and Troubleshooting

Answers to common questions about validity, signatures, notarization, and correcting submitted Statements of Values.


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