ACORD 3 Insurance Form PDF – Download Instantly Online

Property Loss Notice

ACORD 3 Form (2022/06)

Property & Casualty

June 2022

2 pages

PDF, Fillable PDF


The insurance carrier often requires an Acord 3 form for a general liability incident, including property damage or bodily injury. The insurance agent or broker submits this form to notify the insurance company of the claim for the property loss. This form contains details information about the policyholder, the incident that happened, and the property loss. Timely submission initiates the investigation process for handling claims and settlements.


Accurately completing this form ensures legal compliance related to the incident, protecting you in the event of disputes that may arise later.

This form helps insurers assess the situation and initiate the claim process effectively, saving time during stressful conditions.

An individual or business accurately completes this form and submits it within the timeframe, which helps avoid claims denials.


It contains policy number, effective dates, and insurance company details to verify the legal insurance policy

Includes exact time and date of the damage or loss to meet the criteria for coverage determination.

Comprehensive details about the policyholder and additional contact information for transparent communication during the investigation.

Location where the damage occurred to verify that the incident has not happened at a different address from the insured address.

Contains proper information about the nature of the accident, how it happened, and property damage.

Proper documents that the Police, fire department, and other relevant authorities are timely informed about the accident.


  1. Fill in the date, time, and location of the accident.
  2. Write the insurance policy details, including policy number and effective date.
  3. Producer information, including name, address, and contact details.
  4. Write the policyholder’s name, address, and contact number.
  5. Give a detailed description of the incident and property damage.
  6. Provide details of witnesses who were informed about the accident (Police, Fire Department, etc.)
  7. Provide additional remarks relevant to the claim.
  8. The insured or authorized representative must sign the form.
  9. Submit the completed form to the insurance company to start the investigation process.

You must attach incident photos, police report, or witness statements to make the claims process transparent.

Yes, we provide the latest version of the fillable PDF form. Simply fill out this form online here and get an instant printout.

No, it streamlines the claim process. However, approval depends on the coverage and investigation.

An individual, business owner, or policyholder under a liability insurance policy can report notice of a liability claim after an incident.

Any legal action under liability coverage, property damage, or bodily injury requires this form to report a claim.

It includes policyholder information, the insurer’s name, the period of the incident, and a detailed description of the occurrence.

After completing the form, submit it to your insurance provider to start the process.

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