¶¶Òõ¶ÌÊÓÆµ

Insurance Affidavit Template for United States

Create a bespoke document in minutes,  or upload and review your own.

4.6 / 5
4.8 / 5

Let's create your Insurance Affidavit

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Get your first 2 documents free

Your data doesn't train Genie's AI

You keep IP ownership of your information

Key Requirements PROMPT example:

Insurance Affidavit

"I need an Insurance Affidavit to support my property damage claim following a flood on January 15, 2025, with specific sections addressing photographic evidence and contractor estimates for repairs."

Document background
The Insurance Affidavit is a crucial document in the U.S. insurance claims process, used when formal sworn statements are required to support or process an insurance claim. This document contains detailed information about the claim, including the circumstances, dates, and other relevant facts, all declared under oath. The affidavit must comply with state-specific insurance regulations and typically requires notarization to be legally valid. It serves as a formal record of testimony and can be used in legal proceedings if disputes arise.
Suggested Sections

1. Affiant Information: Personal/business details of the person making the sworn statement including full name, address, and relationship to the insurance claim

2. Insurance Claim Details: Specific information about the insurance claim including policy number, date of incident, and type of claim

3. Sworn Statements: The actual declarations being made under oath regarding the truthfulness and accuracy of the claim

4. Verification: Statement confirming the truth of the information provided under penalty of perjury

5. Notarization Block: Space for notary signature, seal, and required notarial language as per state requirements

Optional Sections

1. Additional Witness Statements: Used when additional testimonies from witnesses are relevant to support the insurance claim

2. Supporting Documentation Reference: Section listing and describing attached evidence or documentation that supports the affidavit

3. Loss Details: Detailed section specifically for property damage or loss claims, including itemized descriptions

4. Medical Information Release: Authorization section for release of medical information, required for health insurance-related claims

Suggested Schedules

1. Schedule A - Supporting Documents: Comprehensive list of all documents provided to support the affidavit claims

2. Schedule B - Photographic Evidence: Catalog of photos or visual documentation related to the insurance claim

3. Schedule C - Witness Information: Detailed information about additional witnesses including contact information and relevance to the claim

4. Schedule D - Cost Documentation: Collection of receipts, estimates, invoices, or other financial documentation supporting the claim amount

Authors

Alex Denne

Head of Growth (Open Source Law) @ ¶¶Òõ¶ÌÊÓÆµ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Clauses















Industries

False Claims Act: Federal law (31 U.S.C. ยงยง 3729-3733) that imposes liability on persons and companies who defraud governmental programs. Relevant for insurance affidavits involving federal programs or claims.

Insurance Fraud Prevention Act: Federal legislation designed to prevent and punish insurance fraud, establishing requirements for truthful statements in insurance-related documents.

HIPAA: Health Insurance Portability and Accountability Act - Federal law that protects sensitive patient health information and must be considered if the affidavit involves health insurance matters.

McCarran-Ferguson Act: Federal law that establishes the framework for insurance regulation, primarily delegating insurance regulation to individual states.

State Insurance Codes: Individual state-specific laws and regulations governing insurance operations, requirements, and compliance within each state's jurisdiction.

State Fraud Statutes: State-specific laws defining insurance fraud and establishing penalties for false statements in insurance documents, including affidavits.

Notary Requirements: State-specific laws governing the proper execution and notarization of affidavits, including witness requirements and formatting.

Federal Rules of Evidence: Rules governing the admission of evidence in federal courts, including requirements for affidavits and sworn statements.

State Rules of Evidence: State-specific rules governing the admission of evidence in state courts, including requirements for affidavits and sworn statements.

NAIC Guidelines: National Association of Insurance Commissioners guidelines providing standardized practices and requirements for insurance documentation.

State Insurance Commissioner Regulations: Specific regulations issued by state insurance commissioners governing insurance practices and documentation requirements.

Fair Claims Settlement Practices Acts: State laws establishing standards for the settlement of insurance claims and related documentation requirements.

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

Find the exact document you need

Letter Of Explanation Of Relationship For Mortgage

A U.S. regulatory document used in mortgage applications to explain and verify relationships between parties involved in the lending process.

find out more

Letter Of Explanation For Credit Inquiries For Mortgage

A U.S.-compliant formal letter explaining recent credit inquiries to mortgage lenders during the loan application process, addressing credit report activities and their purposes.

find out more

Statutory Declaration Partner Visa Applicant

A formal sworn statement used in U.S. immigration proceedings to declare the genuine nature of a relationship for partner visa applications, complying with federal statutory declaration requirements.

find out more

Not Me Affidavit

A U.S. legal document where an individual declares under oath that they did not perform specific actions or authorize particular transactions, typically used in identity theft or fraud cases.

find out more

Statutory Declaration Authorised Witness

A formal written statement made under penalty of perjury before an authorized witness in the United States, carrying legal weight and requiring proper execution under federal and state laws.

find out more

Family Member Character Letter For Court

A formal character reference letter submitted to U.S. courts by a family member, providing personal testimony about a defendant's character and family role during legal proceedings.

find out more

Ancient Mortgage Affidavit

A sworn statement used in U.S. property law to clear title issues related to old, presumably satisfied mortgages that lack formal discharge documentation.

find out more

Letter Of Explanation For Mortgage Loan

A U.S. mortgage lending document where borrowers explain unusual circumstances or potential red flags in their loan application to the lending institution.

find out more

Joint Affidavit Of Two Disinterested Person

A U.S. legal document where two independent witnesses jointly provide sworn testimony about facts they have witnessed, requiring proper notarization and compliance with federal and state requirements.

find out more

Family Member Proof Of Residency Letter

A U.S. legal document verifying a family member's residence at a specific address, typically used for official purposes and often requiring notarization.

find out more

Business Records Affidavit

A sworn statement used in U.S. jurisdictions to authenticate business records and establish their admissibility as evidence under Federal Rules of Evidence and state laws.

find out more

Affidavit Of 2 Disinterested Person

A U.S. legal document containing sworn statements from two unbiased witnesses testifying to specific facts under penalty of perjury, typically used when primary documentation is unavailable.

find out more

Verification Of Residency Form

A U.S. legal document that formally verifies and documents an individual's primary residence address, complying with federal and state regulations.

find out more

Statutory Declaration

A formal written statement declaring facts as true under penalty of perjury, governed by U.S. federal and state laws.

find out more

Good Moral Character Letter Immigration

A formal character reference letter for U.S. immigration purposes that attests to an applicant's moral character and integrity under USCIS requirements.

find out more

Proof Of Income Letter Self Employed

A U.S.-compliant formal letter documenting and verifying income for self-employed individuals, used for official income verification purposes.

find out more

Affidavit Of Good Conduct

A legally binding sworn statement used in the United States declaring an individual's good character and conduct history, requiring proper notarization and compliance with federal and state regulations.

find out more

Sponsor Form For Visitor Visa

A U.S. immigration document where a sponsor formally commits to supporting a foreign visitor during their temporary stay in the United States.

find out more

Proof Of Residency Letter

A U.S.-compliant formal document verifying an individual's current residential address and duration of residency, used for various official and administrative purposes.

find out more

Affidavit Of Age Declaration

A notarized legal document used in the United States where an individual formally declares their age under oath, typically used for official age verification purposes.

find out more

Proof Of Income Letter

A formal U.S. document verifying an individual's income and employment status, issued by employers for various official purposes including rental, mortgage, and visa applications.

find out more

Zero Income Affidavit Form

A U.S. legal document where an individual formally declares they have no current source of income under penalty of perjury.

find out more

Zero Income Affidavit

A U.S. legal document where an individual formally declares they have no current income, typically used for government assistance programs.

find out more

Witness Affidavit

A legally binding sworn statement documenting a witness's testimony, governed by U.S. federal and state laws.

find out more

Verifying Affidavit

A sworn written statement used in US legal proceedings to verify facts or documents as true under penalty of perjury.

find out more

Vehicle Affidavit

A legally binding sworn statement regarding vehicle details, compliant with U.S. federal and state requirements.

find out more

Uninsured Deed Affidavit

A sworn statement used in U.S. property transactions to verify property details and ownership history when title insurance isn't being obtained.

find out more

Unemployment Affidavit Form

A legally binding document used in the U.S. unemployment benefits system where claimants make sworn statements about their employment status and eligibility for benefits.

find out more

Unemployment Affidavit

A sworn statement used in the U.S. to officially declare unemployment status and circumstances for benefit claims.

find out more

Trespass Affidavit

A U.S. legal document authorizing law enforcement to address trespassing on private property on behalf of the property owner.

find out more

Travel Consent Letter For Minor Travelling With One Parent

A U.S. legal document providing parental consent for a minor to travel with one parent, meeting border control and airline requirements.

find out more

Travel Consent Letter For Minor

A U.S. legal document providing authorization for a minor to travel domestically or internationally, either alone or with a designated adult who is not their legal guardian.

find out more

Travel Affidavit For Minors

A U.S. legal document providing parental authorization for a minor's travel, typically used when the child travels without both parents.

find out more

Travel Affidavit

A legally binding sworn statement used in the United States to declare travel plans and purposes, typically requiring notarization.

find out more

Translation Affidavit

A U.S. legal document certifying the accuracy of a translation, sworn by a qualified translator under penalty of perjury.

find out more

Transfer Tax Affidavit

A U.S. legal document declaring property transfer details and associated taxes for local authority recording purposes.

find out more

Transfer On Death Designation Affidavit Form

A US legal document that designates beneficiaries to receive specific assets upon the owner's death, bypassing probate procedures.

find out more

Transfer On Death Designation Affidavit

A U.S. legal document designating beneficiaries to receive assets upon the owner's death, bypassing probate.

find out more

Transfer On Death Affidavit

A U.S. legal document that enables automatic property transfer to designated beneficiaries upon the owner's death, bypassing probate.

find out more

Third Party Affidavit Of Bona Fide Marriage

A U.S. legal document where a third party testifies under oath about the authentic nature of a marriage for immigration purposes.

find out more

Third Party Affidavit

A formal sworn statement by an independent witness, recognized under U.S. federal and state laws, providing testimony about facts within their personal knowledge.

find out more

Testamentary Affidavit

A sworn written statement used in U.S. probate proceedings to provide evidence regarding a deceased person's will or estate matters.

find out more

Tenant Affidavit

A legally binding sworn statement made by a tenant in the United States, verifying specific information about their tenancy or residency status.

find out more

Temporary Guardianship Affidavit

A U.S. legal document that temporarily transfers specific parental rights to a designated guardian for a set period.

find out more

Tax Affidavit Form

A legally binding sworn statement used in the United States for tax-related declarations and compliance with IRS requirements.

find out more

Tax Affidavit

A legally binding sworn statement used in U.S. tax matters, compliant with IRS and state tax requirements.

find out more

Sworn Statement Of Witness

A legally binding document used in U.S. jurisdictions where a witness provides sworn testimony about facts they have personal knowledge of, verified under oath.

find out more

Sworn Letter

A legally binding written statement made under oath and notarized in accordance with U.S. federal and state requirements.

find out more

Sworn Declaration Of All Properties Of The Estate

A legally binding U.S. document that provides a complete inventory of all assets in a deceased person's estate, sworn under penalty of perjury.

find out more

Sworn Affidavit For Marriage

A legally binding sworn statement used in the United States to verify marriage-related information and eligibility under federal and state laws.

find out more

Survivorship Affidavit Form

A U.S. legal document confirming property transfer rights upon the death of a joint owner.

find out more

Survey Affidavit

A U.S. legal document containing a surveyor's sworn statement about property boundaries and features.

find out more

Student Affidavit

A legally binding sworn statement used in the U.S. educational system where students formally declare specific facts under penalty of perjury.

find out more

Spouse Affidavit

A legally binding sworn statement verifying marriage status under U.S. law, used for various official purposes.

find out more

Social Security Affidavit

A legally binding sworn statement used in the United States to verify or declare information related to Social Security matters, governed by federal law.

find out more

Small Estate Form

A U.S. legal document used to transfer property in small estates without formal probate proceedings.

find out more

Small Estate Declaration

A U.S. legal document used to transfer property from small estates to heirs without formal probate proceedings, subject to state-specific value thresholds.

find out more

Small Estate Certificate

A U.S. legal document that enables simplified settlement of small estates without formal probate proceedings.

find out more

Small Estate Affidavit Form

A U.S. legal document used to transfer property in small estates without formal probate proceedings, subject to state-specific requirements.

find out more

Small Estate Affidavit For Bank Account

A U.S. legal document used to claim funds from a deceased person's bank account when the estate value falls below state-specific small estate thresholds, bypassing formal probate.

find out more

Small Estate Affidavit

A U.S. legal document used to transfer assets from small estates without formal probate proceedings.

find out more

Small Claims Affidavit Form

A legal document used in U.S. small claims courts to initiate civil actions for smaller monetary disputes, subject to state-specific requirements.

find out more

Small Claims Affidavit

A sworn statement used to initiate small claims court proceedings in U.S. jurisdictions for monetary disputes under specified limits.

find out more

Single Status Letter For Marriage

A U.S. legal document certifying an individual's unmarried status and legal eligibility to marry.

find out more

Single Status Certificate

A U.S. legal document certifying an individual's unmarried status, typically used for international purposes or legal proceedings.

find out more

Single Status Affidavit Form

A U.S. legal document where an individual swears to their unmarried status before a notary public.

find out more

Single Status Affidavit

A U.S. legal document declaring an individual's current marital status, sworn before a notary public.

find out more

Single Affidavit For Marriage

A notarized sworn statement used in the United States declaring an individual's single status and legal eligibility to marry.

find out more

Single Affidavit

A legally binding sworn statement made under oath in the United States, verified by a notary public.

find out more

Signature Name Affidavit

A U.S. legal document where an individual formally declares, under oath, that multiple names or signatures belong to them.

find out more

Signature Affidavit

A U.S. legal document containing a sworn statement verifying the authenticity of a signature, executed before a notary public.

find out more

Shared Residence Affidavit

A U.S. legal document verifying that multiple individuals share the same residential address, typically used for administrative purposes.

find out more

Shared Housing Affidavit

A U.S. legal document verifying shared living arrangements between multiple occupants in a single residence.

find out more

Separation Affidavit

A U.S. legal document declaring married couples' intention to live separately, serving as official proof of separation date and circumstances.

find out more

Seller Affidavit Form

A U.S. legal document containing sworn statements by a property seller regarding the property's status and ownership details.

find out more

Seller Affidavit For Vehicle

A legal document used in the US that contains a seller's sworn statement about a vehicle's condition and status during a sale transaction.

find out more

Seller Affidavit

A legally binding sworn statement used in US real estate transactions where sellers declare facts about their property and ownership status.

find out more

Self Proving Affidavit Form

A U.S. legal document that verifies proper will execution through sworn statements from the testator and witnesses, certified by a notary public.

find out more

Self Proving Affidavit For Will

A U.S. legal document that authenticates a will's execution through witness statements and notarization, eliminating the need for witness testimony in probate court.

find out more

Self Proving Affidavit

A U.S. legal document that verifies proper will execution through notarized statements from testator and witnesses, streamlining future probate proceedings.

find out more

Self Employment Affidavit

A legally binding document used in the United States that formally declares and verifies an individual's self-employed status.

find out more

Self Affidavit For Birth Certificate

A notarized self-declaration document used in the United States to verify birth details when original documentation is unavailable or requires supplementation.

find out more

Scrivener Affidavit

A U.S. legal document used to correct clerical or typographical errors in previously recorded documents, typically requiring notarization and official recording.

find out more

Same Person Affidavit

A U.S. legal document where an individual declares under oath that multiple name variations refer to the same person.

find out more

Same Name Affidavit Form

A US legal document where an individual swears under oath that different versions of their name refer to the same person.

find out more

Same Name Affidavit

A U.S. legal document where an individual swears under oath that multiple name variations refer to the same person.

find out more

Sale Affidavit

A notarized sworn statement used in the US to officially document and verify sale transactions and ownership transfers.

find out more

Return Affidavit Of Served Subpoena

A legal document used in U.S. jurisdictions that provides sworn proof of successful subpoena service to a recipient.

find out more

Residential Real Property Affidavit

A sworn statement used in U.S. real estate transactions to declare facts about residential property ownership and condition.

find out more

Residential Affidavit

A U.S. legal document providing sworn testimony about residential status or living situation, requiring notarization under state law.

find out more

Residency Affidavit Form

A legally binding document used in the United States to officially declare and verify an individual's residential status and location.

find out more

Repossessed Motor Vehicle Affidavit

A legal document used in the US to formally document and verify the details of a vehicle repossession following loan default.

find out more

Rental Affidavit

A legally binding sworn statement used in the US to document rental-related facts and circumstances, requiring notarization.

find out more

Relative Caregiver Affidavit

A U.S. legal document authorizing a relative to make decisions for a minor child when parents are unable to do so.

find out more

Real Estate Tax Affidavit

A U.S. legal document declaring property value and tax status for real estate transfers.

find out more

Real Estate Affidavit

A legally sworn statement used in U.S. property transactions to declare facts about real estate matters, executed under oath and notarized according to state law.

find out more

Purchase Affidavit

A legally binding sworn statement used in the United States to formally declare and verify details of a purchase transaction.

find out more

Property Transfer Affidavit

A U.S. legal document that serves as a sworn statement declaring the transfer of property ownership, typically used for tax assessment purposes.

find out more

Property Owner's Affidavit Of Evidence

A U.S. legal document containing sworn statements by a property owner regarding facts about their property, used as evidence in legal proceedings.

find out more

Property Affidavit

A legally binding sworn statement regarding real property matters, governed by U.S. federal and state laws.

find out more

Download our whitepaper on the future of AI in Legal

By providing your email address you are consenting to our Privacy Notice.
Thank you for downloading our whitepaper. This should arrive in your inbox shortly. In the meantime, why not jump straight to a section that interests you here: /our-research
Oops! Something went wrong while submitting the form.

³Ò±ð²Ô¾±±ð’s Security Promise

Genie is the safest place to draft. Here’s how we prioritise your privacy and security.

Your documents are private:

We do not train on your data; ³Ò±ð²Ô¾±±ð’s AI improves independently

All data stored on Genie is private to your organisation

Your documents are protected:

Your documents are protected by ultra-secure 256-bit encryption

Our bank-grade security infrastructure undergoes regular external audits

We are ISO27001 certified, so your data is secure

Organizational security

You retain IP ownership of your documents

You have full control over your data and who gets to see it

Innovation in privacy:

Genie partnered with the Computational Privacy Department at Imperial College London

Together, we ran a £1 million research project on privacy and anonymity in legal contracts

Want to know more?

Visit our for more details and real-time security updates.