LOSS ADJUSTER VISIT RECORD
Editorial worksheet from ADI Leak Detection. Not an insurer form.
ADI is a detection contractor, not your loss adjuster or claims representative.
Complete locally or print. Do not send this record to this website.

Claim reference:
Adjuster / firm / contact:
Appointment / access arrangements:
Documents requested / secure delivery method:

ROOM-BY-ROOM REVIEW (repeat as required)
Room / location:
Observed damage / photograph references:
Technical finding / report and page:
Emergency changes before inspection:
Untested or inaccessible areas:

MEETING DECISIONS
Accepted observations:
Disputed points / evidence to review:
Information still required:
Work authorised in writing / scope and conditions:
Decisions awaiting insurer approval:

FOLLOW-UP (repeat for each action)
Question or action:
Person responsible:
Agreed update date:
Written response / reference:

Meeting summary sent:
Corrections received:
Keep original reports and dated addenda together. Never infer approval from a visit alone.