Cause of Loss Form

A cause of loss form lists the specific perils an insurance contract covers or excludes.

A cause of loss form identifies which causes of damage or injury are covered under a policy.

Coverage mechanics

It acts like a menu for peril classes:

  • Named causes (only listed events are covered).
  • Open perils (broad wording, subject to exclusions and exceptions).
  • Limited subcategories for specific operations or exposures.

Underwriting and claims role

Insurers use the form to price and bind terms, and claims teams use it to check if the reported event is within scope.

Practical example

If a policy is on a named-perils basis, a heat-event loss may be covered while a flood-related component is excluded. The form determines whether the insurer must proceed with full adjustment or deny based on contract terms.