Total Loss Identification Worksheet

Estimator worksheet to compare repair cost against actual cash value and the applicable state total loss threshold so likely total losses can be flagged early.

Vehicle and Claim Identification

• Claim Number
• Vehicle Identification Number (VIN)
• Year / Make / Model
• Date of Loss
• State

Valuation and Estimate Inputs

• Actual Cash Value (ACV)
• Estimated Repair Cost
• Known Supplement Amount
  Enter any known supplement amount if it is already documented; otherwise leave blank.
• State Total Loss Threshold (%)
  Enter the applicable state threshold percentage used to determine whether the vehicle is a likely total loss.
• Threshold Source
  Optional reference for the threshold used, such as state statute, carrier guideline, or internal policy.

Total Loss Screening Result

• Repair-to-ACV Percentage
• Comparison Result
  This result compares the estimated repair percentage to the state total loss threshold.
• Likely Total Loss?
• Escalate to Total Loss Review?
  Select if the estimate should be reviewed by a supervisor, adjuster, or total loss specialist.

Audit Trail and Notes

• Supporting Notes
  Include any assumptions, missing information, or estimate factors that affect the screening result.
• Supporting Documents
  Upload estimate pages, valuation reports, or other supporting documents if available.
• Reviewer Name
• Review Date