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Total Loss Vehicle Valuation Documentation Form

A claim form for documenting a totaled vehicle’s actual cash value, comparable vehicle data, condition adjustments, and settlement support in one place. Use it to make valuation decisions easier to review and defend.

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Built for: Insurance Claims · Auto Appraisal · Fleet Operations · Collision Repair

Overview

This form documents the full support package behind a totaled vehicle settlement: claim and vehicle identification, the valuation method and source, comparable vehicle data, condition adjustments, and the final actual cash value. It is designed for claims teams, appraisers, and reviewers who need a structured record of how the number was reached, not just the final offer.

Use it when a vehicle has been declared a total loss and you need to show the basis for the settlement amount. The template helps you capture the inputs that matter most for review: VIN last 8, loss date, odometer reading, pre-loss condition grade, prior damage disclosures, and the documents that support the valuation. It is also useful when a claimant asks how the offer was calculated or when a supervisor needs to confirm the settlement basis.

Do not use this form as a generic intake for every auto claim. If the vehicle is repairable, a repair estimate workflow is a better fit. If the valuation source is not yet available, or if the claim lacks enough vehicle data to compare fairly, pause and gather the missing facts first. The form works best when the team wants a defensible ACV record with clear fields, review notes, and an attestation that the submission is complete.

What's inside this template

Claim and Vehicle Identification

This section anchors the file to the correct claim and vehicle so every later valuation field is tied to the right loss event.

  • Claim Number (required)
  • Vehicle Year (required)
  • Vehicle Make (required)
  • Vehicle Model (required)
  • VIN Last 8 Characters

    Collect only the last 8 characters unless the full VIN is required for your valuation source.

  • Date of Loss (required)
  • Odometer Reading at Loss (required)

Valuation Basis

This section explains where the valuation came from and why that source and method were used for the ACV calculation.

  • Valuation Method (required)
  • Valuation Source or Vendor (required)
  • Valuation Date (required)
  • Pre-Loss Condition Grade (required)
  • Valuation Notes

    Summarize any assumptions, exclusions, or source limitations that affect the valuation.

Comparable Vehicle Data

This section shows the market evidence behind the valuation and lets reviewers judge whether the comparables are truly comparable.

  • Comparable Vehicles (required)

Condition Adjustments and Deductions

This section records the specific deductions or credits that move the valuation from market data to the subject vehicle’s condition.

  • Condition Adjustments (required)
  • Were prior damages or pre-existing condition issues disclosed? (required)
  • Prior Damage Notes

Actual Cash Value and Settlement Support

This section reconciles the math and states the final settlement basis so the offer can be reviewed without guessing.

  • Gross Valuation Amount (required)
  • Total Adjustments Amount (required)
  • Actual Cash Value (required)
  • Settlement Offer Amount (required)
  • Settlement Basis Summary (required)

    Briefly explain how the settlement offer was derived from the valuation and any policy or deductible considerations.

Audit Trail and Submission

This section preserves the supporting documents, reviewer comments, and attestation needed to complete the claim record.

  • Supporting Documents

    Upload the valuation report, comparable screenshots, or other supporting evidence.

  • Reviewer Notes
  • I confirm this valuation uses the minimum necessary information and is accurate to the best of my knowledge. (required)

How to use this template

  1. 1. Enter the claim and vehicle identification fields first, using the claim number, VIN last 8, loss date, and odometer reading to anchor the record.
  2. 2. Select the valuation method and source, then record the valuation date and the pre-loss condition grade so the basis for the ACV is explicit.
  3. 3. Add the comparable vehicle data with enough detail to show why each comparable was chosen and how it relates to the subject vehicle.
  4. 4. Record each condition adjustment and note any prior damage disclosures so deductions are tied to specific facts rather than general judgment.
  5. 5. Calculate the gross valuation amount, total adjustments, actual cash value, and settlement offer amount, then state the settlement basis in plain language.
  6. 6. Attach supporting documents, add reviewer notes if a second set of eyes is required, and complete the attestation before submitting the form.

Best practices

  • Use the same valuation source and method across similar claims so reviewers can compare outcomes consistently.
  • Keep the comparable vehicle list tight and relevant; choose vehicles that match the subject vehicle’s year, make, model, mileage, and market area as closely as possible.
  • Document every condition adjustment with a short reason, because unexplained deductions are the fastest way to create disputes.
  • Mark prior damage clearly and separate it from normal wear so the settlement basis does not overstate or understate the vehicle’s condition.
  • Attach the source report, photos, and any market evidence at the time of submission so the audit trail is complete.
  • Use conditional logic for optional adjustment fields so users only see the sections that apply to the claim.
  • Keep required fields limited to the facts needed to support the valuation and avoid collecting unnecessary PII.

What this template typically catches

Issues teams running this template most often surface in practice:

Missing or vague valuation source information that makes the ACV hard to verify.
Comparable vehicles that are too different in mileage, trim, or market area to support the subject vehicle.
Condition adjustments entered without a reason, photo, or source note.
Prior damage not disclosed until late in the process, which can change the settlement basis.
A settlement offer amount that does not clearly reconcile to the gross valuation and total adjustments.
Supporting documents attached after submission instead of at the time the valuation is finalized.
Reviewer notes that confirm approval but do not explain any exceptions or overrides.

Common use cases

Auto claims adjuster documenting a total loss settlement
An adjuster uses the form to capture the valuation source, comparable vehicles, and condition deductions before sending the settlement offer. The completed record gives the claim file a clear audit trail and makes the offer easier to explain.
Independent appraiser supporting a disputed ACV
An appraiser fills out the template after a claimant challenges the initial number. The form helps show which comparables were used, what adjustments were applied, and why the final actual cash value was selected.
Claims supervisor reviewing a high-value total loss
A supervisor reviews the submission to confirm the settlement basis, check the comparables, and verify that prior damage and condition grading were handled consistently. Reviewer notes can capture any override or exception.
Carrier audit team checking valuation consistency
An audit team uses the form to compare multiple total loss files and look for missing documentation, inconsistent adjustments, or unsupported settlement offers. The structured fields make it easier to spot patterns.

Frequently asked questions

What is this template used for?

This template is used to document how a total loss vehicle valuation was reached, including the valuation method, comparable vehicles, condition adjustments, and the final actual cash value. It creates a clear record for claim review, settlement support, and later audit. It is especially useful when the valuation needs to be explained to an adjuster, supervisor, or claimant.

When should I use this form in the claim process?

Use it after the vehicle is confirmed as a total loss and before the settlement offer is finalized. It works best once the loss date, vehicle details, valuation source, and comparable data are available. If the claim is still missing core facts, complete those first so the valuation record is not built on incomplete inputs.

Who should complete the valuation documentation?

An adjuster, appraiser, or claims specialist typically completes the form, with a reviewer or supervisor adding notes when needed. The person entering the data should be able to explain the valuation source, the condition grade, and any deductions applied. A separate reviewer can use the audit trail to confirm the settlement basis.

What should be included in the comparable vehicle section?

Include the vehicles used to support the valuation, along with the details needed to compare them fairly, such as year, make, model, mileage, location, and price. The goal is to show why those comparables were selected and how they relate to the subject vehicle. Avoid vague references to market data without enough detail to review the comparison.

How does this template help with compliance or dispute handling?

It creates a documented audit trail of the inputs, adjustments, and settlement basis used to reach the ACV. That helps support consistent claim handling and makes it easier to explain the decision if the valuation is questioned. It also encourages data minimization by collecting only the vehicle and claim details needed for the settlement record.

What are the most common mistakes when filling this out?

Common mistakes include leaving out the valuation source, failing to explain condition adjustments, and using comparables that are not close enough to the subject vehicle. Another frequent issue is entering the settlement offer without showing how it ties back to the gross valuation and deductions. Missing supporting documents can also make the record hard to defend later.

Can this form be customized for different carriers or shops?

Yes. You can add fields for jurisdiction, appraisal vendor, photos, or policy-specific settlement notes, and you can change the comparable vehicle fields to match your valuation workflow. If your process uses conditional logic, you can show extra adjustment fields only when prior damage or unusual wear is present. Keep required fields limited to what is actually needed.

How does this compare to handling total loss valuations in email or spreadsheets?

Email and spreadsheets can work for one-off cases, but they often scatter the evidence across multiple threads and make review harder. This template keeps the claim number, valuation basis, comparables, adjustments, and attestation together in one structured record. That makes it easier to review, reuse, and audit without searching through attachments.

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