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Sample claim file

The first pages of a file generated for a fictional restaurant after a burglary. All data is made up.

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Sample claim file

ResgardaRef. SIN-2026-0142

Generated with Resgarda

Insurance claim file

Location
The Market Corner · 12 rue des Halles, 69002 Lyon
Incident
Burglary with forced entry
Date of incident
3 October 2026, 2:40 am
Policy
Commercial combined policy no. 4471-208
Police report
Filed on 3 October 2026, no. 2026/011873

Contents

  1. Incident summary2
  2. Loss table3
  3. Supporting documents4
Document prepared by the business owner. Resgarda is not an insurance company and does not give legal advice.Page 1 / 3
ResgardaRef. SIN-2026-0142

Loss table

CategoryAmount
Goods€3,420.00
Equipment€2,180.00
Shop window and fittings€1,850.00
Business interruption€7,833.60
Additional costs€640.00
Total claimed€15,923.60

Business interruption = (sales last year − sales this year) × gross margin rate

3 to 16 October: (€18,640 − €7,120) × 68%

Document prepared by the business owner. Resgarda is not an insurance company and does not give legal advice.Page 2 / 3
ResgardaRef. SIN-2026-0142

Supporting documents

  1. Damage photos · 12 views03/10/2026e5c94d…efdf58
  2. Police report receipt03/10/2026057d70…b97912
  3. Stockroom inventory30/09/2026894df8…787904
  4. Supplier invoices · September30/09/2026a11d9a…8bffe9
  5. Till and card terminal invoice14/03/2024948a77…f86cd6
  6. Shop window replacement quote04/10/202651aecc…8d214c
  7. Z reports · October 202531/10/2025526edc…46c4f5
  8. Z reports · October 202616/10/2026d6216a…5ce03d