United States 

Department of 

Agriculture

Federal Crop

Insurance

Corporation

FCIC-25970 (09-2023)

CONTROLLED 

ENVIRONMENT 

PILOT LOSS 

ADJUSTMENT 

STANDARDS 

HANDBOOK 

2024 and Succeeding Crop Years
THIS PAGE IS INTENTIONALLY LEFT BLANK
September 2023 FCIC-24970 TP 1 

UNITED STATES DEPARTMENT OF AGRICULTURE

FARM PRODUCTION AND CONSERVATION

RISK MANAGEMENT AGENCY

TITLE: Controlled Environment Pilot Loss 

Adjustment Standards Handbook

NUMBER: FCIC-25970

OPI: Product Administration Standards Division

EFFECTIVE DATE: 2024 and Succeeding Crop Years ISSUE DATE: September 27, 2023

SUBJECT:

Provides the procedures and instructions for 

administering the Controlled Environment Crop 

Insurance Program

APPROVED: 

/s/ John W. Underwood for

Deputy Administrator for Product Management

REASON FOR ISSUANCE

The CE Pilot Crop Insurance Program Loss Adjustment Standards Handbook is issued and is effective for the CE 

Pilot Crop Insurance Program available beginning with the 2024 crop year. This handbook is effective upon 

approval and until obsoleted.
September 2023 FCIC-24970 TC 1 

CONTROLLED ENVIRONMENT PILOT LOSS ADJUSTMENT STANDARDS HANDBOOK

TABLE OF CONTENTS

PART 1 – GENERAL INFORMATION AND RESPONSIBILITIES ............................................................................. 1

1 General Information...................................................................................................................... 1

2 AIP Responsibilities ....................................................................................................................... 2

3-10 (Reserved) ..................................................................................................................................... 3

PART 2 – POLICY INFORMATION ..................................................................................................................... 4

11 Insurability .................................................................................................................................... 4

12 Causes of Loss ............................................................................................................................... 6

13 Provisions Not Applicable to CAT Level of Coverage ..................................................................... 7

14 Unit Division.................................................................................................................................. 7

15 Multiple Benefits ........................................................................................................................... 7

16-20 (Reserved) ..................................................................................................................................... 7

PART 3 – APPRAISALS ..................................................................................................................................... 8

21 General Information...................................................................................................................... 8

22 Crop Inspection Requirements...................................................................................................... 9

23 Dates ...........................................................................................................................................10

24 Grouping Plants during Appraisals ..............................................................................................10

25 Determining Size Qualifications and Approved Sales Values.......................................................11

26 Basis for Indemnification.............................................................................................................13

27 Establishing Pre-Loss Actual Unit Value.......................................................................................13

28 Establishing Post-Loss Damage Value..........................................................................................14

29 Disease or Contamination Claims................................................................................................15

30 Cold-Related Claims ....................................................................................................................16

31 Special Considerations/Case Procedure ......................................................................................16

32 Deviations and Modifications......................................................................................................16

33 General Information for Worksheet Entries and Completion Procedures...................................16

34-40 (Reserved) ...................................................................................................................................17

PART 4 – INDEMNITY CALCULATIONS & PRODUCTION WORKSHEET.............................................................18

41 General Information....................................................................................................................18

42 Indemnity Calculation Examples ................................................................................................. 18

43 Completing the Production Worksheet.......................................................................................24

EXHIBITS .......................................................................................................................................................25

Exhibit 1 Acronyms and Abbreviations................................................................................................. 25

Exhibit 2 Definitions .............................................................................................................................26

Exhibit 3 Form Standards – Preliminary Appraisal Worksheet for a Specific Plant...............................28

Exhibit 4 Form Standards – Appraisal Worksheet ................................................................................33

Exhibit 5 Form Standards – Production Worksheet..............................................................................36
September 2023 FCIC-24970 1 

PART 1 – GENERAL INFORMATION AND RESPONSIBILITIES

1 General Information

A. Purpose and Objective

The loss adjustment standards for this crop are the official standard requirements for adjusting 

losses in a uniform and timely manner. These standards for this crop and crop year are in effect 

as of the signature date for this handbook located at www.rma.usda.gov/en/Policy-andProcedure/Loss-Adjustment-Standards---25000. 

This handbook remains in effect until cancelled or superseded by reissuance of the entire 

handbook or selected portions (through amendments, bulletins, or FADs). If amendments are 

issued for a handbook, the original handbook as amended shall constitute the handbook. A 

bulletin or FAD can supersede the relevant material in either the original handbook or 

subsequent amendments.

B. Related Handbooks

Important: Not all sections of related handbooks or all procedures in a section apply to the 

CE Program. See Part 3 for more information.

The following table provides handbooks related to this handbook.

Handbook Relation/Purpose

CE ISH Provides instructions for underwriting CE crops under the CP to assure 

uniform acceptance of CE risks.

CIH This handbook provides the official FCIC-approved underwriting 

standards for policies administered by AIPs for the General 

Administrative Regulations, Common Crop Insurance Policy Basic 

Provisions, and Area Risk Protection Regulations.

DSSH This handbook provides the official FCIC-approved form standards for 

use in the sale and service of any eligible Federal crop insurance policy; 

required statements and disclosures; and the standards for submission 

and review of non-reinsured supplemental policies in accordance with 

the SRA.

GSH This handbook provides the official FCIC-approved standards for policies 

administered by AIPs under the General Administrative Regulations, 

Common Crop Insurance Policy Regulations Basic Provisions, including 

the Catastrophic Risk Protection Endorsement; the Area Risk Protection 

Insurance Regulations Basic Provisions; the Stacked Income Protection 

Plan of Insurance; the Rainfall Index Plan; and the Whole-Farm Revenue 

Protection Pilot Policy.

LAM This handbook provides the official FCIC-approved general loss 

adjustment standards for all levels of insurance provided under FCIC 

unless a publication specifies that none or only specified parts of this 

handbook apply.
September 2023 FCIC-24970 2 

1 General Information (Continued)

C. Source of Authority

The FCIC Board of Directors approved the CE Pilot Crop Insurance Program on May 18, 2023, 

under the authority of Section 523 of the Federal Crop Insurance Act.

D. Title VI of the Civil Rights Act of 1964 

The USDA prohibits discrimination against its customers. Title VI of the Civil Rights Act of 1964 

provides that “No person in the United States shall, on the ground of race, color, or national 

origin, be excluded from participation in, be denied the benefits of, or be subjected to 

discrimination under any program or activity receiving Federal financial assistance.” Therefore, 

programs and activities that receive Federal financial assistance must operate in a nondiscriminatory manner. Also, a recipient of RMA funding may not retaliate against any person

because they opposed an unlawful practice or policy, or made charges, testified, or participated 

in a complaint under Title VI.

It is the AIPs’ responsibility to ensure that standards, procedures, methods, and instructions, as 

authorized by FCIC in the sale and service of crop insurance contracts, are implemented in a 

manner compliant with Title VI. Information regarding Title VI of the Civil Rights Act of 1964 

and the program discrimination complaint process is available on the USDA public website at 

www.ascr.usda.gov. For more information on the RMA Non-Discrimination Statement, see the 

DSSH. 

2 AIP Responsibilities

A. Standards Utilization

All AIPs shall utilize these standards for both loss adjustment and loss training for the applicable 

crop year. These standards, which include crop appraisal methods, claims completion 

instructions, and form standards, supplement the general (not crop-specific) loss adjustment 

standards identified in the LAM. 

B. Form Distribution

The following is the minimum distribution of forms completed by the adjuster and signed by 

the insured (or the insured’s authorized representative) for the loss adjustment inspection.

(1) One legible copy to the insured; and

(2) The original and all remaining copies as instructed by the AIP.

C. Record Retention

It is the AIP’s responsibility to maintain records (documents) as stated in the SRA and described 

in the LAM.
September 2023 FCIC-24970 3 

1 General Information (Continued)

D. Form Standards

(1) The entry items and completion instructions in Exhibits 3-5 are the minimum 

requirements for the Appraisal Worksheet and Claim Form (hereafter referred to as 

“Production Worksheet”). All entry items are “Substantive” (they are required).

(2) The Privacy Act and Non-Discrimination statements are required statements that must 

be printed on all forms or provided to the insured as a separate document. These 

statements are not shown on the example form(s) in Exhibits 3 and 4. The current NonDiscrimination Statement and Privacy Act Statement can be found on the RMA website 

at: www.rma.usda.gov/About-RMA/Laws-and-Regulations/Required-Statements, or 

successor website.

(3) The certification statement required by the current DSSH must be included on the 

Production Worksheet directly above the insured’s signature block immediately 

followed by the statement below:

“I understand the certified information on this Production Worksheet will be used to 

determine my loss, if any, to the above unit. The insurance provider may audit and 

approve this information and supporting documentation. The Federal Crop Insurance 

Corporation, an agency of the United States, subsidizes and reinsures this crop 

insurance.” 

(4) Refer to the DSSH for other crop insurance form requirements (such as point size of 

font, and so forth). The current DSSH can be found on the RMA website at: 

https://www.rma.usda.gov/Policy-and-Procedure/Underwriting---24000 or successor 

website. 

3-10 (Reserved)
September 2023 FCIC-24970 4 

PART 2 – POLICY INFORMATION

The AIP determines the insured has complied with all policy provisions of the insurance contract. The CP, 

which are to be considered in this determination, include (but are not limited to):

11 Insurability

A CE producer may insure one or more of the plant production practices (soil, hydroculture, and all 

other growing media). At additional coverage, a CE producer may choose to insure only certain plant 

categories within each plant production practice insured. All plants within each insured plant category 

under a plant production practice must be insured.

(1) If the insured selects CAT coverage for a plant production practice, all plant categories within 

the plant production practice must be insured at CAT coverage.

(2) If the insured selects additional coverage for a plant production practice, a different coverage 

percentage may be selected for each insured plant category under the insured plant production 

practice. 

(3) The CEVR may be revised no more than twice during the crop year. The increased insurance 

will not attach until the 31st day after the AIP receives an acceptable revised CEVR. The revision 

can only increase SVs. CEVR revisions are allowed for the following situations:

(a) changes in the CE (increased growing area, inventory volume, or inventory value, etc.);

(b) clerical errors (The reason for the upward revision must be indicated in the remarks 

section of the CEVR form stating, “revised upward for clerical error correction.”);

(c) acquisition of another CE in the same county that did not have CE crop insurance 

coverage on its plants (Plants of the same insured plant categories can be included in a 

revised CEVR; however, new plant categories or new plant production practices may not 

be added.); or

(d) acquisition of another CE that had CE crop insurance in force (The existing CE policy can

be transferred to the buyer in accordance with the BP. The revised CEVR in this 

situation is not considered one of the two allowable revisions.). 

(4) For a new application, coverage will not attach until the later of the start date of the crop year 

or the 31st day after the AIP receives a signed application, CEVR, and catalog, unless the AIP 

notifies the insured in writing that the CE does not meet insurability requirements, or the 

submitted documentation is not acceptable. In that case, insurance will attach the 31st day 

after the AIP receives an acceptable CEVR and catalog.

(5) For each subsequent crop year, coverage will begin at the same coverage percentage and SV on

June 1 or October 1, as applicable, provided the insured has provided the appropriate 

documentation or the required certification that there are no material changes in the CEVR 

previously submitted.
September 2023 FCIC-24970 5 

11 Insurability (Continued)

(6) If a carryover insured submits a new CEVR by the SCD, but the AIP notifies the insured the new 

CEVR is unacceptable, the insured must provide an acceptable CEVR within 30 days after the 

rejection of an unacceptable CEVR has been sent. If the new CEVR is still unacceptable, 

insurance will not attach for the crop year. If the new CEVR is acceptable, insurance attaches 

on the 31st day after the AIP receives all documents required for an acceptable CEVR.

(7) If the carryover insured fails to submit a new CEVR or fails to submit a certification that the 

information for the prior crop year is appropriate, insurance will not attach for the crop year.

(8) Changes to coverage percentages, SVs, insured plant production practices, or plant categories 

must be requested by submitting a new CEVR on or before the SCD.

(9) Insurable plants within the plant production practice(s) insured will be all specific plants in the 

insured plant categories grown in the county for which a premium rate is provided by the 

actuarial documents and that:

(a) the insured has an insurable share;

(b) are determined by the AIP to be acceptable;

(c) are grown in a CE inspected by the AIP and determined to be acceptable;

(d) are grown in an appropriate medium;

(e) are irrigated, unless otherwise provided by the SP;

(f) are grown in accordance with good production practices for which premium rates have 

been established;

(g) are not stock plants;

(h) may produce edible fruits, nuts, buds, flower, or greenery for sale; 

(i) are not any plants classified by a state or county as illegal to grow or sell in the county in 

which the CE is located. For example, growing or selling plants classified as invasive 

species is illegal in many states and counties. Further, insurance shall not attach or be 

provided for any plant considered a controlled substance under the provisions of the 

Food Security Act of 1985 (Pub. L. 99-198) and the regulations promulgated under the 

Act by USDA; and

(j) may include plants grown in containers with two or more different genera, species, 

subspecies, varieties, or cultivars of plants, so long as such production is consistent with 

good production practices and there is no reason to believe that such mixed production 

practice has any adverse effect on compliance with biosecurity protocols or the level of 

disease or contamination risk for the operation. The insured will specify which plant 

category the containers will be insured.
September 2023 FCIC-24970 6 

11 Insurability (Continued)

(10) Insurance ends on the basic unit at the earliest of:

(a) the date of final adjustment of a loss when the total indemnities due equal the amount 

of insurance;

(b) harvest (Specific plants that produce edible fruits, nuts, buds, flowers, greenery or any 

portion of the plant are not considered harvested until the last month the plant no 

longer produces these products or the plant is removed from the growing medium to 

end production.); 

(c) removal of all the specific plants from the CE (for any reason);

(d) failure of the structure or its equipment, where CE environment cannot be maintained.; 

(e) midnight local time on May 31st or September 30th, as applicable, of the crop year;

(f) abandonment or destruction of the crop; or

(g) for specific plants, when meeting the definition of dead/ZMV plant. 

12 Causes of Loss

A. Insured COLs

Insurance is provided for unavoidable damage caused only by the unknown introduction of a 

plant disease or contamination into the CE operation at no fault of the CE operator resulting in 

a destruction order that requires destruction of the plants. Unknown introduction means the 

infected plant material was not detected by biosecurity protocols.

B. Uninsured COLs 

In addition to the COLs excluded in Section 12 of the BP, the following are not covered COLs: 

(1) The inability to market the specific plants resulting solely from:

(a) the refusal of a buyer to accept such plans; or

(b) boycott. 

(2) Any damage or loss of production for any reason other than a disease or contamination

that requires destruction of the insured plants; 

(3) Any cause of loss if the only damage suffered is a failure of specific plants to grow to an 

expected size; or

(4) Any damage caused by not following recognized good production practices.
September 2023 FCIC-24970 7 

13 Provisions Not Applicable to CAT Level of Coverage

Basic Units by plant category are not applicable if CAT coverage is elected. 

14 Unit Division

(1) Unit division on a geographic basis (i.e., different sections, FSNs, etc.) is not available.

(2) Section 34 of the BP is not applicable.

(3) If the insured elects additional coverage for a plant production practice, a basic unit, as defined 

in Section 1 of the BP, will be divided into additional basic units for each insurable plant 

category the insured chooses within a plant production practice for which a premium rate is 

provided by the actuarial documents.

(4) The unit number assigned for a unit must be specific for that particular unit. If a loss is reported 

for part of a unit, the entire unit must be appraised. Additionally, all plant categories within 

that unit must be appraised separately, even if only one plant category has been damaged by 

disease or contamination. 

(5) Only the plant categories listed in the actuarial documents are insurable.

(6) For additional coverage, the plant categories the insured did not elect for insurance are 

uninsurable and not subject to adjustment in the event of a loss.

15 Multiple Benefits

In accordance with Section 3(b)(4) of the CP, if the insured has coverage under a CE policy and a 

Nursery Value Select or Nursery Field Grown & Container policy, refer to paragraph 806A(1) in the GSH.

16-20 (Reserved)
September 2023 FCIC-24970 8 

PART 3 – APPRAISALS

21 General Information

A. General Requirements:

Potential production will be appraised in accordance with the BP, CP, the SP, and with the 

procedures specified in this handbook and in the LAM.

In addition to insured’s duties in Section 14 of the BP, in case of damage to the insured plants, 

the insured must:

(1) protect non-infected plants from the disease or contamination; 

(2) give the AIP notice within 72 hours of the insured’s initial discovery of damage, but not 

later than 15 days after the end of the insurance period; 

(3) cooperate with the AIP in the investigation or settlement of claim; 

(4) document insured plants have a plant disease or contamination and must be destroyed 

pursuant to a destruction order, as defined in the CP; 

(5) understand that if plants are destroyed without an order described in (4) above, those 

plants are not eligible for an indemnity unless a destroy order deadline is prior to the 

date an AIP can send out an adjuster. In that case, the insured may use documentation 

to be eligible for a claim; and 

(6) obtain written consent prior to changing or discontinuing normal growing practices with 

respect to care and maintenance of the insured plants. Failure to obtain the AIP’s 

written consent will result in denial of the claim on the unit for which written consent 

was not obtained. 

B. Duties of the Insured if Claiming an Indemnity

If the insured intends to claim an indemnity on any unit, the claim for indemnity must be 

submitted not later than 60 days after the date of the loss, but in no event later than 60 days 

after the end of the insurance period.

If the insured fails to meet the above requirements and such failure results in the AIP’s inability 

to inspect the dead/ZMV production, all such production will be considered uninsurable, and 

the claim will be denied. Plants suffering uninsurable damage will not be considered insurable 

or indemnifiable if a subsequent loss occurs. Refer to the LAM for further instructions.

The insured must maintain the identity of plants that are damaged during the crop year due to 

a loss event, whether it is an insurable COL or not.
September 2023 FCIC-24970 9 

21 General Information (Continued)

B. Duties of the Insured if Claiming an Indemnity (Continued)

The insured must maintain an inventory including the number of all specific plants that are 

determined to have insurable damage and their location in the CE and this inventory should be 

updated as changes in the status from alive and infected to destroyed (e.g., death) occurs. If 

requested, the insured must provide:

(1) the most recent inventory; and

(2) purchase and verifiable sales records from the date of the most recent inventory to the 

date of loss occurrence.

If possible and/or practicable, the infected plants may be moved to separate from non-infected 

plants. Such as attachment of uniquely number indelible labels attached to damaged plants or 

groups of plants. The AIP must evaluate the proposed method of preserving identity to 

determine if it is acceptable.

22 Crop Inspection Requirements

In addition to any pre-acceptance CE inspection, any growing season and loss claim inspections are to 

be performed by loss adjusters. The loss adjuster reviews the insured’s documentation such as 

inventory, a destruction order, biosecurity self-certification form and any additional documents 

insured can provide to support the claim. The loss adjuster completes the production worksheet and 

submits the supporting documentation complete the claim. The destruction order must be included in 

the supporting documentation. The use of a CE crop consultant or state or federal official in 

collaboration with the loss adjuster may be needed to complete the inspection or to complete a claim. 

The AIP is responsible for arranging for the crop consultant to assist the loss adjuster. The opinion of 

the consultant must meet or exceed the following minimum requirements:

(1) The opinion must be in writing, signed and dated.

(2) The opinion must include:

(a) a statement disclosing any familial or business relationship with the insured CE, AIP, loss 

adjuster, or agent other than a fee for providing a written opinion;

(b) the name of who requested the opinion;

(c) the name of the CE;

(d) the mailing and physical address of the CE, including the county where the CE is located;

(e) the date of inspection;

(f) the plant category(ies) inspected;

(g) the plant production practice inspected;
September 2023 FCIC-24970 10

22 Crop Inspection Requirements (Continued)

(h) the specific plants inspected;

(i) the total number of each of the specific plants in the unit inspected;

(j) the cause of damage is disease or contamination (included in the destruction order); 

(k) the identified disease(s) or cause of contamination (included in the destruction order);

(l) for dead/ZMV plants, by specific plant, state: 

(i) the name of disease(s) or cause of contamination sustained by the plants that 

results in the dead/ZMV determination; 

(ii) the number of dead/ZMV plants; and

(m) provide the basis for the opinion (industry guidelines, state regulations, etc.), and 

provide all photographs of the damage, as appropriate, and documentation supporting 

the COL.

(3) The AIP shall not accept written opinions that do not meet these minimum standards.

23 Dates

(1) AIP representatives will confer with the insured(s) to set appraisal dates.

(2) Appraise the unit as soon as possible after the date of damage.

24 Grouping Plants during Appraisals

(1) While performing the appraisal, an inventory must be created to establish the total number of 

each specific plant in the unit. The quantity of each specific plant in the unit is evaluated to 

determine the insurable amount of undamaged plants not subject to a destruction order and 

dead/ZMV plants. Dead/ZMV plants will be destroyed. All plants in the unit must be accounted 

for. 

(2) CE records may be used to document the CE’s inventory of undamaged plants not subject to a 

destruction order prior to a loss after these records have been verified to be acceptable. 

Acceptable CE records include purchase, planting, sale, and inventory records. Purchase and 

sales records must be verifiable. Verifiable purchase and sales records must show the purchase 

or sale of specific plants containing:

(a) the name and address of the purchaser;

(b) the date of sale; and

(c) the complete genera or common name of the specific plant(s) sold, number of each of 

these specific plants sold, and the actual wholesale price received for each specific 

plant. Exclude all discounts, shipping charges, or any amounts that do not directly relate 

to the wholesale value of the specific plants.
September 2023 FCIC-24970 11

24 Grouping Plants during Appraisals (Continued)

(3) Records must be kept during this process. Records created by the insured after a loss are not 

acceptable records.

(4) The CE Pilot Appraisal Worksheet (Exhibit 3) is used to determine pre-loss actual unit value and 

post-loss damage value.

25 Determining Size Qualifications and Approved Sales Values

A. Size Qualifications

(1) Specific plants may be measured by caliper, height, or width, as per the insured’s 

catalog.

(2) Plants that are not of a size listed in the insured’s catalog will be insurable at an 

approved sales value prorated based on the nearest sizes listed in the catalog and their 

approved sales value.

(3) Plant height does not include the height of the root ball for balled-and-burlapped plants. 

Plant width measurements use the width of the crown (branches and foliage).

B. Approved Sales Value

(1) The approved sales value for each specific plant will be used when determining the preloss actual unit value and post-loss damage value.

(2) The approved sales value for each specific plant is, in order of precedence:

(a) the insured’s average weighted wholesale price (net of all discounts) for each 

specific plant within each plant category determined for, not to exceed 1.5 times 

the catalog price, unless otherwise specified in the Special Provisions:

(i) the 60-day period immediately preceding the date of the insured COL; or

(ii) if no sales occurred in the 60-day period immediately preceding the date 

of the insured COL, the 12 calendar months immediately preceding the 

date of the insured COL; or

(b) if no wholesale sales occurred for the specific plant during the 12 calendar 

months immediately preceding the date of the insured COL, average contract 

price (net of all discounts), not to exceed 1.5 times the wholesale catalog price, 

unless otherwise specified in the Special Provisions, for all future wholesale 

deliveries of the specific plant insured during the insurance period; or
September 2023 FCIC-24970 12

25 Determining Size Qualifications and Plant Prices (Continued)

B. Approved Sales Value (Continued)

(c) if no wholesale sales occurred for the specific plant during the 12 calendar 

months immediately preceding the date of the insured COL or there is no 

contract price for future wholesale deliveries of the specific plant, then the 

insured’s wholesale catalog price for that specific plant multiplied by the 

difference between 1.00 and the largest percentage discount (calculated as a 

percentage if the discount is recorded as a dollar amount) that the insured 

provides to any buyer for any quantity of any specific plant.

(i) If the insured’s catalog does not contain all applicable discounts, the 

wholesale catalog price for the specific plant will be decreased by 10 

percent. 

(ii) Notwithstanding (c), discounts will not be applied to prices for plants 

grown under license from the holder of a patent issued by the US Patent 

and Trademark Office provided the license specifically establishes the 

required sales price.

(iii) A discount stated as a dollar value relative to a specific dollar amount or a 

range of dollar amounts for a purchase will be converted to a percentage 

rate by dividing the dollar amount of such discount by the dollar amount 

to which such discount applies.

(3) If no records for a specific plant exist as outlined in 2(a) or 2(b) above, the approved 

sales value for that specific plant will be determined by prorating the approved sales 

values of the nearest size of that specific plant using first 2(a) then 2(b) above.

Approved Sales Value Proration Procedures

Step Action

1 Identify the nearest sizes listed in the insured’s catalog for the plant identified 

by its complete botanical or common name. These are the reference plants.

2 Determine the approved sales value for the plants identified in 1.

3 Determine the difference in size between the larger and smaller sizes in 1 by 

subtracting the smaller size from the larger.

4 Determine the difference in the approved sales values determined in 2 by 

subtracting the smaller value from the larger.

5 Divide 4 by 3, retaining the units. This represents the approved sales value 

difference per size unit.

6 Determine the size difference between the specific plant and the next nearest 

plant from 1 by subtracting the smaller size from the larger.

7 Multiply the result of 6 by the result of 5. This is the value difference between 

the next nearest size plant and the specific plant.

8a If the next nearest size plant is smaller than the specific plant, add the result of 

7 to the approved sales value for the next nearest size plant.

8b If the next nearest size plant is larger than the specific plant, subtract the 

result of 7 from the approved sales value for the next nearest size plant.
September 2023 FCIC-24970 13

25 Determining Size Qualifications and Plant Prices (Continued)

B. Approved Sales Value (Continued)

(4) Plants that are:

(a) Larger than the largest size listed in the insured’s catalog will be insurable at the 

approved sales value for the largest size listed in the catalog.

(b) Smaller than the smallest size listed in the insured’s catalog will be insurable at 

an approved sales value prorated based on actual size and the approved sales 

value for the smallest size listed in the catalog for that specific plant.

26 Basis for Indemnification

Claims must be submitted as “final claims,” each of which will build upon the information obtained 

from any previous “final claims” for the unit for the crop year. Each claim reduces the amount of 

insurance. A claim is payable whenever the percent of loss is greater than zero and the total of all 

indemnities to date is less than the amount of insurance.

27 Establishing Pre-Loss Actual Unit Value

Market value establishment of CE plants differs from other crops because market reports that are 

available for most other insured crops are not available for CE. The CP requires that the insured submit 

a CEVR for each basic unit, for all growing locations and structures within the county, which includes 

the insured plant category, SV, coverage percentage, and the insured’s share.

Prior to determining the amount of any loss, AIPs must request and verify documentation to support 

pre-loss inventories of specific plants and approved sales value used to determine the pre-loss actual 

unit value. No indemnity will be paid for specified plants for which the documentation is inadequate.

(1) Pre-loss actual unit value of plants that are oversized relative to the current physical size of the 

plant will be adjusted for the size listed in the insured’s catalog appropriate for the actual plant 

size.

(2) Pre-loss actual unit value is established using the following, as applicable:

(a) The approved sales value for each specific plant is calculated as described in Paragraph 

25. 

(b) The quantity of each specific plant in the unit prior to the loss.

(i) If possible, this number is to be obtained by taking an inventory (count) of the 

specific plants in the unit that existed before the loss event occurred.

(ii) Alternatively, this number may be established by subtracting appropriate sales 

and adding appropriate purchases from the number of that specific plant as 

documented by the insured’s records from the most recent inventory record.
September 2023 FCIC-24970 14

27 Establishing Pre-Loss Actual Unit Value (Continued)

(A) The purchase records must be verifiable.

(B) The inventory record must have been produced prior to the loss, be 

dated, be the most recent available, and be certified by the insured as 

such. 

(3) If plants have disappeared due to an uninsurable COL (hurricane, tornado, flood, etc.), obtain 

records from the insured to establish the number of such plants and include that number in the 

totals for the respective specific plant.

Step Action

1 Determine the number of each specific plant that was in the unit immediately prior 

to the occurrence of the COL.

2 Multiply the approved sales value for each insured specific plant by the number of 

that specific plant in the unit.

3 Sum all the values obtained in step 2.

28 Establishing Post-Loss Damage Value

Refer to the CP for definition of dead/ZMV plant. In determining the post-loss damage value, AIPs 

must use the same approved sales value for specific plants that was used to determine pre-loss actual 

unit value (Paragraph 27).

The damage factor for establishing the post-loss damage value is 1.0 for plants included in a 

destruction order . 

The loss adjuster performs all the actions in the table below for each specific plant.

Step Action

1 Use the number of each specific plant that was used to determine pre-loss actual unit value.

2 The adjuster classifies plants from step 1 into one of two groups:

(a) plants which are not included in destroy order; or

(b) plants included in destroy order.

3 The adjuster multiplies the number of each specific plant in the group of plants not included 

in the destroy order by the applicable approved sales value.

4 The adjuster sums the results from step 3 to obtain the post-loss damage value.
September 2023 FCIC-24970 15

28 Establishing Post-Loss Damage Value (Continued)

Use the following to address issues with plants that require special attention during the loss 

adjustment procedures.

Group Information

Omitted plant: 

Specific plants in 

an insured plant 

category not 

listed in the 

catalog.

If the complete botanical or common name is missing, but the genus, species, or a 

common name (ignoring the variety, cultivar, or color) is listed in the catalog, use 

the lowest approved sales values for plants in that broader grouping.

If the complete botanical or common name is missing and the genus, species, or a 

common name (ignoring the variety, cultivar, or color) is not listed in the catalog, 

the plant is uninsurable and not included in either the pre-loss actual unit value or 

the post-loss damage value.

Plants in 

uninsured plant 

categories.

For additional coverage, all specific plants in plant categories the insured has 

elected not to insure are uninsurable. Neither pre-loss unit value nor post-loss 

damage value is calculated for these plant categories. If there is any doubt about 

a plant belonging to a plant category, consult an expert. Refer to the SP and 

USDA Plants website for guidance: https://plants.sc.egov.usda.gov/. For CAT 

coverage, all plant categories under the insured plant production practice must 

be insured.

Prohibited 

plants. 

A prohibited plant is any plant classified by any government entity as illegal to 

grow or sell in the county in which the CE is located and is uninsurable, even if 

otherwise qualifying as insurable.

Insurance shall not attach to or be provided for any plant considered a controlled 

substance under the provisions of the Food Security Act of 1985 (Pub. L. 99-198) 

and the regulations promulgated under the Act by USDA.

If during any inspection or settlement of a claim, it is determined that prohibited 

plants are being grown, reduce the pre-loss unit value and post-loss damage 

value of any affected unit by the value of the prohibited plant(s).

29 Disease or Contamination Claims

The CP specifies that insurance is not provided against any loss due to any natural peril other than a 

disease or contamination that requires destruction of the plants pursuant to an order issued as 

described in Section 10 of the CP.

Plants with a disease or contamination and that are covered by a destruction order must be destroyed 

and that destruction must be verified before a claim for indemnity can be finalized. Such plants are 

considered to have ZMV. The destruction order may include non-damaged plants in a buffer zone. 

Those plants in buffer are eligible for an indemnity.

A claim must include a destruction order, as defined in the CP 

A claim must include a completed biosecurity self-certification document, as defined in the CP. 
September 2023 FCIC-24970 16

30 Cold-Related Claims

The CP specify that insurance is not provided against any loss caused by cold temperatures.

31 Special Considerations/Case Procedure

(1) Grafted or budded plants are insurable only after the graft union has formed. The approved 

sales value for grafted or budded plants will be in the catalog if that is how it is sold.

(2) Insurable damage that occurs at the end of the insurance period is to be covered by the AIP of 

record at the time damage occurred, provided timely NOL is given.

(3) Once liability is accepted by the assuming company, the assuming company is liable for 

coverage from that date. The inspection affirms the CE’s potential to produce a marketable 

product without undue probability of loss.

(4) A revised CEVR must be made no later than 30 days before the end of the crop year. A timelyfiled revised CEVR will be in effect on the 31st day after the written request to change coverage 

is submitted unless, within the 30-day waiting period:

(a) the proposed increase in the SV was rejected in writing by the AIP; or

(b) a loss occurred on the unit for which the revised report was prepared.

Note: Downward revisions and premium reductions are only allowed when appropriate to 

correct AIP clerical errors and to remove values for uninsurable plants. Complete any 

revisions to the CEVR according to instructions provided by the AIP.

32 Deviations and Modifications

Deviations in appraisal methods require FCIC written authorization (as described in the LAM) prior to 

implementation. 

33 General Information for Worksheet Entries and Completion Procedures

(1) The completion instructions for the required entry items on the Appraisal Worksheets in 

Exhibits 3 and 4 are “Substantive” (i.e., they are required).

(2) Include the AIP’s name in the Appraisal Worksheet title if not preprinted on the Appraisal 

Worksheet or when a worksheet entry is not provided.

(3) Include the claim number on the Appraisal Worksheet (when required by the AIP), when a 

worksheet entry is not provided.

(4) CE appraisals are to be made when directed by the AIP or when a notice of damage has been 

received. Refer to the LAM for additional reasons for appraisals.

(5) Make separate appraisals for each insured specific plant in each insured plant category within a 

basic unit.
September 2023 FCIC-24970 17

33 General Information for Worksheet Entries and Completion Procedures (Continued)

(6) Document all uninsured COLs in the Remarks section.

(7) Document different specific plants in the insured plant category on the Appraisal Worksheets.

(8) A separate Appraisal Worksheet is required for each insured plant category in each basic unit 

inspected. 

34-40 (Reserved)
September 2023 FCIC-24970 18

PART 4 – INDEMNITY CALCULATIONS & PRODUCTION WORKSHEET

41 General Information

Successive indemnities may be paid on the same basic unit. Each indemnity paid reduces the amount 

of insurance remaining on the basic unit unless the producer has filed a revised CEVR to report an 

upward revision in the number of plants. 

The maximum indemnity is limited to the amount of insurance for the basic unit. When the amount of 

indemnity paid equals the amount of insurance, no additional coverage is available for the remainder 

of the crop year. However, coverage can be increased or re-established if the CE is restocked and a 

revised CEVR is completed and approved by the AIP.

42 Indemnity Calculation Examples

Example 1. First Claim CAT Coverage

Pre-loss Actual Unit Value Less than SV

Step Action Result

Established with the Application

A Enter share as a decimal percentage 1.0000

B Coverage Percentage =

for CAT coverage, enter 0.50 

OR

for additional coverage, enter the elected coverage 

percentage

0.50

C Price =

for CAT coverage, enter 0.55

OR

for additional coverage, enter 1.00

0.55

D Enter SV $100,000

E Initial amount of insurance = A × B × C × D $27,500

Values at the Time of Loss

F Enter Pre-loss Actual Unit Value $80,000

G Enter Post-loss Damage Value $60,000

H Percent of Loss = (G/F) 0.750000

I Total amount from previous loss occurrences,

excluding price and share

0

J Total amount of any previous indemnity payments 0

K Indemnity = lesser of (E - J) or 

(A × B × C × H × lesser of (F or (D - I)))

$16,500

L Remaining amount of insurance (E - J - K) $11,000
September 2023 FCIC-24970 19

42 Indemnity Calculation Examples (Continued)

Example 2. First Claim Additional Coverage

Pre-loss Actual Unit Value Less than SV

Step Action Result

Established with the Application

A Enter share as a decimal percentage 1.0000

B Coverage Percentage =

for CAT coverage, enter 0.50

OR

for additional coverage, enter the elected coverage percentage 

0.75

C Price =

for CAT policies 0.55

OR

for additional coverage enter 1.00

1.00

D Enter SV $100,000

E Initial amount of insurance = A × B × C × D $75,000

Values at the Time of Loss

F Enter Pre-loss Actual Unit Value $80,000

G Enter Post-loss Damage Value $60,000

H Percent of Loss = (G/F) 0.750000

I Total amount from previous loss occurrences,

excluding price and share

0

J Total amount of any previous indemnity payments 0

K Indemnity = lesser of (E - J) or

(A × B × C × H × (lesser of F or (D - I)))

$45,000

L Remaining amount of insurance (E - J - K) $30,000
September 2023 FCIC-24970 20

42 Indemnity Calculation Examples (Continued)

Example 3. First Claim Additional Coverage

Pre-loss Actual Unit Value More than SV

Step Action Result

Established with the Application

A Enter share as a decimal percentage 1.0000

B Coverage Percentage =

for CAT coverage, enter 0.50

OR

for additional coverage, enter the elected coverage percentage

0.75

C Price =

for CAT policies 0.55

OR

for additional coverage enter 1.00

1.00

D Enter SV $100,000

E Initial amount of insurance = A × B × C × D $75,000

Values at the Time of Loss

F Enter Pre-loss Actual Unit Value $160,000

G Enter Post-loss Damage Value $100,000

H Percent of Loss = (G/F) 0.625000

I Total amount from previous loss occurrences,

excluding price and share

$0

J Total amount of any previous indemnity payments $0

K Indemnity = lesser of (E - J) or

(A × B × C × H × (lesser of F or (D - I)))

$46,875

L Remaining amount of insurance (E - J - K) $28,125
September 2023 FCIC-24970 21

42 Indemnity Calculation Examples (Continued)

Example 4. Second Claim Additional Coverage

Cumulative Pre-loss Actual Unit Values More than SV

Step Action Result

Established with the Application

A Enter share as a decimal percentage 1.0000

B Coverage Percentage =

for CAT coverage, enter 0.50

OR

for additional coverage, enter the elected coverage percentage 

0.75

C Price =

for CAT policies 0.55

OR

for additional coverage enter 1.00

1.00

D Enter SV $100,000

E Initial amount of insurance = A × B × C × D $75,000

Values at the Time of Loss

F Enter Pre-loss Actual Unit Value $80,000

G Enter Post-loss Damage Value $60,000

H Percent of Loss = (G/F) 0.750000

I Total amount from previous loss occurrences,

excluding price and share

$47,250

J Total amount of any previous indemnity payments $47,250

K Indemnity = lesser of (E - J) or

(A × B × C × H × (lesser of F or (D - I)))

$27,750

L Remaining amount of insurance (E - J - K) $0
September 2023 FCIC-24970 22

42 Indemnity Calculation Examples (Continued)

Example 5. First Claim Additional Coverage

Pre-loss Actual Unit Value Less than SV

Step Action Result

Established with the Application

A Enter share as a decimal percentage 1.0000

B Coverage Percentage =

for CAT coverage, enter 0.50

OR

for additional coverage, enter the elected coverage percentage 

0.75

C Price =

for CAT policies 0.55

OR

for additional coverage enter 1.00

1.00

D Enter SV $100,000

E Initial amount of insurance = A × B × C × D $75,000

Values at the Time of Loss

F Enter Pre-loss Actual Unit Value $80,000

G Enter Post-loss Damage Value $60,000

H Percent of Loss = (G/F) 0.750000

I Total amount from previous loss occurrences,

excluding price and share

$0

J Total amount of any previous indemnity payments $0

K Indemnity = lesser of (E - J) or

(A × B × C × H × (lesser of F or (D - I)))

$27,750

L Remaining amount of insurance (E - J - K) $0
September 2023 FCIC-24970 23

42 Indemnity Calculation Examples (Continued)

Example 6. Second Claim Additional Coverage

Cumulative Pre-loss Actual Unit Value More than SV

Step Action Result

Established with the Application

A Enter share as a decimal percentage 1.0000

B Coverage Percentage =

for CAT coverage, enter 0.50

OR

for additional coverage, enter the elected coverage percentage

0.75

C Price =

for CAT policies 0.55

OR

for additional coverage enter 1.00

1.00

D Enter SV $100,000

E Initial amount of insurance = A × B × C × D $75,000

Values at the Time of Loss

F Enter Pre-loss Actual Unit Value $80,000

G Enter Post-loss Damage Value $40,000

H Percent of Loss = (G/F) 0.500000

I Total amount from previous loss occurrences,

excluding price and share

$45,000

J Total amount of any previous indemnity payments $45,000

K Indemnity = lesser of (E - J) or

(A × B × C × H × (lesser of F or (D - I)))

$20,625

L Remaining amount of insurance (E - J - K) $9,375
September 2023 FCIC-24970 24

43 Completing the Production Worksheet

(1) The completion instructions for the required entry items on the Production Worksheet in 

Exhibit 4 are “Substantive” (i.e., they are required).

(2) The Production Worksheet is a form specific to CE loss adjustment. A separate set of 

Production Worksheets is needed for each basic unit loss inspection; a Production Worksheet 

must document all the insured plant categories in the basic unit.

(3) If a change or correction is necessary, strike out entry and enter correct entry above previous 

entry. The adjuster and insured should initial all changes.

(4) Refer to the LAM for instructions regarding the following:

(a) Delayed notices and delayed claims.

(b) Corrected claims or fire losses (double coverage) and cases involving uninsured COLs, 

unusual situations, controversial claims, concealment, or misrepresentation.

(c) “No Indemnity Claims” (which must be verified by a CE inspection or notification from 

the insured that the value of the plants remaining after the loss is equal to or more than 

the SV minus any prior indemnity payments).

(5) The loss adjuster is responsible for determining if the insured has complied with the 

requirements under the notice and claim provisions of the CP. If the insured has not, the loss 

adjuster should contact the AIP for guidance. 

(6) All CE inspections initiated through a NOL are considered final inspections.

(7) Specific loss calculations are discussed in the instructions for the completion of the Production 

Worksheet. For each loss occurrence, the claim is settled on a unit basis.
September 2023 FCIC-24970 25

EXHIBITS 

Exhibit 1 Acronyms and Abbreviations

The following table provides the acronyms and abbreviations used in this handbook.

Approved

Acronym/Abbreviation Term 

AIP Approved Insurance Provider

BP Common Crop Insurance Policy, Basic Provisions

CAT Catastrophic Risk Protection

CE Controlled Environment

CEVR Controlled Environment Value Report

CFR Code of Federal Regulations

CIH Crop Insurance Handbook, FCIC-18010

COL Cause of Loss

CP CE Pilot Crop Provisions

DSSH Document and Supplemental Standards Handbook, FCIC-24040

FAD Final Agency Determination

FCIC Federal Crop Insurance Corporation

FSN Farm Serial Number

GSH General Standards Handbook FCIC-18190

ISH CE Pilot Insurance Standards Handbook, FCIC-24420

LAM Loss Adjustment Manual, FCIC-25010

NOL Notice of Loss

CEVR CE Value Report

OPI Office of Primary Interest

RMA Risk Management Agency

SCD Sales Closing Date

SP Special Provisions

SRA Standard Reinsurance Agreement

SV Selected Value

USDA United Stated Department of Agriculture

XPS Excluding Price and Share Calculation

ZMV Zero market value
September 2023 FCIC-24970 26

Exhibit 2 Definitions

See the BP, GSH, CP, ISH, and LAM for definitions not specific to loss adjustment.

Biosecurity self-certification: A document the insured completes, that certifies the implementation of good 

production practices regarding phytosanitary and biosecurity processes.

Botanical name: The Latin, scientific, or legal form of a plant name. Parts of the name may be genus, specific 

epithet (species), subspecies, variety, and cultivar.

Common name: The name by which a plant may be known in everyday commerce.

Caliper: The diameter of a tree, measured at a point 6 inches above the ground line if the resulting 

measurement is no more than 4 inches. If the resulting measurement is more than 4 inches, the 

measurement is made at a point 12 inches above the ground line.

Catalog: Any document in a format that meets the requirements set forth in Section 6(k) of the CP issued by 

the CE operation and used to advise actual and/or potential wholesale buyers of the amount the insured is

charging for the purchase of each specific plant that are offered for sale, including all applicable discounts. 

Such documents may be by season or any other basis consistent with the CE operation’s practices. If the 

insured has plants in an insured plant category in the CE operation that are not yet available for sale and are 

not included in the catalog, the insured must submit a supplement to the catalog that meets the requirements 

of Section 6(k) of the CP. 

Coverage percentage: The percentage of the SV the insured elects to insure. For additional level of coverage, 

the insured may select from 50.0 percent to 75.0 percent in 5.0 percent increments. For CAT level of 

coverage, the coverage percentage is 50 percent.

Dead/ZMV plant: A specific plant that, due to an insured cause of loss, must be destroyed pursuant to a 

destruction order.

Destruction Order: An order issued by an official authorized to enforce the terms of the Plant Protection Act 

or similar regulations established by a State requiring destruction of plants. 

Percent of loss: Post-loss damage value divided by pre-loss actual unit value.

Price election percentage: A value equal to 1.00 if the insured elects additional coverage or 0.55 if the insured 

elects CAT coverage.
September 2023 FCIC-24970 27

Exhibit 2 Definitions (Continued)

Prohibited plants: Any plant classified by a state or county as illegal to grow or sell in the county in which the 

CE is located and is uninsurable, even if otherwise qualifying as insurable. Further, insurance shall not attach 

to or be provided for any plant considered a controlled substance under the provisions of the Food Security 

Act of 1985 (Pub. L. 99-198) and the regulations promulgated under the Act by USDA. For example, growing or 

selling plants classified as invasive species is illegal in many states and counties. No indemnity will be paid on 

any such plant. If during any inspection of the CE or during the settlement of a claim, the AIP determines that 

prohibited plants are being grown or held for sale, the AIP will reduce the inventory value (mandatory CEVR 

revision) of any affected unit by the value of the prohibited plant(s). For additional information on prohibited 

plants, refer to Paragraph 28. 

Specific plant: A plant identified by the complete botanical or common name as listed in the insured’s 

catalog, or as otherwise defined in the Special Provisions. The products of plants being grown solely for 

harvest of buds, flowers, greenery, or any portion of the plant are also considered specific plants.

Quantity: For specific plants sold by the count, the actual number of such plants. For specific plants that are 

harvested, and the production is sold by weight, the number of pounds. The number of cartons or other 

containers will be converted to an equivalent number of pounds if such measures are used for sale.

Wholesale: The sale of specific plants to retailers for resale and not directly to the end-user, except to endusers including but not limited to landscape contractors, government entities or organizations, restaurants, 

grocers, and commercial vegetable and fruit producers.
September 2023 FCIC-24970 28

Exhibit 3 Form Standards – Preliminary Appraisal Worksheet for a Specific Plant

An example of a specific plant Appraisal Worksheet that illustrates completed entry items is provided at the 

end of this exhibit. Separate worksheets are completed for each specific plant insured in a basic unit. A 

summary Appraisal Worksheet is then used to combine values for all specific plants in a plant category within 

the basic unit. Finally, the Production Worksheet is then used to combine values from different plant 

categories within the basic unit. Example specific plant Appraisal Worksheet items are numbered 

consecutively below. See Paragraphs 2D and 33 for additional requirements and information.

Element/Item Number Description

1. Insured’s Name Name of the insured that identifies EXACTLY the person (legal entity) to whom 

the policy is issued.

2. Policy Number Insured’s assigned policy number.

3. Unit Number (1) For an additional level of coverage, enter the basic unit number from 

the CEVR after it is verified to be correct.

(2) For CAT level of coverage, enter a unit number to represent the basic 

unit by share and plant production practice.

4. Crop Year Four-digit crop year, as defined in the CP, for which the claim has been filed.

5. Cause(s) of Damage Name of the insured cause(s) of loss for this crop as listed in the LAM.

6. Date of Damage Enter a SPECIFIC DATE of damage. This consists of the first three letters of the 

month and the specific date (e.g., Sep 11) or, for additional damage due to a 

subsequent loss, with attention to a specific date of damage occurring 

following any applicable increased amount of insurance (due to an upwardrevised CEVR) in effect at the time damage was occurring.

7. Inspection Number Number of the inspection for the crop year (e.g., 1).

8. Plant Production 

Practice Code

Three-digit code number, entered exactly as specified on the actuarial 

documents for the plant production practice (practice) carried out by the 

insured, e.g., (204) Soil; (205) Hydroculture; or (206) All other growing media, 

as applicable.

9. State Code Enter the numeric state code (e.g., 12).

10. County Code/Zip Code Enter the numeric county code and zip code (e.g., 55/33825).

11. CAT Policy Check the appropriate box; “Yes” if the insured elected CAT coverage or “No” 

if the insured elected additional coverage.
September 2023 FCIC-24970 29

Exhibit 3 Form Standards – Preliminary Appraisal Worksheet for a Specific Plant (Continued)

Element/Item Number Description

12. Unit Structure Check the appropriate box, depending on the unit structure the insured 

selected:

(1) basic units by plant production practice; or

(2) basic units by plant category. 

Only additional coverage policies may have basic units by plant category. CAT 

coverage policies must have basic units by plant production practice.

13. Plant Category Code Enter the three-digit code for each plant category as specified on the actuarial 

documents.

14. Field ID For plants grown in separate locations (i.e., separate structures) but insured as 

a single basic unit, enter any combination of letters and/or numbers up to 5 

characters, identifying the location of the specific plants appraised (e.g., B2), 

and provide a separate Preliminary Appraisal Worksheet for a specific plant for 

each location. Otherwise leave blank.

15. Specific Plant 

Name/Size

Include specific plant name and size details as necessary to establish the plant 

identity approved value (item 16) for the Appraisal Worksheet line.

16. Approved Sales Value Enter the approved sales value of the specific plant as determined in 

accordance with Paragraph 25B.

17. Number of the 

Specific Plant in the 

Unit.

Enter the total number of the specific plant in the basic unit as determined by 

procedures described in Paragraph 27. 

18. Required Number of 

Plants in the Sample

Leave blank.

19. Actual Number of 

Plants in the Sample

Leave blank.

20. Adjuster 

Determination of 

Number of Plants in 

Sample by Condition

For a specific plant in a basic unit, enter the number in each of the following 

damage groups:

20a. UD: Plants not diseased or contaminated and will not be destroyed.

20b. D/Z: Plants affected by a covered disease or contamination and that 

must be destroyed.

20c. Leave blank.

21d. Leave blank.

21. Final Determination of 

Number of Plants in 

Sample by Condition

21a. Leave blank.

21b. Leave blank.

21c. Leave blank.

21d. Leave blank.
September 2023 FCIC-24970 30

Exhibit 3 Form Standards – Preliminary Appraisal Worksheet for a Specific Plant (Continued)

Element/Item Number Description

22. Damage Factor For a specific plant (item 15) in a specific location (item 14), enter the damage 

factor for the damage groups UD and D/Z:

22a. UD: Leave blank.

22b. D/Z: Dead/ZMV = 1.00. 

22c. Leave blank.

22d. Leave blank.

23. Specific Plant Sample 

Pre-Loss Value

Enter the product of the Approved Sales Value of the Specific Plant multiplied 

by the Actual Number of Plants (item 16 × item max(20a or 20b)). Round to 

two decimal places.

24. Specific Plant Sample 

Post-Loss Damage 

Value

Enter the product of the Approved Sales Value of the Specific Plant multiplied 

by number of Plants and by the applicable Damage Factor (item 23 × max(22a, 

22b)). Round to two decimal places.

25. Percent of Loss Enter the result of dividing the Specific Plant Sample Post-loss Damage Value 

by the Specific Plant Sample Pre-loss Value (item 24 / item 23). Round to six 

decimal places.

26. Pre-Loss Value of the 

Specific Plant in the 

Unit

Enter the product of the Approved Sales Value of the Specific Plant multiplied 

by the Number of the Specific Plant in the Unit (item 16 × item 17). Round to 

two decimal places.

27. Post-Loss Damage 

Value of the Specific 

Plant in the Unit

Enter the product of the Percent of Loss multiplied by the Pre-Loss Value of the 

Specific Plant in the Unit (item 25 × item 26). Round to two decimal places.

28. Remarks On the last page of the Appraisal Worksheet for a Specific Plant, enter:

(1) Date of appraisal.

(2) Documentation for any adjustment in plant value due to uninsured 

causes.

(3) Cause assessed for uninsured COL appraisals.

(4) Plants grown in the CE not belonging to the insured or plants belonging 

to the insured but grown in a CE not owned by the insured.

(5) Any other pertinent information pertaining to the inspection.

If additional space is needed, use and attach a Special Report and refer to the 

attachment in the Remarks section.

29. Insured’s Signature 

and Date

Insured’s (or insured’s authorized representative’s) signature and date. 

BEFORE obtaining insured’s signature, REVIEW ALL ENTRIES on the Appraisal 

Worksheet WITH THE INSURED, particularly explaining codes, etc., which may 

not be readily understood.

30. Adjuster’s Signature, 

Code Number, and 

Date 

Signature of adjuster, code number, and date signed after the insured (or 

insured’s authorized representative) has signed. For an absentee insured, 

enter adjuster’s code number ONLY. The signature and date will be entered 

AFTER the absentee has signed and returned the Appraisal Worksheet.
September 2023 FCIC-24970 31

Exhibit 3 Form Standards – Preliminary Appraisal Worksheet for a Specific Plant (Continued)

Element/Item Number Description

31. Consultant’s Name 

and Date

Name of consultant and date, if present and assisting with the appraisal.

32. Page Number Page number and total number of pages for the UNIT/CATEGORY (Example: 

Page 1 of 1, Page 1 of 2, Page 2 of 2, etc.).
September 2023 FCIC-24970 32

Exhibit 3 Form Standards – Preliminary Appraisal Worksheet for a Specific Plant (Continued)
September 2023 FCIC-24970 33

Exhibit 4 Form Standards – Appraisal Worksheet

An example of an Appraisal Worksheet that illustrates completed entry items is provided at the end of this 

exhibit. Separate Appraisal Worksheets are completed for each plant category insured in a basic unit. The 

Production Worksheet is then used to combine values from different plant categories within the basic unit. 

Standard Appraisal Worksheet items are numbered consecutively below. See Paragraphs 2D and 33 for 

additional requirements and information.

Element/Item Number Description

1. Insured’s Name Name of the insured that identifies EXACTLY the person (legal entity) to whom the 

policy is issued.

2. Policy Number Insured’s assigned policy number.

3. Unit Number (1) For additional coverage, enter the basic unit number from the CEVR after it 

is verified to be correct.

(2) For CAT coverage, enter a unit number to represent the basic unit by share 

and plant production practice.

4. Crop Year Four-digit crop year, as defined in the CP, for which the claim has been filed.

5. Cause(s) of Damage Name of the insured cause of loss for this crop is plant disease (code 81) or for 

contamination use (code 72). Use supporting documentation to identify the name 

of the disease or contamination that occurred. State in the Remarks section.

6. Date of Damage Enter a SPECIFIC DATE the disease or contamination was discovered. This consists 

of the first three letters of the month and the specific date (e.g., Sep 11).

7. Inspection Number Number of the inspection for the crop year (e.g., 1).

8. Practice Code Three-digit code, entered exactly as specified on the actuarial documents for the 

plant production practice (practice) carried out by the insured.

9. State Code Enter the numeric state code (e.g., 12).

10. County Code/Zip 

Code Enter the numeric county code and zip code (e.g., 55/33825).

11. CAT Policy Check the appropriate box; “Yes” if the insured selected CAT coverage or “No” if 

the insured selected additional coverage.

12. Unit Structure Check the appropriate box, depending on the unit structure the insured selected:

(1) basic units by plant production practice; or

(2) basic units by plant category. 

Only additional coverage policies may have basic units by plant category. CAT 

coverage policies must have basic units by plant production practice.

13. Plant Category 

Code

Enter the three-digit code for each plant category as specified on the actuarial 

documents.

14. Field ID Enter any combination of letters and/or numbers up to 5 characters, identifying 

the location of the plants (e.g., B2).
September 2023 FCIC-24970 34

Exhibit 4 Form Standards – Appraisal Worksheet (Continued)

Element/Item Number Description

15. Specific Plant 

Name/Size

Include specific plant name and size for all plants in the plant category being 

documented. Make one entry for each insured specific plant from the 

corresponding Preliminary Appraisal Worksheet for a Specific Plant.

16.Specific Plant PreLoss Actual Unit 

Value

Enter the appropriate value (item 26) from the Preliminary Appraisal Worksheet 

for the Specific Plant.

17.Specific Plant PostLoss Damage ValueEnter the appropriate value (item 27) from the Preliminary Appraisal Worksheet 

for the Specific Plant.

18.Pre-Loss Actual Unit 

Value – This Page

Enter the sum of the item 16 values on each Appraisal Worksheet page. Enter 

values rounded to whole dollars.

19.Post-Loss Damage 

Value – This Page

Enter the sum of the item 17 values on each Appraisal Worksheet page. Enter 

values rounded to whole dollars.

20.Pre-Loss Actual Unit 

Value – Category

On the last page enter the sum of the item 18 values on all the Appraisal 

Worksheet pages. Enter values rounded to whole dollars.

Otherwise leave blank.

21.Post-Loss Damage 

Value – Category

On the last page enter the sum of the item 19 values on all the Appraisal 

Worksheet pages. Enter values rounded to whole dollars.

Otherwise leave blank.

22.Remarks On the last page of the Appraisal Worksheet for each plant category in the basic 

unit, enter:

(1) Date of appraisal.

(2) Documentation for any adjustment in plant value due to, uninsured 

causes. 

(3) Cause assessed for uninsured COL appraisals, identified by specific plant.

(4) Any other pertinent information pertaining to the inspection.

If additional space is needed, use and attach a Special Report and refer to the 

attachment in the Remarks section.

23. Insured’s Signature 

and Date

Insured’s (or insured’s authorized representative’s) signature and date. BEFORE 

obtaining insured’s signature, REVIEW ALL ENTRIES on the Appraisal Worksheet 

WITH THE INSURED, particularly explaining codes, etc., which may not be readily 

understood.

24. Adjuster’s Signature, 

Code Number, and 

Date 

Signature of adjuster, code number, and date signed after the insured (or 

insured’s authorized representative) has signed. For an absentee insured, enter 

adjuster’s code number ONLY. The signature and date will be entered AFTER the 

absentee has signed and returned the Appraisal Worksheet.

25. Consultant’s Name 

and Date

Name of consultant and date, if present and assisting with the appraisal.

26. Page Number Page number and total number of pages for the UNIT/CATEGORY (Example: 

Page 1 of 1, Page 1 of 2, Page 2 of 2, etc.).
September 2023 FCIC-24970 35

Exhibit 4 Form Standards – Appraisal Worksheet (Continued)

Company: Claim No.:

2. POLICY NUMBER

XXXXXXX

6. DATE OF DAMAGE

Sept 11

13. PLANT CATEGORY 

CODE

857

(1) ABC COMPANY XXXXXXX

For Illustration Purposes Only

CE PILOT SUMMARY

APPRAISAL WORKSHEET

1. INSURED’S NAME 3. UNIT NUMBER

I M INSURED 0001-0001-BU

4. CROP YEAR 7. INSPECTION NUMBER

9. STATE CODE

47

11. CAT POLICY 12. UNIT STRUCTURE SELECT ONE

Yes

yyy 1

Basic Units by Plant 

Production Practice

14. Field ID

1

10. COUNTY CODE/ZIP CODE

61/37339

Basic Unit by Category

No X

15. Specific Plant (Name/Size) 16. SPECIFIC PLANT PRE-LOSS ACTUAL UNIT VALUE 17. SPECIFIC PLANT POST-LOSS DAMAGE VALUE (19d)

Peace Rose/6-inch pot $600.00 $600.00 

Peace Rose/8-inch pot $800.00 $800.00 

Peace Rose/10-inch pot $1,000.00 $1,000.00 

Olympiad Rose/6-inch pot $11,120.00 $11,120.00 

Olympiad Rose/8-inch pot $1,200.00 $1,200.00 

Olympiad Rose/10-inch pot $47,235.00 $47,235.00 

Lincoln Rose/6-inch pot $8,500.00 $8,500.00 

Lincoln Rose/8-inch pot $15,200.00 $15,200.00 

Lincoln Rose/10-inch pot $19,000.00 $19,000.00 

$958,253 

21. CATEGORY POST-LOSS DAMAGE VALUE

$697,510 

22. REMARKS: 

Rosa rugosa/bare root $42,000.00 $42,000.00 

18. PRE-LOSS ACTUAL UNIT VALUE - THIS PAGE

$146,655 

19. POST-LOSS DAMAGE VALUE - THIS PAGE

$146,655 

This form example does not illustrate all required entry items (e.g., signatures, dates, etc.).

8. PRACTICE CODE

204

5. CAUSE(S) OF 

DAMAGE

Disease

Specific plant name and number used for propagation. None

Specific plant name and number lost due to uninsured damage. None. 

Appraisal completed MM/DD/YYYY

23. Insured’s signature 24. Adjuster’s signature and code number 25. Consultant’s name Date

20. CATEGORY PRE-LOSS ACTUAL UNIT VALUE
September 2023 FCIC-24970 36

Exhibit 5 Form Standards – Production Worksheet

Example Production Worksheets that illustrate completed entry items are provided at the end of this exhibit. 

Standard Production Worksheet items are numbered consecutively below. See Paragraphs 2D and 41 for 

additional requirements and information.

Element/Item Number Description

1. Crop/Code # “CE”/code 1020

2. Unit Number Unit number from the CEVR, after it is verified to be correct.

3. Cropping Practice Three-digit code, entered exactly as specified on the actuarial documents for the 

plant production practice (practice) carried out by the insured, as applicable.

4. Location 

Description 

Land location that identifies the legal description, if available, and the location of 

the basic unit (e.g., section, township, and range; FSA Farm Numbers; FSA 

Common Land Units (CLU) and tract numbers; GPS identifications; or Grid 

identifications) as applicable for the crop.

5. Date(s) of Damage First three letters of the month(s) during which the determined insured damage 

occurred for the inspection and cause(s) of damage listed in item 6.

6. Causes(s) of 

Damage

Name “plant disease” or “contamination" as the loss for this crop. The insured 

cause of damage is coded as “plant disease” (code 81) or for contamination use 

(code 72). State the name of the disease or contamination that occurred by using 

the insured’s supporting documents, such as the destroy order, for the claim. If it 

is evident that no indemnity is due, enter “No Indemnity Due” and enter the 

insured cause of damage in the Narrative or on a Special Report.

7. Insured Cause % Enter 100%.

8. Company/Agency Name of the AIP and agency servicing the contract.

9. Name of Insured Name of the insured that identifies EXACTLY the person (legal entity) to whom the 

policy is issued.

10. Claim # Claim number as assigned by the AIP.

11. Policy # Insured’s assigned policy number.

12. Crop Year Four-digit crop year, as defined in the CP, for which the claim is filed.

13. Date Notice of Loss The date the notice of damage was given for the unit in item 2. Enter the Date of 

Notice (MM/DD/YYYY).

14. Assign. of 

Indemnity

Check the appropriate box, check “Yes” ONLY if an assignment of indemnity for CE 

is in effect for the crop year; otherwise, check “No.” Refer to the LAM.

15. Unit Division Check the appropriate box:

(1) by plant category, if insured selected basic units by plant category; or

(2) by plant production practice, if insured selected basic units by plant 

production practice.

Only additional coverage policies may have basic units by plant category. All CAT 

coverage policies must have basic units by plant production practice.

Enterprise, optional and whole-farm units are not allowed.
September 2023 FCIC-24970 37

Exhibit 5 Form Standards – Production Worksheet (Continued)

Element/Item Number Description

16. Transfer of Right to 

Indemnity 

Check the appropriate box, check “Yes” ONLY if a transfer of right to an 

indemnity is in effect for the unit for the crop year; otherwise, check “No.” 

Refer to the LAM.

17. SV Enter the value declared on the most recently accepted CEVR of the insurable 

specific plants in a basic unit in whole dollars.

18. Companion Policies (1) If no other person has a share in the unit (insured has 100 percent 

share), MAKE NO ENTRY.

(2) In all cases where the insured has LESS than a 100 percent share of a 

loss-affected basic unit, ask the insured if the OTHER person sharing in 

the unit has a multiple-peril crop insurance contract (i.e., not crop-hail, 

fire, etc.). If the other person does not, enter “NONE.”

(a) If the other person has a multiple-peril contract and it can be 

determined that the SAME AIP services it, enter the contract 

number. Handle these companion policies according to AIP 

instructions.

(b) If the OTHER person has a multiple-peril crop insurance contract 

and a DIFFERENT AIP or agent services it, enter the name of the 

AIP and/or agent (and contract number) if known.

(c) If unable to verify the existence of a companion contract, enter 

“Unknown,” and contact the AIP for further instructions.

(3) Refer to the LAM for information regarding companion contracts. 

Differing ownership (share) constitutes a basis for additional units.

SECTION I – IMMEDIATELY PRIOR TO THIS LOSS

19a.Basic Unit XPS 

Liability

Basic unit amount of insurance, prior to reduction for price election percent and 

share. It is the current SV reported on the most recently accepted CEVR (item 

17) multiplied by the coverage percentage (item 22a) as a decimal, rounded to 

whole dollars. Complete this entry on only the first page of each inspection 

when multiple-page unit claim forms are required.

19b. Basic Unit Previous 

Indemnity(ies) 

Sum of “Preliminary Indemnities” (item 34) from Production Worksheets as 

calculated during previous loss occurrences for the unit.

(1) For all cases, if the Inspection Number equals 1 enter “0.”

(2) Enter the sum of all “Preliminary Indemnities” (item 34) calculated 

during previous loss occurrences.

Complete this entry on only the first page of each inspection when multiplepage unit claim forms are required.
September 2023 FCIC-24970 38

Exhibit 5 Form Standards – Production Worksheet (Continued)

Element/Item Number Description

19c.Basic Unit Effective 

XPS Liability

“Basic Unit XPS Liability” (item 19a) minus “Basic Unit Previous Indemnities” 

(item 19b).

20a.Basic Unit CYD Make no entry.

20b.Basic Unit Previous 

Occurrence 

Deductible

Make no entry.

20c.Remaining 

Deductible

Make no entry.

SECTION II – THIS LOSS

There are six item 26, “Category” columns (26a - 26f), on the Production Worksheet. A separate Production 

Worksheet is required for each basic unit. For basic units with multiple plant categories applicable, use one 

column for each insured plant category and enter the same unit number on all the plant categories (e.g., 0001-

0001 BU, etc.). Use additional pages if the unit has more than six plant categories insured.

If basic units by plant category are applicable, use column 26a to document the loss. For CAT coverage 

policies and additional coverage policies with basic units with multiple types, use columns 26a - 26f as 

applicable to enter information and “Summary this page” and TOTAL columns to calculate the loss. Complete 

“TOTAL” column on the first Production Worksheet page to document the unit loss.

21. Inspection Number If the inspection is due to a notice of damage, enter the number of the 

inspection (e.g., 1), otherwise leave blank.

22a. Coverage Level % Enter the elected coverage percentage to four decimal places.

22b. OLO Make no entry.

23. Insurable Unit Value Enter the lesser of the Basic Unit Effective XPS Liability (item 19c) or the sum of 

the Pre-Loss Actual Unit Value (item 27). Complete the entries in item 27 before 

completing this entry.

24. Sum of Previous 

Insured Losses

Enter sum of “Basic Unit Previous Indemnity” (item 19b) from any previous 

Claim Forms from the current Crop Year.

25. Damage similar to 

other nurseries in 

the area?

Make no entry.

26a-26f. Plant 

Category

For each plant category in the basic unit, enter the plant category code in items 

26a through 26f, as necessary. If appropriate because of the number of insured 

plant categories in the basic unit use additional pages, as necessary.
September 2023 FCIC-24970 39

Exhibit 5 Form Standards – Production Worksheet (Continued)

Element/Item Number Description

27a-27f. Pre-Loss 

Actual Unit Value

For each plant category entered in item 26a-26f, enter the amount from item 20 

of the CE Summary Appraisal Worksheet in whole dollars.

27. “Summary This 

Page” Column Enter the sum of the entries in items 27a-27f on this page.

27. “TOTAL” Column Enter the sum of the entries in item 27 “Summary This Page” column from all 

pages in the Production Worksheet for the basic unit.

28a-28f. Post-Loss 

Damage Value

For each plant category entered in item 26, enter the amount from item 21 of 

the CE Summary Appraisal Worksheet in whole dollars.

28. “Summary This 

Page” Column

Enter the sum of the entries in items 28a-28f on this page.

28. “TOTAL” Column Enter the sum of the entries in item 28 “Summary This Page” column from all 

pages in the Production Worksheet for the basic unit.

29. Percent of Loss 

“TOTAL” Column

Enter the result of dividing the item 28 “TOTAL” column value by the item 29 

“TOTAL” column value. Round to six decimal places.

30. Amount of Insured 

Loss “TOTAL” 

Column

Make no entry.

31. Occurrence 

Deductible “TOTAL” 

Column

Make no entry.

32. Percent Share 

“TOTAL” Column

Enter the insured’s share rounded to four decimal places (e.g., 1.0000).

33. Price Election 

Percent “TOTAL” 

Column

For additional coverage, enter 1.00.

For CAT coverage, enter 0.55.

34. Preliminary 

Indemnity “TOTAL” 

Column

Enter, in whole dollars, the result of multiplying the lesser of the Insurable Unit 

Value (item 23) or the Pre-Loss Actual Unit Value (item 27 “TOTAL” column) by 

the entry in the Occurrence Deductible “TOTAL” column (item 31).

If the value is zero, enter “no indemnity due” in the “Summary this page” 

column for item 32.
September 2023 FCIC-24970 40

Exhibit 5 Form Standards – Production Worksheet (Continued)

Element/Item Number Description

35. Indemnity “TOTAL” 

Column

If the entry in “Summary this page” column for item 35 is “no indemnity due,” 

enter zero. Otherwise,

Multiply the percent of loss (item 29) by the coverage percentage (item 22a); and 

multiply the result by the lesser of the Pre-Loss Actual Unit Value (item 27 

“TOTAL” column) or the SV (item 17) minus the Total Amount of Any Previous 

Indemnity (item 19b), and multiply the result by the Percent Share (item 32). 

Enter the result rounded to whole dollars.

36. Narrative If more space is needed, document on a Special Report, and enter “See Special 

Report.” Attach the Special Report to the Production Worksheet.

(1) Explain any uninsured causes, unusual, or controversial cases.

(2) If there is an appraisal for uninsured causes due to hail/fire exclusion, 

show the original hail/fire liability per acre and the hail/fire indemnity per 

acre.

(3) State that there is “No other fire insurance” when fire damages or 

destroys the insured crop and it is determined that the insured has no 

other fire insurance. Refer to the LAM for more information.

(4) Explain any errors found on the CEVR.

(5) Explain a “No” checked in item 24.

(6) Explain any difference between the date of inspection and signature 

dates. For an ABSENTEE insured, enter the date of the inspection AND 

the date of mailing the Production Worksheet for signature.

(7) When any other adjuster or supervisor or consultant accompanied the 

adjuster on the inspection, enter the code number of any other adjuster, 

or supervisor, and the name of any consultant present during the 

inspection and the date of inspection.

(8) Explain any delayed notices or delayed claims as instructed in the LAM.

(9) Document the name of the insured COL (i.e., the specific pathogen). 

(10) Document the calculation for the plants missing from the catalog.

(11) Document any other pertinent information, including photographs taken 

as documentation.
September 2023 FCIC-24970 41

Exhibit 5 Form Standards – Production Worksheet (Continued)

Element/Item Number Description

37. Insured’s Signature 

and Date

Insured’s (or insured’s authorized representative’s) signature and date. BEFORE 

obtaining Insured’s signature, REVIEW ALL ENTRIES on the Production Worksheet 

WITH THE INSURED or the insured’s authorized representative, particularly 

explaining codes, etc., that may not be readily understood.

38. Adjuster’s 

Signature, Code 

Number, and Date 

Signature of adjuster, code number, and date signed after the insured (or 

insured’s authorized representative) has signed. For an absentee insured, enter 

adjuster’s code number ONLY. The signature and date will be entered AFTER the 

absentee has signed and returned the Production Worksheet.

39. Witness’ Signature 

and Date

Signature of witness and date signed after the insured (or insured’s authorized 

representative) and adjuster has signed. For an absentee insured or if signatures 

are not witnessed, leave blank.

40. Other Signature(s) 

and Date(s)

Signature(s) of others if present when the loss adjustment was conducted (e.g., 

consultants, etc.) and the date signed.

41. Page Numbers Page numbers - (Example: Page 1 of 1, Page 1 of 2, Page 2 of 2, etc.).
September 2023 FCIC-24970 42

Exhibit 5 Form Standards – Production Worksheet (Continued)

This form example does not illustrate all required entry items (e.g., signatures, dates, etc.).

1. Crop/Code #: 2. Unit Number: 3. Cropping

CE Practice:

1020 0001-0001-BU 204 12 Crop Year

Sep 11 YYYY

DISEASE

100 Yes No X

15. Unit Division Yes No

Basic Units by Plant 

Category: 17. SV

CE PILOT PRODUCTION WORKSHEET/CLAIM FORM (FOR ILLUSTRATION PURPOSES ONLY)

8. Company: 9. Name of Insured:

ABC INSURANCE COMPANY I M INSURED

5. Date(s) of Damage:

6. Cause(s) of Damage:

ANY CITY, ANY STATE

ABC AGENCY

 Agency: 11. Policy #: XXXX-XXX-XXX

ANY CITY, ANY STATE ANY CITY, ANY STATE

24. Sum of Previous Losses:

$958,253.00 $0.00 

SECTION II - THIS LOSS

21. Inspection Number:

20a. Basic Unit Crop Year Deductible

SV X (1.000 – Coverage Level %)

1,500,000

18. Companion Policies:

SECTION I - IMMEDIATELY PRIOR TO THIS LOSS

19a. Basic Unit XPS Liability:

Excluding Price & Share $0.00 

Plant Production 

Practice:

26c. Numeric Code 26d. Numeric Code 26e. Numeric Code 26f. Numeric Code

25. Damage similar to other nurseries in the area?

26. Plant Category: Summary This Page TOTAL

26a. Numeric Code

840

26b. Numeric Code

841

$958,253.00 $958,253.00 

28. Post-loss damage value: $315,690.00 $326,880.00 

27. Pre-loss actual unit value: $525,253.00 $433,000.00 

$697,510.00 $697,510.00 

29. Percent of Loss 0.727898

30. Amount of Insured Loss

32. Percent Share:

31. Occurrence Deductible:

33. Price Election Percent:

$523,133 

36. Narrative: (If more space is needed, attach a Special Report)

4. Location Description:

123 WEST PINE

35. Indemnity

1.00

34. Preliminary Indemnity $

1.0000

19b. Basic Unit Previous Indemnity(ies):

Sum of item 34, previous losses

20b. Basic Unit Previous Occurrence Deductible(s): Sum of item 31, 

previous losses

1

22a. Coverage Level

0.7500

22b. OLO:

7. Insured Cause %:

$1,125,000.00 

23. Insurable Unit Value 

 

 MM/DD/YYYY

$1,125,000.00 

10. Claim #: XXXXXXX

13. Date Notice Loss:

14. Assign of Indemnity:

16. Transfer of Right to Indemnity:

19c. Basic Unit Effective XPS Liability:

19a – 19b or 38 from page 1 if > 6 units

20c. Remaining Deductible

20a – 20b or 33 from page 1 if > 6 units