Escape of water survey report template (free download)
An escape of water survey has one job: give the insurer enough fact to decide cover and approve a scope, in one visit. That means recording where the water came from, whether the leak was sudden or long-running, how far it travelled and what has to be dried, stripped out or replaced.
This template follows the order an adjuster reads in. Claim details and circumstances first, then the source, then the evidence (moisture readings and photos), then the damage schedule and a recommended scope. It deliberately records facts that bear on cover — how long the leak had been running, prior repairs, make-safe already done — without drawing a cover conclusion, which is the insurer’s call.
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Escape of water survey report
For loss adjusters and building consultants attending a leak claim: circumstances, source of the escape, moisture readings and a room-by-room damage schedule.
1. Claim and property details
2. Circumstances of loss
3. Source of the escape
4. Moisture mapping
| Room | Material | Reading | Dry reference | Photo ref |
|---|---|---|---|---|
5. Damage schedule
| Room | Element | Damage observed | Extent | Repair / replace | Photo ref |
|---|---|---|---|---|---|
6. Recommendations and scope
What the escape of water survey report covers, section by section
1. Claim and property details
Identifies the claim and the building so the report can be filed against the right policy. Record who attended: a disputed account later is often a question of who said what on site.
Fields to capture: Claim number; Insurer / instructing party; Insured name; Risk address; Date of loss (as reported); Date and time of inspection; Attendees on site; Property type; Construction (walls / floor / roof).
2. Circumstances of loss
The insured’s account, in their words, plus the facts that help separate a sudden event from a gradual one: when the water was first noticed and how, previous repairs, and any make-safe already carried out.
Fields to capture: Insured’s account of the incident; When was the water first noticed, and how?; Previous leaks or repairs at this location; Make-safe completed?; Make-safe by (plumber / restorer) and date.
3. Source of the escape
Pin the source down as precisely as access allows, and say how it was identified. “Leak from the bathroom” is not a source; “failed flexible hose to the vanity basin cold tap” is.
Fields to capture: Source location; Source type; How identified; Is the leak still active?; Evidence of long-term leaking (staining, rot, mould, corrosion); Source photo references.
4. Moisture mapping
A reading against a dry reference for every affected room. Readings are the evidence for the drying scope and for where strip-out stops, so note the meter used and take a dry reading of the same material in an unaffected area.
Fields to capture: Meter make and mode; Water category (IICRC S500); a register with columns: Room, Material, Reading, Dry reference, Photo ref.
5. Damage schedule
Room by room, element by element, with a repair-or-replace call on each. This is the table a builder or restorer will price from, so be specific about extent (linear metres of skirting, square metres of flooring).
Fields to capture: a register with columns: Room, Element, Damage observed, Extent, Repair / replace, Photo ref.
6. Recommendations and scope
What has to happen next and in what order: rectify the source, dry, strip out, reinstate. Flag anything outside your expertise for a specialist rather than estimating it.
Fields to capture: Source rectification required; Drying / restoration recommended; Strip-out and reinstatement scope; Further investigation (leak detection, plumber, hygienist); Prepared by / company / date.
Tips from the field
- Take the wide shot of each room before the close-ups. A close-up of a stain means nothing to a reviewer who cannot see where it is.
- Photograph the meter display with the material behind it, so each reading is evidenced rather than transcribed.
- Record what you could not access (behind tiles, under fixed cabinetry). Unknown extent is a finding, not a gap.
- Keep the insured’s account separate from your observations. If the two conflict, say so plainly.
Standards referenced
- IICRC S500: the water damage restoration standard used by most Australian restorers; its water categories are used in this template.
Check the current edition and your state or territory’s requirements; this template is a starting point, not a substitute for the standard.
Frequently asked questions
What is an escape of water survey?
It is an inspection carried out for an insurance claim after water has escaped from a pipe, fitting, appliance or wet area. It records the source of the leak, how long it appears to have been running, the extent of damage and the work needed to dry and reinstate the property.
Does this template decide whether the claim is covered?
No. It records the facts an insurer needs to make that decision, such as when the leak was noticed, evidence of long-term leaking and previous repairs. The cover decision belongs to the insurer or the loss adjuster.
What moisture readings should I record?
Take a reading in each affected material and a dry reference reading of the same material in an unaffected area, note the meter and mode used, and photograph the meter display in place. Map readings room by room so the drying scope and strip-out line can be justified.
Can I use this template on a phone or tablet?
The download is a Word document you can print or fill in on a computer. To fill it in on site and produce the finished report automatically, the same sections can be built as a SurveyThanks form, with photos and readings captured on the device.
Fill this in on your phone and generate the report automatically
Build these sections as a SurveyThanks form, capture photos and answers on site, and the finished report renders into your own Word template.