Jewelry Appraisal & Claim Evaluation

Form Instruction Guide

In the absence of an JISO Jewelry Form (JISO 78, 79, 805, 806), using this form will help determine adequacy of content of the appraisal submitted. This form contains the minimal information necessary to determine jewelry value. It can be used to verify key information and aid in policy typing.

JISO 18 is a tool for both Underwriting and Claims Departments.

Month/day/year on which the form is completed.

Producer's name and address.

Identification code assigned to your agency or brokerage firm by the insurance company receiving this form.

If your agency uses a subcode identification system with the company, enter the appropriate code.

Agency Customer ID
Customer's identification number assigned by the agency.

Insured/Claimant's Name and Mailing Address
Name and mailing address of the insured as found on the declarations page of the policy.

Policy #
Number assigned by the insurance company for the policy.

Enter the estimated premium for this item.

Prior Policy #
List the complete policy number, including prefix and suffix.

Name of the insurance company that will receive the application. Do not use group names, use the actual name of the company within the group in which you wish to have the policy issued. Also, if applicable, indicate the type of plan or policy program (Preferred) that you wish to use when issuing the policy. Use the specific plan name that is unique to that company.

Home Phone
Home telephone number, including area code, of the insured. Check Day and/or evening.

Effective Date
Date on which the terms and conditions of the policy commenced.

Expiration Date
Date on which the terms and conditions of the policy will expire or have expired.

Business Phone #
Business telephone number, including area code and extension, of the insured. Check day and/or evening.

This form may be used by either Underwriting or Claims. Check the box for the department filling out the form.

Date of Loss

If Underwriting is using the form, write "NA. If Claims is using the form, fill in the date of loss.

Claim #

Item _____ of _____
Item number of the total items appraised within this appraisal as of the stated date.

Class Code #
Class codes allow for systematically tracking major jewelry groups. The coding facilitates determining actual loss experience, thereby creating a mechanism for more effective exposure rating for different jewelry groups (gold items, diamond jewelry, etc.)

Code Description
This short class designation aids in locating specific jewelry items on large schedules. (Code numbers and descriptions are from Jewelry Inventory and Sales Classification Manual, 1988, widely used in the jewelry industry. See FACTS 35, in Jewelry Insurance: The Underwriting and Claims Reference Manual.)


All key information necessary for valuation of items made with precious metal (gold, silver, platinum) is contained in the described fields. This enables underwriting to determine insurance to value and assists adjusters in calculating replacement/actual cash value. This format assures inclusion of critical information, as missing descriptions are visually obvious. Details can be found in the Quick Reference Guide located in front of Jewelry Insurance: The Underwriting and Claims Reference Manual. For additional details required for watches, see below, "Items Requiring Special Information."

This format provides all necessary stone specifics for determination of value. Multiple stone entries are allowed so like kind stones can be grouped together. For special requirements of jade, opal and pearl, see section below.

Optional Description
This area is for other information the appraiser feels is necessary to fully describe the item.

Items Requiring Special Information
Jadeite, opals, pearls and watches require the additional specific information listed. Refer to Jewelry Insurance: The Underwriting and Claims Reference Manual for details.

Appraisal Attached  |  Sales Receipt Attached   |  Color Photograph Attached

The name of the underwriter or adjuster filling out this form.

Interview Date
Fill in this date if additional information was sought from insured, jeweler, appraiser, etc.

If there was an interview, give the name of the person interviewed. This space can also be used to list any additional information that would clarify this claim.