Subrogation Agreement
WHEREAS, on
____________________, ____________________, an insurance company (“Insurance
Company”), was presented with a claim arising from:
AUTOMOBILE COLLISION
under insurance
coverage provided to POLICYHOLDER, under its coverage for:
AUTOMOBILE
COLLISION/COMPREHENSIVE
and, WHEREAS, on
_________________________, Insurance Company paid a claim in an amount of
$________________, with
a deductible of $__________ arising from
the perils and covered by the policy stated above, NOW, THEREFORE:
POLICYHOLDER, his heirs
and assigns, herewith assign and convey to Insurance Company and any all rights
against any entity who may be liable to POLICYHOLDER for the loss stated above.
Insurance Company shall
pursue any and all responsible parties at its own expense, and may at its
option, bring such action in its own name or that of POLICYHOLDER.
POLICYHOLDER herewith
covenants and agrees to fully assist Insurance Company in pursuit of its rights
of subrogation herein.
INSURANCE COMPANY may
at its option pursue the deductible loss of POLICYHOLDER. In the event that
INSURANCE COMPANY does so, it shall notify POLICYHOLDER, and, further,
POLICYHOLDER agrees that if any recovery is made that it will share in all
costs related thereto pro rata.
POLICYHOLDER further
agrees not to release or exonerate the adverse party or parties or enter into
any compromise with them without the prior approval of INSURANCE COMPANY.
POLICYHOLDER shall
execute any and all instruments reasonably required by INSURANCE COMPANY in
connection herewith.
Date: _____________________________________
___________________________________________________
Policyholder
____________________________________________________
Insurance Company
Subrogation Agreement
Review List
This review list is provided to inform you about this
document in question and assist you in its preparation. This subrogation agreement can be applied to
many other circumstances, such as buying out the rights to a lawsuit.
- Make multiple copies. Give one to each signatory. Keep a copy with the transaction file.
0 comments:
Post a Comment