Insurance

Subrogation Agreement

Vicky Randolph Vicky Randolph
How To Use

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Subrogation Agreement

WHEREAS, on _________________, _______________________________, an insurance company, was presented with a claim arising from: ________________________ under insurance coverage provided to _________________________, under its coverage for: __________________________________,

and, WHEREAS, on _________________________, _______________________________ paid a claim in an amount of $_________ (__________________________________________ & _____/100 dollars), with a deductible of $__________ (______________________________________________ & ____/100 dollars), arising from the perils and covered by the policy stated above,

NOW, THEREFORE:

_________________________, his heirs and assigns, herewith assign and convey to _________________________ and any all rights against any entity who may be liable to ______________________ for the loss stated above.

_________________________ 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 _______________________________________.

_________________________ herewith covenants and agrees to fully assist _________________________ in pursuit of its rights of subrogation herein.

_________________________ may at its option pursue the deductible loss of ________________________________.

In the event that ________________________ does so, it shall notify __________________________, and, further, __________________________ agrees that if any recovery is made that it will share in all costs related thereto pro rata.

_________________________ further agrees not to release or exonerate the adverse party or parties or enter into any compromise with them without the prior approval of _______________________________.

_________________________ shall execute any and all instruments reasonably required by __________________________ in connection herewith.

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Date

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