Subrogation PDF Doc
Subrogation PDF Doc
Claim No:
Policy No:
Incident Date:
Insured:
1. In consideration of your paying to us the sum of Rs. ,/. (Rupees only) in
pursuance of the said policy in respect of loss due to theft, we the owners hereby empower
and authorizes you to prosecute legally all our actionable claim, rights and remedies both in
equity and at law against the administration, other public bodies, persons whosoever is liable
in respect thereof and/or for whom or other financial assistance, subsidy, etc. in respect of
such loss or damage.
2. We hereby subrogate to you all rights remedies that we have, in consequence of or arising
from theft to the said properties and we further grant to you full power to take and use all lawful
ways and means and recover the said goods/any part thereof and or loss from whom it may
concern.
3. We also hereby authorize you to use our name in any action or proceedings that you may
bring either in your own name or in relations to any of the matters hereby authorised to you
and we undertake for ourselves to assist and concur in any matters or proceedings which
you may deem expedient or necessary in any such actions or proceedings and to execute all
deeds and/or documents including any and ail pleadings and reasons which.may be
necessary therefore and generally to assist therein by all means in our power.
4. We hereby appoint you, your officers and agents and their successors severally our agents
and attorneys in fact with irrevocable power to collect ail such claims and to begin prosecute
compromise arbitrate or withdraw either in our name or in your name but at your expense if
any and ail legal proceedings which may deem necessary to enforce such claim or claims
including proceedings before any Tribunal/Forum and to execute in our name only documents
which may be necessary to carry into effect the purpose of this agreement.
5. We further undertake if called upon by you to do so ourselves to institute any such action or
proceedings that may direct on your behalf it being understood that you are to indemnify us
and any other persons whose names may necessarily be used against any costs charges or
expenses which may be incurred in respect of any action or proceedings that may be taken
virtue of this agreement.
6. The payment receipted for herein is accepted with the undertaking that the said payment
shall not ensure to the benefit of any tort, lessor or misfeasement under the writer does not
waive any rights or remedies which or subrogation or otherwise against any tort lessor or
misfeasement and acceptance of this receipt shall not prejudice or take any right or
remedies which the said underwriter would otherwise have any virtue of such payments.
7. We further agree that any moneys collected from any government, state or authorities or
any persons shall be your property and if received in the first instance by the undersigned.
We undertake to make over to you immediately the amount so recovered.
8. We hereby further agree that in the event of the lost goods subsequently being traced we
undertake to accept and take delivery of the same and the claim shall then be re -adjusted on
the correct basis of the then loss and in the event of any refund providing to be due to the
underwriter on demand to make such refund to you.
TO WITNESS WE HAVE SET OUR HAND THIS DAY OF ,200_.
Signature: _
Witness:
Name:
Address: _