This document is a non-waiver agreement between an insurance company and an insured regarding an insurance claim for property damage under an all risk policy. The agreement allows the insurance company to investigate the cause and amount of loss without waiving or modifying any of its rights under the insurance policy. Both parties agree to cooperate during the claims investigation process without prejudice to their legal rights and obligations. The document is signed and notarized.
This document is a non-waiver agreement between an insurance company and an insured regarding an insurance claim for property damage under an all risk policy. The agreement allows the insurance company to investigate the cause and amount of loss without waiving or modifying any of its rights under the insurance policy. Both parties agree to cooperate during the claims investigation process without prejudice to their legal rights and obligations. The document is signed and notarized.
This document is a non-waiver agreement between an insurance company and an insured regarding an insurance claim for property damage under an all risk policy. The agreement allows the insurance company to investigate the cause and amount of loss without waiving or modifying any of its rights under the insurance policy. Both parties agree to cooperate during the claims investigation process without prejudice to their legal rights and obligations. The document is signed and notarized.
This document is a non-waiver agreement between an insurance company and an insured regarding an insurance claim for property damage under an all risk policy. The agreement allows the insurance company to investigate the cause and amount of loss without waiving or modifying any of its rights under the insurance policy. Both parties agree to cooperate during the claims investigation process without prejudice to their legal rights and obligations. The document is signed and notarized.
Insured : Location : Property Involved Claim : Date of Loss :
IT IS HEREBY AGREED by and between the above-named Insured and the Insurance Company or companies whose names are indicated below that anything done or to be done by said Insurance Company or Companies, or on their behalf, in connection with the above-described loss, including any investigation into cause or amount of loss or other matter relative thereto, shall not waive, invalidate, forfeit or modify any of their rights under the terms and condition of the respective policies issued by them.
This agreement is made for the convenience of the parties hereto, to permit investigation of the claim and ascertainment of appropriate values of loss or damage to the property involved to be made without delay and without prejudice to any of their rights.
IN WITNESS WHEREOF, the parties have hereunto set their hands on this ___________day of ____________in _________.
INSURANCE COMPANY INSURED
By: By: ______________________________ Policy Number: ___________________ ________________________________ Date Issue: ____________________ ID:_______________No. __________ Expiry Date: ______________________ Date of Issue _________________ Place of Issue: _________________ Expiry Date _________________ Place of Issue ________________
BEFORE ME, A Notary Public for and in the ________________________, province of
___________________, this _____ day of ____________, 20____ personally appeared the above-named persons, who have satisfactorily proven to me their identity through their identifying documents written below their names and signatures, that they are the same persons who executed and voluntarily signed the foregoing instrument, which they acknowledged before me as their free and voluntary act and deed.
The foregoing instrument which related to a Non-Waiver Agreement, consisting of one (1) page including this Acknowledgment which has been signed on the left margin of each and every page by the parties and the witnesses.
WITNESS MY HAND AND NOTARIAL SEAL on the date and place above written.
NOTARY PUBLIC Doc. No. _______; Page No. _______; Book No. _______; Series of ________.
