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Public Adjuster Release Form
"I need a Public Adjuster Release Form to discharge our adjuster who successfully handled our factory fire insurance claim, with a settlement of £2.5M reached on January 15, 2025, including specific provisions for confidentiality and staged payment releases."
1. Parties: Identification of the public adjuster and the releasing party
2. Background: Context of the insurance claim and adjustment services provided
3. Definitions: Key terms used in the release form
4. Release Statement: Clear statement of release from liability
5. Consideration: Statement of consideration given for the release
6. Execution: Signature blocks and date
1. Confidentiality: Additional clause used when parties wish to keep terms confidential - recommended for sensitive or high-value claims
2. Indemnification: Additional protection against future claims - recommended for complex or high-risk cases
3. Severability: Ensures remainder of agreement stands if part is invalid - recommended for longer, more complex releases
4. Governing Law: Specifies jurisdiction and applicable law - recommended when parties are in different jurisdictions
1. Schedule of Claims: Detailed list of claims being released
2. Service Details: Description of adjustment services provided
3. Payment Schedule: Details of payment arrangements if being made in installments
Authors
Scope of Release
Consideration
No Admission of Liability
Confidentiality
Acknowledgment
Entire Agreement
Representations and Warranties
Authority to Execute
Severability
Governing Law
Jurisdiction
Assignment
Waiver
Third Party Rights
Data Protection
Further Assurance
Notices
Force Majeure
Amendment
Counterparts
Indemnification
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