Subrogation Release Form Template for United States

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Key Requirements PROMPT example:

Subrogation Release Form

"I need a Subrogation Release Form for an auto accident claim settlement where my insurance company paid $25,000 for vehicle damage, and we're now releasing our right to recover from the at-fault driver's insurance company following a settlement reached on January 15, 2025."

Document background

The Subrogation Release Form is a critical document in U.S. insurance claim settlements, used when an insurance company decides to waive its right to pursue reimbursement from a third party who caused the loss. This document is typically executed after settlement negotiations and includes specific details about the incident, parties involved, and settlement amount. It's essential in various scenarios, from auto accidents to property damage claims, and must comply with both state and federal insurance regulations. The form provides legal finality to claims and prevents future recovery attempts by the insurance company.

Suggested Sections

1. Identification of Parties: Names and details of insurer, insured, and third party

2. Incident Details: Description of loss/incident, date, location, and claim number

3. Settlement Amount: Specific amount being paid in settlement

4. Release Language: Formal release of subrogation rights

5. Signature Block: Space for signatures, dates, and notarization if required

Optional Sections

1. Medicare Compliance: Additional provisions required when the claimant is Medicare-eligible

2. Confidentiality Clause: Agreement to keep settlement terms confidential, used when requested by either party

3. Choice of Law: Specifies governing law for the agreement, used when parties are in different jurisdictions

Suggested Schedules

1. Schedule A - Payment Details: Breakdown of settlement amount and payment terms

2. Schedule B - Incident Report: Detailed description of incident and related claims

3. Schedule C - Insurance Policy Details: Reference to relevant insurance policy numbers and coverage

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Relevant Industries

Insurance
Healthcare
Construction
Transportation
Real Estate

Relevant Teams

Legal
Claims
Risk Management
Compliance
Finance

Relevant Roles

Claims Adjuster
Risk Manager
Insurance Underwriter
Legal Counsel
Subrogation Specialist

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A U.S. legal document that releases a supplier's mechanic's lien rights against a property after receiving payment for materials or services.

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Let's create your Subrogation Release Form

Authors

Alex Denne

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