Insurance Power of Attorney
I. Appointment of Agent
This Power of Attorney is made on [Date], by [Your Name], residing at [Your Address], referred to as the "Principal", and appoints [Agent's Name], residing at [Agent's Address], referred to as the "Agent". grant the authority to deal with all matters related to my insurance, including but not limited to negotiating with insurance companies, making amendments to policies, submitting claims, receiving insurance payments, and performing all other insurance-related tasks.
II. Purpose:
This Power of Attorney is created for the specific purpose of granting the Agent the authority to act on behalf of the Principal in all matters relating to insurance, including but not limited to filing claims, negotiating with insurance companies, making policy changes, and managing insurance affairs.
III. Roles and Responsibilities of Agent:
Filing Claims: The Agent is authorized to initiate and pursue insurance claims on behalf of the Principal, including submitting all necessary documentation and information to the relevant insurance companies.
Negotiating with Insurance Companies: The Agent is empowered to negotiate settlements, handle disputes, and communicate with insurance companies regarding coverage, premiums, and any other matters related to insurance policies held by the Principal.
Policy Management: The Agent has the authority to make changes to insurance policies held by the Principal, including but not limited to adding or removing coverage, adjusting policy limits, and renewing or canceling policies as deemed necessary.
Communication: The Agent is authorized to receive and respond to all correspondence from insurance companies on behalf of the Principal, including letters, emails, and phone calls.
Record Keeping: The Agent shall maintain accurate records of all insurance-related transactions, including policy documents, claim filings, correspondence, and payments, and provide copies to the Principal upon request.
IV. Duration
Unless the Principal decides to revoke it using a written document, this Power of Attorney will continue to remain in effect without any specified end date or time limit.
V. Signature Section:
IN WITNESS WHEREOF, I have executed this Insurance Power of Attorney on [DATE].
[YOUR NAME] (Principal)
ACCEPTANCE OF THE AGENT
I, [AGENT NAME], acknowledge that I have read and understood the terms and responsibilities outlined in this Power of Attorney document. I accept the appointment as Agent and agree to act under the instructions and limitations provided herein.
[AGENT'S NAME]
WITNESS ACKNOWLEDGEMENT
We, the undersigned witnesses, attest that the Principal and Agent signed this Power of Attorney in our presence and that they appeared to be of sound mind and acting willingly.
[WITNESS 1 FULL NAME]
[DATE]
[WITNESS 2 FULL NAME]
[DATE]
NOTARY ACKNOWLEDGEMENT
On this day of in the year , before me, a Notary Public in and for said County and State, personally appeared [YOUR NAME], known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged that they executed the same for the purposes therein contained.
Witness my hand and official seal.
[NOTARY PUBLIC'S NAME]
My Commission Expires:
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