Public Adjuster Contract Template – US

Disclaimer

The information provided is intended solely as a general example relevant to agreements for representation in insurance claim adjustments. It does not serve as legal advice and should not replace consultation with a qualified legal professional experienced in insurance law or contractual agreements. Jurisdictional laws and regulations may vary, and adjustments might be necessary to ensure compliance with local requirements. The use of this example is at the user’s own risk, and we accept no liability for any errors, omissions, or consequences resulting from its use without professional review.

Please note: This is a sample Public Adjuster Contract template for illustrative purposes only. Actual terms may vary based on specific agreements and applicable laws.

Public Adjuster Contract Sample

Parties Involved:

Adjuster: XYZ Public Adjusters LLC
Address: 123 Insurance Ave, Cityville, State, ZIP

Policyholder: John Doe
Address: 456 Maple Street, Cityville, State, ZIP

Claim Description:

The claim involves the property located at 789 Pine Road, Cityville, State, ZIP, or other relevant property details as specified in subsequent negotiations.

Scope of Services:

The adjuster shall assess the claim, prepare estimates, and negotiate with the insurance company on behalf of the policyholder, in accordance with applicable laws and standards of professional conduct.

Compensation Terms:

The adjuster shall be entitled to a fee of 10% of the settlement amount recovered, payable upon successful resolution of the claim or as otherwise agreed herein.

Adjuster Responsibilities:

The adjuster agrees to perform all duties related to claim assessment, documentation, negotiation, and communication, in compliance with relevant laws and ethical standards.

Governing Law:

This agreement shall be governed by the laws of the State of [State]. Disputes shall be resolved within the jurisdiction of the courts of [State].

Additional Provisions:

• The policyholder agrees to cooperate fully with the adjuster in the claims process.
• This agreement may be amended only in writing signed by both parties.
• The adjuster’s fee is payable only upon successful settlement or resolution of the claim.

[City], ______________________