Insurance Policy Assumption

INSURANCE POLICY ASSUMPTION

Parties and Policy Identification

Assignor (Original Policyholder):

Assignee (New Policyholder / Applicant):

Policy Period Effective Date:   to  

Recitals

WHEREAS, Assignor is the named insured under the policy identified above; and WHEREAS, Assignee desires to assume the rights and obligations under the identified policy and to continue coverage subject to the terms and conditions set forth herein.

Assumption and Terms

1. Assignment and Assumption. Assignor assigns to Assignee all insurable interests and rights under the policy, and Assignee expressly assumes all future obligations, premiums, deductibles and liabilities arising on or after the Effective Date set forth below. Assignee acknowledges that this instrument does not waive or alter coverages except as expressly provided herein.

2. Effective Date of Assumption:

3. Premiums and Payments. Assignee shall be responsible for payment of all premiums that are due and payable on or after the Effective Date. Failure to make timely payment may result in cancellation or lapse in coverage without further notice. Any premium adjustments, audits or endorsements required by the insurer remain binding on Assignee.

4. Representations and Warranties. Assignee represents that all statements, answers and disclosures provided to the insurer in connection with this Assumption are true, complete and material. Assignee consents to any reasonable investigation necessary for underwriting or risk evaluation.

5. Subrogation and Indemnity. Assignee agrees to hold harmless and indemnify Assignor and the insurer for liabilities, costs, and expenses arising from acts or omissions by Assignee after the Effective Date. The insurer retains all subrogation rights as provided in the policy.

Coverage Selection

The Assignee affirms that the following coverages are intended to continue in force as part of this Assumption (check all that apply):

Property Damage

General Liability

Personal/Medical Payments

Contents Coverage

Flood (if endorsed)

Earthquake (if endorsed)

Business Interruption

Exclusions and Limitations

The Assignee acknowledges the policy's existing exclusions and that no assumption will override exclusionary language, except by specific written endorsement executed by the insurer. Standard exclusions may include but are not limited to:

• Intentional acts, fraud or criminal conduct;
• Wear and tear, gradual deterioration or inherent vice;
• Losses excluded by endorsement or by statute;
• Prior acts or pre-existing damage not reported to insurer.

Assignee acknowledges receipt of and agreement to the listed exclusions: I acknowledge and accept the exclusions and limitations described above.

Beneficiary / Additional Interested Parties

Documentation Checklist

The following documents are attached or will be provided to the insurer as required:

Executed assignment/transfer instrument from Assignor

Proof of identity for Assignee (government ID)

Proof of insurable interest (deed, bill of sale, lease)

Declarations, Certifications and Notices

By signing below, Assignee certifies under penalty of perjury that the information provided in this form and any attachments is true and complete to the best of Assignee's knowledge. Assignee understands that material misstatements or omissions may result in denial of coverage, rescission of the policy, or other remedies available to the insurer under law and policy terms.

Assignee agrees to comply with policy terms, to cooperate with insurer investigations, to promptly notify the insurer of any material change in risk or claim, and to accept endorsements necessary to reflect the change in insured interest. This Assumption is subject to any required insurer approval; if insurer approval is required and not obtained, the Assignee's obligations under this document shall be limited to those effective only upon such approval.

Governing Law: This Assumption shall be governed by the substantive law of the jurisdiction in which the insured risk is located, without regard to choice-of-law provisions. Any dispute arising under this Assumption shall be resolved in the appropriate court of competent jurisdiction within that jurisdiction.

Assignee Contact Information and Identification

Acknowledgment

Assignee acknowledges that acceptance of this Assumption by the insurer may be confirmed by a formal endorsement or written confirmation from the insurer. Until such endorsement has been issued, the insurer's rights and remedies under the policy and applicable law remain reserved.

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