Sample Non-Waiver Agreement

NON-WAIVER AGREEMENT

WHEREAS:

A. _____________________________[name of insurance company] (hereinafter referred to as the "Insurer") has issued a certain policy of insurance bearing policy number ____________[policy number] (hereinafter referred to as the "Policy");

B. On or about _________________[date] at or near___________________[location] there occurred a certain __________________________________[insert description of occurrence i.e. motor vehicle accident, fire, etc.] (which event is hereinafter referred to as the "Occurrence");

C. There have been or will be made claims for payments, benefits or indemnity under the Policy (hereinafter the "Claims") with respect to the injuries, losses, expenses, damages, claims, actions or other proceedings arising as a result of the Occurrence

(which matters are hereinafter collectively referred to as the "Losses");

D. The Insurer may have grounds to void the Policy or to deny liability or coverage thereunder for the Claims or Losses by reason of:

1. breaches of the terms and conditions of the Policy;

2. certain misrepresentations or failure to disclose material information;

3. some or all of the Claims or Losses being of a type either excluded from or not falling within the scope of coverage afforded by the Policy; and/or

4. such other grounds as may presently exist or as may be hereafter discovered; and

   E. The Insurer, its employees, adjusters, lawyers and other agents have experience in investigating, evaluating, defending and settling claims and losses of the sort referred to above and the undersigned wishes to take advantage of such experience while at the same time permitting the Insurer to reserve all rights it may have respecting the coverage matters...