Royal Sundaram General Insurance Co. Ltd.

Vishranthi Melaram Towers

No. 2/319, Rajiv Gandhi Salai (OMR)
Karapakkam, Chaennai - 600097

Dear Sir,

In consideration of your paying to us the sum of Rs. 8,02,532 (Rupees Eight lakh, Two

Thousand, Five Hundred and Thirty two) in full settlement of our claim for the theft of

Motor Vehicle in the premises located at House No. 216, Maidan Garhi, New Delhi-

110068, covered under Policy No. VPN0042004000103, issued by you, we hereby assign

transfer and abandon to you all our rights against any administration/third person caused or

arising by reason of the said loss and grant you full power to take and use all lawful ways

and means in your own name and otherwise at your risk and expense to cover the said loss

and we hereby subrogate to you the same rights as we have in consequence of or arising

from the said loss.

And we hereby undertake and agree to make and execute at your expense all such further

deeds, assignments and documents and to render such assistance as you may reasonably

require for the purpose of carrying out this agreement.

At New Delhi, we set our hands this 04 th day of December, 2020.

(Signature of the Insured)