PRIVY INSURANCE LEGAL SUPPORT AND CLIENT AGREEMENT

This Agreement ("Agreement") is made and entered into on _______________ between

[PRIVY INSURANCE LEGAL SUPPORT] ("PRIVY") and
[________________________________________________________________________
________________________________________________________________________

WHEREAS, CLIENT has suffered a loss of money due to the actions of an insurance
broker/agent/company officer, and the company has failed to take action to remedy the
situation, leaving CLIENT in a state of destitution;
WHEREAS, PRIVY provides prompt and reliable legal services to CLIENT in order to obtain
a refund of the money lost;

NOW, THEREFORE, the parties agree as follows:

1. SERVICES PROVIDED. PRIVY agrees to provide legal services to CLIENT to obtain

a refund of the money lost due to the actions of the insurance broker/agent/company
officer. PRIVY will represent CLIENT in court, send emails and written
correspondence on behalf of CLIENT, and perform any other legal actions necessary
to obtain the refund.

2. PERMISSION TO ACT. CLIENT agrees to give PRIVY permission to act on their

behalf, including sending emails and written correspondence, representing them in
court, and performing any other legal actions necessary to obtain the refund.

3. PAYMENT FOR SERVICES. CLIENT agrees to pay PRIVY a fee of 25 percent of

the amount obtained in the refund, including all applicable taxes.

4. CONVERSION OF POLICY. If the insurance ombudsman and company offer to

convert the policy into a single premium policy, CLIENT agrees to pay PRIVY a fee
of 12 percent of the converted amount. In case of default of fee, strict legal action will
be taken.
5. It is being clarified that the CLIENT is voluntarily entrusting their insurance matter to
PRIVY, without any undue influence, compulsion, or coercion, with the expectation of
a favorable outcome.
 6. APPLICABLE LAW. This Agreement shall be governed by and construed in
accordance with the laws of India.

Policy description on which Privy will work and try its level best efforts to get a refund
of the amount:
Sr Insurance Company Policy Amount
No Name No.
.
1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

SIGNATURES. This Agreement may be executed in counterparts, and facsimile

signatures shall be binding and considered as original signatures.
IN WITNESS WHEREOF, the parties have executed this Agreement as of the date
first written above.
[CLIENT] and [PRIVY INSURANCE LEGAL SUPPORT]
SIGNATURE ADDRESS DATE
Authorized officer Privy
Insurance Legal Support, #
669, Sector-64, Mohali,
Punjab -160062