IBC Claim Form 5C
RESERVATION OF RIGHTS LETTER
Letterhead of Insurance Company
[Date]
[Insured]
[Insured’s Address]
Dear [Insured]:
Re:
Insured
Policy No.
Claimant
Date of Loss
This will acknowledge receipt of the [demand letter from # dated #; Notice of Claim
dated # by #; Statement of Claim issued # by #].
[Name of Insurance Company] requires further information to determine if [name the
target of the demand letter or the defendant in the Notice of Claim or Statement of Claim]
is entitled to coverage under the Policy, whether for defence or indemnity, and [Name of
Insurance Company] must make an investigation in this respect.
The ongoing investigation by [Name of Insurance Company] shall in no way be
construed as a waiver in any form by [Name of Insurance Company] of its rights under
the Policy. Further, the actions of [Name of Insurance Company] in respect of these
investigations are not to be construed as confirming any right to a defence or to any form
of indemnification for any of the claims.
We recommend that you consult with your Legal counsel on matters of coverage under
the Policy including any claims for damages which may exceed the Policy limits and
your uninsured exposure. We will be pleased to cooperate with your counsel.
Yours very truly,