平安车险代位追偿申请书

平安车险代位追偿申请书英文回答：
Subrogation Claim Application for Ping An Auto Insurance.
Claimant Information:
Name:
Contact Information:
Policy Number:
Incident Details:
Date of Incident:
Location of Incident:
Description of Incident:
Responsible Party Information: Name:
Contact Information:
Insurance Carrier:
Policy Number:
Damages Claimed:
Property Damage:
Medical Expenses:
Other Damages:
Subrogation Request:
I, the undersigned, hereby request that Ping An Auto Insurance subrogate its rights to pursue recovery of the above-claimed damages from the responsible party. I understand that Ping An Auto Insurance has the right to investigate the incident and determine the validity of the claim.
Authorization:
I authorize Ping An Auto Insurance to take all necessary steps to recover the damages claimed herein, including but not limited to:
Investigating the incident.
Negotiating with the responsible party or their insurance carrier.
Filing a lawsuit if necessary.
I further authorize Ping An Auto Insurance to receive and retain any amounts recovered from the responsible party
or their insurance carrier. Signatures:
Claimant:
Date:
Ping An Auto Insurance: Date:
中文回答：
平安车险代位追偿申请书。

申请人信息：
姓名：
联系方式：
事故详情：
事故发生日期：事故发生地点：事故经过：
责任方信息：
姓名：
联系方式：
保险公司：
保单号：
追偿索赔：
医疗费用：
其他损失：
代位追偿请求：
本人特此请求平安车险代位追偿，以追回上述索赔的损失。

本人明白平安车险有权调查事故并确定索赔的有效性。

授权：
本人特此授权平安车险采取一切必要措施追回所索赔的损失，包括但不限于：
调查事故。

与责任方或其保险公司谈判。

必要时提起诉讼。

本人进一步授权平安车险接收并保留从责任方或其保险公司追回的款项。

签名：
申请人：
日期：
平安车险：
日期：
注意事项：
本申请书应由索赔人本人填写并签名。

索赔人应提供准确、完整的索赔信息。

平安车险将根据具体情况调查和处理索赔。

平安车险有权拒绝不合理的或欺诈性的索赔。