家人代领交通事故理赔委托书样板

家人代领交通事故理赔委托书样板

Sample of Authorization Letter for Family to

Receive Traffic Accident Claims

委托人（患者本人）：[患者姓名]，性别：[性别]，年龄：[年龄]，身份证号：[身份证号]，住址：[详细住址]。

Client (patient himself): [patient name], gender: [gender], age: [age], ID number number: [ID number number], address: [detailed address].

受托人（家人）：[家人姓名]，性别：[性别]，年龄：[年龄]，身份证号：[身份证号]，住址：[详细住址]，与患者关系：[与患者

关系]。

Trustee (family member): [family name], gender: [gender], age: [age], ID number number: [ID number number], address: [detailed address], relationship with patients: [relationship with patients].

本人XXX于XXXX年XX月XX日因交通事故受伤住院，现因行动

不便，无法亲自前往保险公司领取交通事故理赔款项。本人特委托XXX作为我的合法代理人，全权代表我领取交通事故理赔款项，并处

理与此相关的所有事宜。

I, XXX, was hospitalized due to a traffic accident on XX/XX/XXXX. Due to limited mobility, I am unable to personally go to the insurance company to collect the traffic accident claim payment. I hereby appoint XXX as my legal representative to fully represent me in collecting traffic accident claims and handling all matters related to this matter.

受托人在处理委托事项时，必须遵守法律法规，维护我的合法权益。受托人在领取理赔款项时，需向保险公司提供我的身份证复印件、相关理赔材料以及本委托书。如因受托人的过失或违法行为造成我的损失，受托人应承担相应的法律责任。

The trustee must comply with laws and regulations and safeguard my legitimate rights and interests when handling entrusted matters. The trustee is required to provide a copy of my ID card, relevant claim materials, and this power of attorney to the insurance company when collecting the claims. If my losses are caused by the fault or illegal behavior of the trustee, the trustee shall bear corresponding legal responsibilities.

本委托书自签署之日起生效，有效期至理赔款项领取完毕之日止。如需变更或终止本委托书，双方应协商一致并以书面形式确认。

This power of attorney shall come into effect from the date of signing and shall remain valid until the date of completion of claim collection. If there is a need to change or terminate this power of attorney, both parties shall negotiate and confirm in writing.

特此委托。

Hereby commissioned.

委托人（患者本人）签名：[患者本人签名]

Signature of Principal (Patient): [Patient's signature] 受托人（家人）签名：[家人签名]

Signature of trustee (family member): [Family member signature]

签署日期：XXXX年XX月XX日

Signing date: XX/XX/XXXX

注意事项：

Notes:

1、本委托书应由患者本人签署，并附上患者身份证复印件；

This power of attorney should be signed by the patient themselves and accompanied by a copy of the patient's ID card;

2、受托人需提供自己的身份证复印件；

The trustee shall provide a copy of their ID card;

3、如有需要，可请专业律师协助起草或审核本委托书；

If necessary, professional lawyers can assist in drafting or reviewing this power of attorney;

4、本委托书一式两份，委托人和受托人各执一份，以备查验。

This power of attorney is made in duplicate, with the principal and trustee each holding one copy for verification.

以上是一份基本的家人代领交通事故理赔委托书样板。在实际使用中，请根据大家的具体情况和需求进行适当修改。如有任何疑问，请咨询专业人士。

The above is a basic sample of a family member's proxy for traffic accident claims. In practical use, please make appropriate modifications according to everyone's specific situation and needs. If you have any questions, please consult a professional.