"Kansas Alternative Mediation Program Insurance Company Mediation Agreement" - Kansas

Kansas Alternative Mediation Program Insurance Company Mediation Agreement is a legal document that was released by the Kansas Insurance Department - a government authority operating within Kansas.

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KANSAS ALTERNATIVE MEDIATION PROGRAM
INSURANCE COMPANY MEDIATION AGREEMENT
Insurance Company Name
NAIC #
The above named insurance company agrees to enter into the Kansas Alternative Mediation
Program (K.A.M.P.) in a good faith effort to resolve any dispute with a person(s) involving an
insurance dispute. The insurance company agrees to keep statements and information disclosed
during any mediation process confidential to the extent allowed by law. The insurance company
agrees to send a representative from the insurance company who is authorized to settle the
insurance dispute. The insurance company agrees to pay any cost of the mediation process as
billed by the Kansas Insurance Department.
Insurance Company Contact Person
Insurance Company Contact Persons Direct E-Mail
Insurance Company Contact Persons Direct Phone No.
Insurance Company Contact Persons Fax No.
Authorized Signer for the Insurance Company ________________________________________
KANSAS ALTERNATIVE MEDIATION PROGRAM
INSURANCE COMPANY MEDIATION AGREEMENT
Insurance Company Name
NAIC #
The above named insurance company agrees to enter into the Kansas Alternative Mediation
Program (K.A.M.P.) in a good faith effort to resolve any dispute with a person(s) involving an
insurance dispute. The insurance company agrees to keep statements and information disclosed
during any mediation process confidential to the extent allowed by law. The insurance company
agrees to send a representative from the insurance company who is authorized to settle the
insurance dispute. The insurance company agrees to pay any cost of the mediation process as
billed by the Kansas Insurance Department.
Insurance Company Contact Person
Insurance Company Contact Persons Direct E-Mail
Insurance Company Contact Persons Direct Phone No.
Insurance Company Contact Persons Fax No.
Authorized Signer for the Insurance Company ________________________________________