Kansas Residential Repair Post-Loss Insurance Assignment

KANSAS RESIDENTIAL REPAIR POST-LOSS INSURANCE ASSIGNMENT

Current-law notice: For assignments made on or after July 1, 2026, 2026 Kansas Session Laws chapter 32, § 1(b)(1) makes an assignment of post-loss residential property insurance benefits to a repair provider void. The assignment terms below cannot transfer those benefits under current law.

Before signing: This is a voluntary assignment of selected rights under an existing property and casualty insurance claim for a building housing one to four families and any related detached structures. It is separate from the repair contract. Complete the loss, policy, work, payment and contact fields. Print the statutory notice below in capitalized 14-point type in every signed copy; check the final PDF or paper size. Give the named insured a signed copy and send a copy to the insurer within three business days after signing.

1. Parties, property and claim

Named insured: [FULL LEGAL NAME]

Named insured's relationship to property: ☐ Owner ☐ Possessor

Insured property: [STREET ADDRESS, CITY, KANSAS ZIP]

Residential contractor: [FULL LEGAL NAME AND ENTITY TYPE]

Contractor's business address: [STREET ADDRESS, CITY, STATE ZIP]

Contractor's cancellation email: [EMAIL ADDRESS]

Contractor's cancellation mailing address: [STREET ADDRESS, CITY, STATE ZIP]

Insurance company: [LEGAL NAME AND CLAIMS CONTACT]

Policy number: [NUMBER]
Claim number: [NUMBER / NOT YET ASSIGNED]
Date and description of loss: [DATE; DESCRIBE COVERED EVENT AND DAMAGE]

Repair agreement: [TITLE AND DATE OF SEPARATE SIGNED AGREEMENT]

Work covered by this assignment: [DESCRIBE THE SPECIFIC ROOF, EXTERIOR, INTERIOR OR CLEANUP WORK, OR ATTACH A SIGNED SCOPE]

2. Limited assignment

The named insured assigns to the contractor the insured's rights and benefits under the identified policy only for the identified loss and work. The contractor may submit and pursue the corresponding claim, communicate with the insurer, and seek payment for that work, subject to the policy and law. The contractor may be named as a copayee for benefits payable for that work. This assignment gives no right to benefits for unrelated losses, property or work, and does not enlarge the insurer's policy obligations.

Maximum amount assigned, if the parties choose a limit: $[AMOUNT / NO SEPARATE LIMIT]. The repair agreement controls the price and work obligations between the owner and contractor. This assignment does not change the owner's deductible or create a promise that the insurer will cover the work.

The assignment does not impair the interest of a mortgagee listed on the policy declarations page. The insurer may continue to communicate directly with the named insured or that mortgagee. The named insured may also communicate with the insurer, request claim information, and receive insurer notices. The contractor shall give the named insured copies of material claim submissions and insurer decisions about the assigned work.

Mortgagee shown on policy declarations, if any: [NAME / NONE; VERIFY AGAINST DECLARATIONS]

3. Statutory notice

Print the complete notice below in capitalized 14-point type in the signed assignment.

AN ASSIGNMENT OF RIGHTS OR BENEFITS IS VOLUNTARY. YOU ARE AGREEING TO ASSIGN CERTAIN RIGHTS THAT YOU HAVE UNDER YOUR INSURANCE POLICY. WITH AN ASSIGNMENT, THE RESIDENTIAL CONTRACTOR SHALL BE ENTITLED TO PURSUE ANY RIGHTS OR REMEDIES THAT YOU, THE INSURED POLICY HOLDER, HAVE UNDER YOUR INSURANCE POLICY. PLEASE READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING.

THE INSURER MAY ONLY PAY FOR THE COST TO REPAIR OR REPLACE DAMAGED PROPERTY CAUSED BY A COVERED PERIL, SUBJECT TO THE TERMS OF THE POLICY.

4. Named insured's cancellation right

The named insured may cancel this assignment within five business days after signing it, in addition to any other right to revoke. To exercise this contractual method, send a dated written cancellation identifying the insured, property and claim to the contractor's email or mailing address in Section 1. A cancellation emailed within that period is effective when sent; a cancellation mailed within that period is effective when deposited with postage prepaid. The contractor shall acknowledge a cancellation and promptly inform the insurer. Cancellation of this assignment does not itself cancel the separate repair agreement; any cancellation rights for that agreement are governed by its terms and applicable law.

Execution date (date both signatures are complete): [__/__/____]
Fifth business day after execution: [__/__/____]
Contractor's copy-to-insurer deadline, three business days after execution: [__/__/____]

5. Contractor compliance and delivery

The contractor confirms that it is in compliance with the Kansas roofing registration act to the extent that act applies to the work and contractor. The contractor will provide a copy of this signed assignment to the identified insurer within three business days after it is signed.

Kansas roofing registration number, if applicable: [NUMBER / NOT APPLICABLE AND REASON]

Method and date copy sent to insurer: [EMAIL / MAIL / PORTAL; DATE; CONFIRMATION]

6. Signatures

I have read this assignment, the statutory notice and the cancellation section. I choose to make the limited assignment described above.

Named insured signature: ______________________________ Date: [__/__/____]

Printed name: [FULL NAME]

Contractor authorized signature: ______________________________ Date: [__/__/____]

Printed name and title: [NAME; TITLE]

Sources and references

• 2026 Kansas Session Laws, chapter 32, § 1(b)(1)
• Kansas Secretary of State session-law index (July 1, 2026 publication)
• K.S.A. § 50-6,143 — residential property insurance assignments
• Kansas Revisor 2026 amended and repealed sections index