I/We hereby acknowledge receipt of BHT 364,391.21 (Baht Three Hundred Sixty Four Thousand Three Hundred Ninety One and 21/100) in full and final satisfaction/settlement and discharge of all claims, costs, expenses, damages, causes of action (whether now apparent or not) that I/We have or may have against Samaggi Insurance Public Company Limited in respect of the claim made by me/us for damage/loss sustained through an accident which occurred and /or was discovered on 26th May 2015.
I/We also declare that I/We am/are legally authorized to give this discharge and receive this compensation. It is agreed and understood that this payment is made to me/us without prejudice and admission of liability on the part of Samaggi Insurance Public Company Limited.
By virtue of and to the extent of such payment I/We hereby subrogate Samaggi Insurance Public Company Limited all of my/our rights and remedies in respect of the subject-matter insured against any person or corporation liable for the said incident, and authorized Samaggi Insurance Public Company Limited to use my/our name to the extent necessary to exercise all or any such rights and assistance that they may reasonably require of me/us when exercising such rights and remedies.