Settlement Agreement Release of All Claims for Personal Injury

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									This is an agreement between two parties that are currently involved in a personal injury
lawsuit or dispute for the settlement of all claims. This agreement sets forth the terms
between two parties for the payment of monetary compensation to one party in
exchange for the forbearance of all personal injury claims against the other party. This
agreement should be used by individuals or entities that are currently involved in a
personal injury lawsuit or dispute but want to settle their claims outside the courtroom.
                                PERSONAL INJURY

This Settlement and Release Agreement (“Agreement”) is made and entered into as of this ____
Day of _____, 20__, [Instruction: Insert date.] by and between _____ [Instruction: Insert first
party’s name. For clarity, said party is referred to herein as Party 1, however, it is
recommended this is revised to reflect a more applicable name.] (“Party 1”) and _____
[Instruction: Insert second party’s name. For clarity, said party is referred to herein as
Party 2, however, it is recommended this is revised to reflect a more applicable name.]
(“Party 2”).

WHEREAS, Party 1 has instituted an action in _____ [Instruction: Insert court name.] against
PARTY 2, captioned _____ [Instruction: Insert court filing information.] (“the Lawsuit”)
asserting various claims against PARTY 2, including but not limited to, claims to recover money
damages for personal injuries (“Injuries”) allegedly suffered as a result of _____ [Instruction:
Insert issues set forth in lawsuit.] based on theories of _____ [Instruction: Insert claim
theories.], and all claims asserted or which could have been asserted in the Lawsuit, which
claims PARTY 2 denies; and

WHEREAS the parties wish to resolve and settle all of their past, present and any future claims,
disputes and controversies, including but not limited to those relating to the subject matter of the

NOW, THEREFORE, in consideration of the mutual promises set forth in this Agreement and
for other good and valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, the parties agree as follows:


1. Recitals. The foregoing Recitals are incorporated into and constitute a part of this

2. No Admission of Liability. This Agreement is entered into as an expedient and cost-effective
   alternative to costly litigation. The parties make no admission of liability, express or
   implied, by entering into this Agreement, and any such liability, express or implied, is hereby
   specifically denied.

3. Party 2’s Payment to Party 1. Party 2, in exchange for the releases set forth below and in
   exchange for Party 1 not seeking compensation from any insurer of Party 2, and for other
   good and valuable consideration, the receipt and sufficiency of which are hereby
   acknowledged, agrees to pay Party 1 the total amount of _____ [Instruction: Insert amount
   to be paid.] payable within 21 days from the execution of this Agreement by the Parties
   [Instruction: If payment arrangements vary from that set forth herein, revise this
   language to reflect the parties’ agreement.]. The parties agree that should ___
   [Instruction: Insert party to make payment.] fail to make any of the required payments
   pursuant to the schedule described in this Agreement, immediately upon the failure to make

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    the payment, the entire settlement amount (less any amounts that have been previously paid)
    shall become immediately due and payable and the parties stipulate that judgment in that
    amount shall be entered against ____ [Instruction: Insert party name.]on behalf of _____
    [Instruction: Insert party name.]. The parties agree that jurisdiction for this stipulated
    judgment shall be proper in _____ [Instruction: Insert state.].

4. Releases. For and in consideration of the foregoing and other good and valuable
   consideration, the receipt and sufficiency of which if hereby acknowledged, and upon the full
   execution of this Agreement, Party 1 on behalf of himself, his agents, heirs, administrators,
   attorneys, successors and assigns, does hereby dismiss, release and hold harmless Party 2, its
   stockholders, officers, directors, employees, agents, insurers, attorneys, predecessors,
   successors and assigns, if any, of and from any and all matters, debts, dues, sums of money,
   covenants, controversies, agreements, promises, trespasses, damages, losses, expenses, costs,
   liabilities, obligations, claims, demands, grievances, suits, causes of action, complaints,
   judgments, decrees, executions of whatever kind, in law or in equity, absolute, contingent,
   likely or unlikely, known or unknown, which have existed from the beginning of time to the
   date of this Agreement, including but not limited to all claims Party 1 asserted or which
   could have been asserted in the Lawsuit and any and all claims arising out of the Lawsuit.

    The parties understand the word “claims” to include all actions, claims, and grievances,
    whether actual or potential, known or unknown, and specifically but not exclusively all
    claims arising out of the actions described herein. All such claims (including related
    attorneys’ fees and costs) are forever barred by this Agreement and without regard to whether
    those claims are based on any alleged breach of a duty arising in contract or tort; any alleged
    unlawful act, including, without limitation, discrimination and harassment; any other claim or
    cause of action; and regardless of the forum in which it might be brought, except that an
    enforcement claim pursuant to a default or breach of this Agreement shall not be barred, but
    may be brought as specifically set forth herein.

    The release set forth in this Agreement is intended to have the broadest possible application
    and includes, but is not limited to, any tort, contract, common law, constitutional or other
    statutory claims arising out of any federal, state or local laws. The release set forth herein
    shall apply to the present and future officers, directors, stockholders, attorneys, agents,
    insurers, servants, members, representatives, employees, subsidiaries, subcontractors,
    contractors, affiliates, partners, family members, predecessors, and successors in interest and
    assigns of the parties.

5. Dismissals. Each party shall file a dismissal with prejudice of the actions specifically set
   forth herein and a dismissal with prejudice of any action pending in arbitration, if any, as to
   all claims, causes of action, and parties.

6. Transfer and Assignment. Each party hereto warrants to the other that it has not assigned,
   transferred nor purported to assign or transfer any claim or rights thereto against the other
   party hereto that arose prior to the execution of this Agreement and that it will not assign or
   transfer or purport to assign or transfer hereafter any such claim or rights thereto.

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7. Optional Language: Confidentiality. The parties agree they will keep the fact, terms,
   negotiation, and amount of this Agreement completely confidential and that they will
   not disclose any information concerning this Agreement to anyone, provided either
   party may make such disclosures as are required by law and as are necessary for
   legitimate enforcement or tax compliance purposes. Notwithstanding the foregoing,
   each of the parties may discuss the fact, terms, negotiation and amount of this
   Agreement with their respective attorneys, accountants and to the extent necessary to
   enter into this Agreement, employees and/or directors and/or officers, subject to any
   such additional persons being subject to this confidentiality clause.

8. Costs and Expenses. The parties shall be responsible for their respective attorneys’ fees and
   costs and expenses incurred in this matter.

9. Controlling Law. This Agreement shall be governed by, and construed and enforced in
   accordance with, the laws of the State of _____ [Instruction: Insert state.]. The parties
   hereby irrevocably consent to personal jurisdiction and venue in the _____ [Instruction:
   Insert court.] for any and all Claims arising out of this Agreement or enforcement of this
   Agreement over which that court has subject matter jurisdiction.

10. Amendments. This Agreement cannot be altered or otherwise amended except by written
    instrument signed by all of the parties hereto.

11. Entire Agreement. The parties acknowledge and agree that this Agreement constitutes the
    full, complete, and entire agreement or the parties and that there are no other representations,
    covenants, warranties, or other agreements binding of the parties that are not expressly set
    forth herein.

12. Rule of Construction. The parties acknowledge and agree that they have each had the
    opportunity to have this Agreement reviewed by counsel of their choosing. Therefore, the
    normal rule that ambiguities are construed against the drafter shall not apply in connection
    with the interpretation and construction of this Agreement.

13. Validity of Agreement. The parties represent and agree that the person executing this
    Agreement on behalf of each party has the full and complete permission and authority of the
    respective entity for which he is executing this Agreement, and have the full right and
    authority to commit and fully bind themselves, their representatives, agents, principals,
    predecessors, successors, and privies according to the provisions hereof. This Agreement is a
    legally valid, binding and enforceable obligation of the parties in accordance with its terms.

14. Counterpart Signatures. This Agreement may be executed in one or more counterparts,
    including by facsimile, each of which shall be deemed an original and all of which together
    shall constitute one and the same instrument.

15. Voluntary Signature. This Settlement Agreement is executed voluntarily and without any
    duress or undue influence on the part or behalf of the Parties hereto, with the full intent of
    releasing all claims. The Parties acknowledge that: (a) They have read this Settlement
    Agreement; (b) They have been represented in the preparation, negotiation, and execution of
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    this Settlement Agreement by legal counsel of their own choice or that they have voluntarily
    declined to seek such counsel; (c) They understand the terms and consequences of this
    Settlement Agreement and of the releases it contains; (d) They are fully aware of the legal
    and binding effect of this Settlement Agreement.

WITNESS our hands and seals as of the date set forth below.

As of this ___ day of ____, 20__ [Instruction: Insert date.]

Insert Party 1 Signature Block

Insert Party 2 Signature Block

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