Medical Malpractice Settlement

MEDICAL MALPRACTICE SETTLEMENT AGREEMENT

(Florida – Court-Ready Template)

Use note: This form is designed for a living, competent adult settling an identified Florida medical-negligence claim. A minor, ward, incapacitated person, estate, or wrongful-death matter requires a claim-specific authority, allocation, guardianship, and court-approval plan before signature or funding. Do not treat replacement of the claimant’s name as sufficient customization.

TABLE OF CONTENTS

1. Document Header
2. Definitions

3. Operative Provisions
   3.1 Settlement Payment & Structured Settlement Option
   3.2 Conditions Precedent
   3.3 Tax Treatment

4. Representations & Warranties

5. Covenants & Ongoing Obligations
6. Default & Remedies

7. Risk Allocation
   7.1 Release Scope
   7.2 Limitation of Liability
   7.3 Insurance

8. Dispute Resolution

9. General Provisions
10. Execution Block

1. DOCUMENT HEADER

This Medical Malpractice Settlement Agreement (this “Agreement”) is entered into and made effective as of [Effective Date] (the “Effective Date”) by and between:

a. [Claimant Full Name], an individual residing at [Address] (“Claimant”); and
b. [Health Care Provider Legal Name], a [Entity Type] organized under the laws of Florida with its principal place of business at [Address] (“Provider”).

Claimant and Provider are each referred to herein individually as a “Party” and collectively as the “Parties.”

RECITALS

A. Claimant has asserted or intends to assert claims against Provider arising from alleged medical malpractice occurring on or about [Date of Alleged Incident] (the “Incident”).
B. Provider expressly denies any liability but desires to resolve all disputes without admission of fault.
C. The Parties wish to settle all Claims (as defined below) while addressing the reporting, lien, tax, and court-approval issues that counsel determines apply to this matter.

NOW, THEREFORE, in consideration of the mutual covenants, releases, and payments set forth herein, the receipt and sufficiency of which are hereby acknowledged, the Parties agree as follows:

2. DEFINITIONS

For purposes of this Agreement, capitalized terms have the meanings set forth below. Defined terms appear alphabetically; cross-references in parentheses identify principal usage.

“Affiliate” means, with respect to a Party, any entity controlling, controlled by, or under common control with such Party.

“Claims” means any and all past, present, or future causes of action, suits, debts, covenants, contracts, controversies, agreements, promises, variances, trespasses, damages, judgments, extents, executions, claims, and demands whatsoever, at law or in equity, whether known or unknown, suspected or unsuspected, disclosed or undisclosed, arising out of or relating to the Incident.

“Confidential Information” (Section 5.2) means the nonpublic existence, terms, and underlying facts of this Agreement and any health information that applicable law or a valid court order protects from disclosure.

“Dispute” (Section 8) means any controversy arising out of or relating to this Agreement, its breach, or its interpretation.

“Final Settlement Amount” (Section 3.1) means the total monetary consideration to be paid to Claimant, inclusive of all damages, costs, interest, and attorneys’ fees allocated under the final settlement documents.

“Reporting Requirements” (Section 5.4) means only the current federal and Florida reporting duties that counsel confirms apply to the Provider, insurer, payment, and claim.

3. OPERATIVE PROVISIONS

3.1 Settlement Payment & Structured Settlement Option

3.1.1 Lump-Sum Payment. The Payor identified in Section 7.3 shall pay the Final Settlement Amount of [US$ _____] (the “Settlement Payment”) on or before [Payment Date], by the written method approved by the receiving trust account or escrow.

3.1.2 Optional Structured Settlement. The Parties may use periodic payments only through a separately reviewed Structured Settlement Addendum identifying the assignment, assignee, funding asset, payment schedule, beneficiaries, death provisions, costs, ownership, and insolvency risk. Section 130 of the Internal Revenue Code supplies requirements for a qualified assignment; merely labeling a payment schedule “structured” does not establish tax treatment. Any contingent fee on a structured or periodic recovery must be calculated consistently with Rules Regulating The Florida Bar 4-1.5(f)(6).

3.1.3 No Assumed Section 766.118 Cap. Although the text of Fla. Stat. § 766.118 remains in the 2026 Florida Statutes, Florida appellate authority describes Estate of McCall v. United States, 134 So. 3d 894 (Fla. 2014), and N. Broward Hospital District v. Kalitan, 219 So. 3d 49 (Fla. 2017), as holding the wrongful-death and personal-injury noneconomic-damages caps unconstitutional. Counsel must confirm current law and case-specific application; this Agreement does not reduce or fix the Settlement Amount by treating § 766.118 as an enforceable cap.

3.1.4 Distribution of Settlement Payment. Claimant’s counsel, [Law Firm Name], shall hold the Settlement Payment in trust and distribute it only under the completed schedule below and the governing fee agreement, court orders, recovery demands, and lien resolutions. Rules Regulating The Florida Bar 4-1.5 requires a written closing statement in a contingent-fee recovery.

3.1.5 Default Interest. Any unpaid portion of the Settlement Payment shall accrue interest at [____ %] per annum simple interest from the Payment Date until paid.

3.2 Conditions Precedent

Payment obligations are conditioned upon:
a. Claimant’s execution and delivery of this Agreement, including the release in Section 7.1;
b. Entry of every guardianship, wrongful-death, probate, bankruptcy, or other approval order identified in the approval schedule below;
c. Funding of each required Medicare, Medicaid, or other holdback; and
d. Delivery of the signed closing statement and payment instructions.

3.3 Tax Treatment

Each Party shall be solely responsible for its own tax liabilities, if any, arising from the Settlement Payment. Section 104(a)(2) excludes qualifying damages received on account of personal physical injuries or physical sickness, other than punitive damages. Tax counsel must determine whether any statutory exception, prior deduction, allocation, or reporting rule changes the treatment. No allocation in this Agreement binds a taxing authority, and no Party makes a tax representation to another.

4. REPRESENTATIONS & WARRANTIES

4.1 Authority. Each Party warrants it has full authority to execute and perform this Agreement, subject to the approvals and authority documents expressly identified in Section 3.2.

4.2 No Assignment of Claims. Claimant represents that no Claims have been assigned or encumbered in whole or in part.

4.3 Independent Counsel. Each Party represents it has consulted with, or had the opportunity to consult with, independent legal counsel regarding this Agreement.

4.4 Survival. The representations and warranties in Sections 4.1–4.3 survive the Effective Date for a period of [two (2) years].

5. COVENANTS & ONGOING OBLIGATIONS

5.1 No Future Claims. Claimant covenants not to commence, prosecute, or cause to be commenced any proceeding based on Claims released herein.

5.2 Confidentiality.
a. Except as required by law, regulation, or court order, the Parties shall maintain Confidential Information in strict confidence.
b. Permitted disclosures include those to counsel, tax advisers, insurers, courts, regulators, licensing boards, Medicare, Medicaid, benefit programs, lienholders, auditors, and as otherwise reasonably necessary to perform or enforce this Agreement.
c. Breach of confidentiality constitutes a material default (Section 6).

5.3 Non-Disparagement. The Parties shall refrain from knowingly publishing false statements of fact about the other Party in relation to the Incident. This section does not prohibit opinions, truthful testimony, required reports, protected government communications, or cooperation with a court, regulator, licensing board, or law-enforcement agency.

5.4 Mandatory Reporting.

Florida Office of Insurance Regulation report. Fla. Stat. § 627.912 assigns the report first to the listed insurer, self-insurer, or other insuring entity. A listed health care practitioner or facility reports only if the claim is not otherwise required to be reported by an insurer or other insuring entity. The statute measures the duty from the first applicable event in § 627.912(1)(c) and requires filing within 30 days.

Federal malpractice-payment report. Under 42 U.S.C. §§ 11131 and 11134, the entity making a covered malpractice payment is the federal reporting actor. The report is made regularly, not less often than monthly, and the required information is also reported to the appropriate state licensing board in the state where the claim arose.

Claimant shall provide accurate information reasonably required for a report, at no additional cost. Nothing in this Agreement changes whether a payment is reportable, directs a false characterization, or structures payment to evade reporting.

5.5 Medicare, Florida Medicaid, and Other Recovery Interests.

Under 42 U.S.C. § 1395y(b)(2)(B), a primary plan and an entity receiving a primary-plan payment can be responsible for reimbursing Medicare conditional payments. Fla. Stat. § 409.910 gives the Florida Agency for Health Care Administration recovery rights and provides that a settlement is not effective against its Medicaid lien unless the agency joins in the release or executes a lien release.

Claimant does not give a blanket warranty that every public or private recovery interest is already known or finally calculated. The Parties instead adopt the inventory, notice, cooperation, escrow, dispute, and payment instructions written in this Agreement and its exhibits. No allocation binds or impairs a nonparty’s rights.

6. DEFAULT & REMEDIES

6.1 Events of Default.
a. Provider’s failure to timely make the Settlement Payment;
b. Material breach of confidentiality (Section 5.2) or non-disparagement (Section 5.3);
c. A Party’s material misrepresentation under Section 4.

6.2 Notice & Cure. The non-breaching Party shall provide written notice specifying the default. The breaching Party has [10] business days to cure monetary defaults and [20] business days to cure non-monetary defaults.

6.3 Remedies. If default is not cured within the cure period, the non-breaching Party may:
i. Seek enforcement of this Agreement through a court with jurisdiction; if the Agreement resulted from court-ordered mediation, Fla. R. Civ. P. 1.730 applies to the signed agreement and available sanctions;
ii. Obtain judgment for any unpaid Settlement Payment plus default interest; and
iii. Recover attorneys’ fees and costs only if the Parties select that remedy below or another applicable law or order authorizes it.

Enforcement-fee election: ☐ Each Party bears its own fees and costs ☐ Substantially prevailing Party may seek reasonable fees and costs ☐ Other: [________________________________]

7. RISK ALLOCATION

7.1 Release Scope

7.1.1 Release by Claimant. Effective only after the conditions in Sections 3.1 and 3.2 are satisfied, Claimant releases the persons and entities individually listed in Exhibit A from claims that the signing Claimant owns as of the Effective Date and that arise from the Incident described in Section 1. A parent, affiliate, insurer, employee, contractor, or agent is not released merely because that category appears in boilerplate.

7.1.2 Release by Provider. Select one:

• ☐ Provider gives no affirmative release beyond accepting Claimant’s performance and any dismissal.
• ☐ After the release conditions are satisfied, Provider releases only the following identified claims against the following identified persons: [________________________________].

7.1.3 Claims Not Released. The release does not include:

• duties created by this Agreement or a structured-settlement addendum;
• care, conduct, injuries, or losses outside the identified Incident;
• later and independent malpractice or other future conduct;
• a claim owned by a nonsigning spouse, child, estate, bankruptcy estate, governmental entity, benefit plan, insurer, or other person;
• Medicare, Medicaid, tax, child-support, reporting, licensing, disciplinary, or regulatory rights of a nonparty; or
• a right applicable law does not permit the signing Claimant to waive.

7.2 Limitation of Liability

No contractual settlement-amount cap applies to a Party’s liability for breach of this Agreement. Damages and remedies remain subject to the Agreement and applicable law. This clause does not reinstate or assume enforceability of the noneconomic-damages caps written in Fla. Stat. § 766.118.

7.3 Insurance

The actual payor and funding source must acknowledge the payment obligation below. No Party represents that insurance limits remain available or unimpaired unless the insurer expressly makes that representation in a signed addendum.

8. DISPUTE RESOLUTION

8.1 Governing Law. This Agreement and any Dispute shall be governed by the laws of the State of Florida without regard to conflict-of-laws principles.

8.2 Forum Selection. A proceeding to enforce this Agreement may be brought in a Florida court with subject-matter jurisdiction, personal jurisdiction, and proper venue. The intended county, if legally available, is [________________] County, Florida.

8.3 No Predispute Arbitration Election. This Agreement does not let either Party unilaterally compel arbitration after a Dispute arises. The Parties may enter a separate written post-dispute arbitration agreement after receiving counsel’s advice.

8.4 No Advance Jury Waiver. This Agreement contains no advance contractual jury-trial waiver.

8.5 Injunctive Relief. The Parties acknowledge that injunctive relief is not contemplated due to the monetary nature of this settlement; however, either Party may seek equitable relief to enforce confidentiality or non-disparagement obligations.

9. GENERAL PROVISIONS

9.1 Amendments & Waivers. No amendment or waiver is effective unless in writing and signed by both Parties. A waiver is effective only for the specific instance and purpose given.

9.2 Assignment. Neither Party may assign or delegate its rights or obligations without the prior written consent of the other Party, except that Provider may assign to its insurer solely for purposes of funding the Settlement Payment.

9.3 Successors & Assigns. This Agreement binds and inures to the benefit of the Parties and their respective successors and permitted assigns.

9.4 Severability. If any provision is held invalid, the remainder of this Agreement shall remain in full force, and the invalid provision shall be reformed to the minimum extent necessary to achieve its intent.

9.5 Integration. This Agreement constitutes the entire understanding between the Parties concerning the subject matter and supersedes all prior negotiations or agreements, whether written or oral.

9.6 Counterparts; Electronic Signatures. The Parties agree to conduct this transaction electronically for purposes of Fla. Stat. § 668.50. The Agreement may be executed in counterparts, and a record or signature may not be denied legal effect solely because it is electronic. This clause does not override a court, agency, filing, notarization, or witnessing requirement that applies to a separate document.

9.7 Headings. Section headings are for convenience only and do not affect interpretation.

10. EXECUTION BLOCK

IN WITNESS WHEREOF, the Parties have executed this Agreement effective as of the date first written above.

CLAIMANT

_______________________________
[Claimant Full Name]
Date: _________________________

PROVIDER

_______________________________
[Authorized Signatory Name]
Title: _________________________
[Health Care Provider Legal Name]
Date: _________________________

PAYOR / INSURER ACKNOWLEDGMENT

_______________________________
[Authorized Signatory Name]
Title: _________________________
[Payor / Insurer Legal Name]
Date: _________________________

CLAIMANT’S COUNSEL ACKNOWLEDGMENT

_______________________________
[Attorney Name], Florida Bar No. [________]
[Law Firm Name]
Date: _________________________

[Notary acknowledgment only if counsel determines it is required for a signer or related approval instrument.]

EXHIBITS

• Exhibit A — Specifically Named Released Persons and Entities
• Exhibit B — Claim, Incident, and Dismissal Schedule
• Exhibit C — Approval Orders and Authority Documents
• Exhibit D — Medicare, Medicaid, and Other Recovery Resolutions
• Exhibit E — Structured Settlement Addendum, if used
• Exhibit F — Contingent-Fee Closing Statement and Distribution Schedule

SOURCES AND REFERENCES

• Florida Statutes: § 627.912, § 409.910, § 744.3025, § 744.387, § 768.25, § 668.50, and § 766.118
• Florida Supreme Court ACIS dispositions: Estate of McCall v. United States and N. Broward Hospital District v. Kalitan
• Florida Rules of Civil Procedure, Rule 1.730
• Rules Regulating The Florida Bar, Rule 4-1.5
• 42 U.S.C. § 11131 and § 11134
• 42 U.S.C. § 1395y(b)
• 26 U.S.C. § 104 and § 130