Medical Malpractice Settlement Agreement (Louisiana)

MEDICAL MALPRACTICE SETTLEMENT AGREEMENT AND RELEASE

(Louisiana — Qualified Health Care Provider; LA Medical Malpractice Act)

1. PARTIES

This Settlement Agreement and Release (the "Agreement") is entered into by and among:

(a) [CLAIMANT NAME], an individual residing at [ADDRESS] ("Claimant"); [and, if applicable, [SPOUSE/HEIR NAMES] as loss-of-consortium / wrongful-death claimants];

(b) [PROVIDER NAME, M.D./D.O./HOSPITAL/CLINIC], a qualified health care provider enrolled in the Louisiana Patient's Compensation Fund (PCF Enrollment No. [__________]) ("Provider");

(c) [PROVIDER'S MALPRACTICE INSURER] ("Insurer"); and

(d) [IF PARTICIPATING] the Louisiana Patient's Compensation Fund Oversight Board ("PCF"), as administrator of the Patient's Compensation Fund (La. R.S. § 40:1231.4).

Each a "Party"; collectively the "Parties."

2. RECITALS

A. Claimant filed a Request for Review of a Medical Malpractice Claim with the Louisiana Division of Administration on [__/__/____] pursuant to La. R.S. § 40:1231.8, alleging that Provider committed malpractice on or about [__/__/____] by [BRIEF DESCRIPTION OF ALLEGED NEGLIGENCE AND INJURY] (the "Claim").

B. A Medical Review Panel [was convened and rendered its opinion on (__/__/____) / was waived by the Parties pursuant to La. R.S. § 40:1231.8(B)(1)(c) / was dissolved upon settlement].

C. The Parties wish to fully and finally compromise the Claim pursuant to La. C.C. arts. 3071-3083 and the Louisiana Medical Malpractice Act.

D. Provider denies liability; this Agreement is a compromise of disputed claims.

3. SETTLEMENT PAYMENT

3.1 Total Settlement. In consideration of the releases herein, Provider and/or Insurer and/or PCF shall pay to Claimant the total sum of $[AMOUNT] (the "Settlement Amount"), allocated as follows:

3.2 Cap Acknowledgment. Claimant acknowledges that recovery against Provider as a qualified health care provider is subject to the $500,000 cap on total damages under La. R.S. § 40:1231.2(B), excluding future medical care and related benefits which are paid from the PCF on an as-incurred basis pursuant to La. R.S. § 40:1231.2(D).

3.3 Future Medical Care. [IF APPLICABLE] Claimant retains the right to apply to the PCF for payment of all future medical care and related benefits causally related to the Claim, in accordance with La. R.S. § 40:1231.3 and the PCF's procedures. This Agreement does not waive or limit such future-medical entitlement.

3.4 Payment Mechanics. Payment of the Provider/Insurer portion shall be made within [30] days of execution. PCF payment shall be made in accordance with La. R.S. § 40:1231.4 after court approval, if required. All payments shall be made to [Claimant / Claimant's counsel trust account], payable to [__________].

3.5 Structured Settlement (Optional). [If selected] Payment shall be structured per Exhibit A (qualified assignment under IRC § 130).

3.6 Court Approval. [If Claimant is a minor or interdict, or if PCF participates] This Agreement is contingent on approval by the district court of [__________] Parish, Louisiana, pursuant to La. C.C.P. art. 4271 (minors) or applicable PCF approval procedures.

4. RELEASE

4.1 General Release. In consideration of the Settlement Amount and future-medical rights preserved, Claimant, on behalf of themselves, their heirs, executors, administrators, successors, and assigns, fully and forever RELEASES, ACQUITS, and DISCHARGES Provider, Insurer, and (subject to Section 3.3) the PCF, and their respective officers, directors, employees, agents, partners, successors, and assigns, from any and all claims, demands, causes of action, damages, costs, expenses, and liabilities of any kind, known or unknown, arising out of or relating to the Claim.

4.2 Louisiana Compromise. This release constitutes a compromise under La. C.C. arts. 3071-3083 and shall have the force of res judicata between the Parties.

4.3 Unknown Claims. Claimant expressly waives the benefit of any rule of law that would otherwise preserve unknown or unanticipated claims.

4.4 Carve-Out. This release does not extend to: (a) Claimant's right to seek future medical care and related benefits from the PCF under La. R.S. § 40:1231.2(D) and § 40:1231.3; (b) enforcement of this Agreement; or (c) claims against any non-released third party.

5. NO ADMISSION OF LIABILITY

Provider denies all allegations of negligence, malpractice, or wrongdoing. This Agreement is a compromise of disputed claims and shall not be construed as an admission of liability or fault.

6. LIEN RESOLUTION

6.1 Medicare / MSP. Claimant represents that all Medicare conditional payments under 42 U.S.C. § 1395y(b)(2) have been identified, reported, and will be satisfied from the Settlement Amount. Claimant shall indemnify Provider, Insurer, and PCF against any Medicare recovery claim.

6.2 Medicaid. Any Louisiana Medicaid lien (La. R.S. § 46:446) shall be satisfied prior to disbursement.

6.3 ERISA / Tricare / VA / Other. Claimant shall identify and satisfy all health-plan, ERISA, Tricare, VA, and hospital liens.

6.4 Medicare Set-Aside. [If Claimant is a Medicare beneficiary or has reasonable expectation of enrollment within 30 months] A Medicare Set-Aside Arrangement in the amount of $[AMOUNT] is established per Exhibit B.

7. NPDB AND REPORTING

7.1 NPDB Report. The Parties acknowledge that any payment made by or on behalf of Provider in satisfaction of this Claim must be reported to the National Practitioner Data Bank within 30 days under 42 U.S.C. § 11131 and 45 C.F.R. § 60.7.

7.2 No Waiver. Provider does not waive, and Claimant does not request a waiver of, NPDB reporting requirements.

7.3 State Reporting. Required reports to the Louisiana State Board of Medical Examiners or other licensing boards shall be made as required by law.

8. CONFIDENTIALITY

8.1 Confidential Terms. The Parties agree to keep the terms of this Agreement, including the Settlement Amount, strictly confidential, except disclosures to: (a) tax, financial, and legal advisors; (b) the PCF and required regulators; (c) NPDB and licensing boards; (d) lien-holders; (e) as required by court order or subpoena; and (f) as required by law.

8.2 No Disparagement. The Parties shall refrain from disparaging statements concerning each other regarding the Claim.

8.3 Permitted Disclosure. Nothing herein restricts any Party from reporting to or cooperating with any governmental authority, including the LSBME, CMS, OIG, or DOJ.

9. TAX TREATMENT

9.1 IRC § 104(a)(2). The Parties intend that the portion of the Settlement Amount allocated to compensation for personal physical injury or sickness qualifies for exclusion from gross income under IRC § 104(a)(2).

9.2 Allocation. The Settlement Amount is allocated: $[__________] personal physical injury; $[__________] loss of consortium; $[__________] other.

9.3 No Tax Advice. No Party has provided tax advice to any other Party. Each Party shall obtain independent tax counsel.

10. INDEMNIFICATION

Claimant shall defend, indemnify, and hold Provider, Insurer, and PCF harmless against any lien, subrogation, or reimbursement claim arising from payment of the Settlement Amount, including Medicare/Medicaid/ERISA claims and attorney charging liens.

11. DISPUTE RESOLUTION

11.1 Governing Law. This Agreement is governed by Louisiana law.

11.2 Venue. Exclusive venue lies in the [__________] Parish District Court, Louisiana.

11.3 Enforcement. This Agreement may be enforced as a Louisiana compromise/transaction (La. C.C. art. 3071).

12. GENERAL PROVISIONS

12.1 Entire Agreement. This Agreement, with its Exhibits, is the entire agreement.

12.2 Amendment. Only by writing signed by all Parties.

12.3 Severability. Invalid provisions shall be severed; the remainder remains in force.

12.4 Counterparts; Electronic Signatures. Permitted under La. R.S. § 9:2607.

12.5 Voluntary Execution. Each Party has had the opportunity to consult independent counsel and executes this Agreement voluntarily.

13. ACKNOWLEDGMENTS

☐ Claimant has read and understood this Agreement.

☐ Claimant acknowledges the $500,000 cap on total damages under La. R.S. § 40:1231.2(B) (excluding future medical care, which is preserved under La. R.S. § 40:1231.2(D)).

☐ Claimant acknowledges that any payment will be reported to the NPDB.

☐ Claimant has been represented by [ATTORNEY NAME], or has knowingly waived counsel.

☐ All known Medicare/Medicaid/ERISA/Tricare/VA liens have been identified.

☐ [If applicable] Medical Review Panel proceedings under La. R.S. § 40:1231.8 have been completed or waived.

14. EXECUTION

Sworn before me this ___ day of __________, 20___.

____________________________
Notary Public — Louisiana
Bar/Notary No.: __________

EXHIBITS

• Exhibit A — Structured Settlement Schedule (if applicable)
• Exhibit B — Medicare Set-Aside Arrangement (if applicable)
• Exhibit C — Lien Resolution Schedule
• Exhibit D — PCF Approval / Court Approval Order (if required)
• Exhibit E — Medical Review Panel Opinion or Waiver

SOURCES AND REFERENCES

• La. R.S. § 40:1231.2 (Damages cap): https://legis.la.gov/Legis/Law.aspx?d=97087
• La. R.S. § 40:1231.8 (Medical Review Panel): https://www.legis.la.gov/legis/Law.aspx?d=964877
• Louisiana Patient's Compensation Fund: https://www.doa.la.gov/doa/mmc/pcf/
• Butler v. Flint Goodrich Hospital, 607 So. 2d 517 (La. 1992) (cap constitutionality)
• NPDB Guidebook: https://www.npdb.hrsa.gov/
• 42 U.S.C. § 1395y(b)(2) (Medicare Secondary Payer)
• IRC § 104(a)(2) (Tax exclusion for personal physical injury damages)