Medical Malpractice Settlement Agreement (Missouri)

MEDICAL MALPRACTICE SETTLEMENT AGREEMENT AND MUTUAL RELEASE

(Missouri)

TABLE OF CONTENTS

1. Document Header
2. Definitions
3. Operative Provisions (Payment, Structure, Liens, Dismissal)
4. Representations & Warranties
5. Covenants (Confidentiality; Reporting; Cooperation)
6. Default & Remedies
7. Risk Allocation (Release; § 538.210 Acknowledgment)
8. Dispute Resolution
9. General Provisions
10. Execution Block

1. DOCUMENT HEADER

1.1 Parties. This Medical Malpractice Settlement Agreement and Mutual Release (the "Agreement") is entered into as of [EFFECTIVE DATE] by and between:

a. [CLAIMANT FULL LEGAL NAME], an individual residing at [ADDRESS] ("Claimant"); and
b. [PROVIDER FULL LEGAL NAME], a [entity type] organized under the laws of Missouri with its principal place of business at [ADDRESS] ("Provider"), together with [INSURER NAME] ("Insurer") solely with respect to funding obligations.

1.2 Recitals.
A. Claimant alleges that Provider's medical services rendered on or about [DATE(S)] caused personal injuries (the "Claim").
B. The Claim is or may be the subject of an action styled [CASE CAPTION], pending in the Circuit Court of [COUNTY], Missouri (the "Action").
C. A Health Care Affidavit was/was not filed under RSMo § 538.225.
D. The Parties wish to resolve the Claim and Action in full and final settlement, without admission of liability, consistent with Missouri law, including RSMo §§ 538.210, 538.220, 538.225, and 538.300.

In consideration of the mutual promises herein, the Parties agree as follows:

2. DEFINITIONS

"Action" — as defined in Recital B.

"Affidavit of Merit" — the legally sufficient opinion required under RSMo § 538.225.

"Catastrophic Personal Injury" — has the meaning in RSMo § 538.205(1).

"Claim" — as defined in Recital A.

"Confidential Information" — as defined in Section 5.2.

"Lien Holders" — Medicare, Medicaid (MO HealthNet), ERISA plans, TRICARE, hospital lienholders under RSMo § 430.225, and any other subrogated party.

"Noneconomic Damages Cap" — the limit on noneconomic damages under RSMo § 538.210, as annually adjusted by 1.7% per § 538.210.8.

"NPDB" — National Practitioner Data Bank, 42 U.S.C. § 11131 et seq.

"Released Claims" / "Released Parties" — as defined in Section 7.2.

"Settlement Amount" — the total consideration under Section 3.1.

"Structured Settlement" — periodic payments pursuant to RSMo § 538.220.

3. OPERATIVE PROVISIONS

3.1 Payment.

(a) Insurer shall pay (or cause to be paid) on behalf of Provider the total Settlement Amount of $[SETTLEMENT_AMOUNT] on or before [SETTLEMENT PAYMENT DATE] by [WIRE / CHECK] payable to [PAYEE — typically "Claimant's counsel IOLTA trust account"].
(b) The Settlement Amount encompasses all economic damages, noneconomic damages (subject to the Noneconomic Damages Cap), attorneys' fees, costs, and statutory lien obligations.

3.2 Structured Settlement (Optional under RSMo § 538.220).

(a) Election. Claimant elects periodic payments under RSMo § 538.220.
(b) Schedule. Payments shall be made as follows:

• $[AMOUNT] annually beginning [DATE] for [TERM] years; and
• One balloon of $[AMOUNT] on [DATE].
  (c) Annuity. Funded through a qualified assignment to [ASSIGNEE] and annuity issued by an A.M. Best A- or better carrier.
  (d) Present Value. The actuarially-determined present value of the periodic payments, plus any lump-sum component, equals the Settlement Amount.
  (e) Non-Acceleration. No commutation, acceleration, or assignment without mutual written consent and court approval where required.

3.3 Lien Resolution.

(a) Claimant shall identify all known Lien Holders on Schedule 3.3 and is responsible for satisfaction from the Settlement Amount.
(b) Medicare / MSP. Claimant shall comply with 42 U.S.C. § 1395y(b)(2) and complete Section 111 MSP reporting; if Claimant is a Medicare beneficiary, Final Demand letter from CMS/BCRC shall be obtained or a Medicare Set-Aside (MSA) considered.
(c) MO HealthNet. Claimant shall resolve any Medicaid lien per RSMo § 208.215.
(d) Hospital Liens. Claimant shall resolve any lien under RSMo § 430.225 et seq.
(e) Claimant shall indemnify Released Parties from any Lien Holder claim per Section 7.3.

3.4 Dismissal. Within [5] Court Days after funding, Claimant shall file a Stipulation of Dismissal with prejudice under Mo. R. Civ. P. 67.02, each Party to bear its own fees and costs except as otherwise provided.

3.5 Conditions Precedent. Execution by all Parties; delivery of IRS Form W-9; receipt of executed dismissal in escrow with [ESCROW AGENT].

3.6 Tax Treatment. The Parties intend that amounts allocable to personal physical injuries are excludable from gross income under IRC § 104(a)(2). No party makes any tax representation; Claimant relies on independent tax counsel.

4. REPRESENTATIONS & WARRANTIES

4.1 Authority. Each Party has full authority to enter and perform this Agreement.
4.2 No Assignment of Claims. Claimant has not assigned the Claim or any Released Claim.
4.3 Liens. All known liens are listed on Schedule 3.3 and will be satisfied from the Settlement Amount.
4.4 Capacity. If Claimant is a minor or protected person, court approval under RSMo ch. 475 or Mo. R. Civ. P. 52.02 has been or will be obtained.
4.5 Survival. Representations survive for [18] months following the Effective Date.

5. COVENANTS

5.1 NPDB / Reporting. Provider (or Insurer) shall make any required NPDB report (42 U.S.C. § 11131 et seq.; 45 C.F.R. Part 60) and any report required under RSMo § 538.300 within applicable deadlines. Provider may contest or submit a subject statement consistent with NPDB procedures.

5.2 Confidentiality. Except as required by law, court order, or NPDB/regulatory reporting, the Parties shall keep the terms confidential. Permitted disclosures: tax/legal advisors, insurers, immediate family, lien holders, and the Court.

5.3 Non-Disparagement. Neither Party shall make statements intended to defame the other concerning the Claim or Action. Nothing herein restricts truthful testimony or required regulatory disclosures.

5.4 No Admission. This Agreement is a compromise of disputed claims and is not an admission of liability by any Party.

5.5 Notice & Cure. Written notice of any alleged breach; [10] Business Day cure period before Section 6 remedies.

6. DEFAULT & REMEDIES

6.1 Events of Default. (a) Failure to deliver payment when due; (b) failure to file dismissal under Section 3.4; (c) material breach of confidentiality.

6.2 Remedies.
(a) Provider/Insurer Default. Upon uncured default, Claimant may enforce by stipulated judgment for the unpaid Settlement Amount plus interest at the Missouri statutory rate under RSMo § 408.020 and reasonable attorneys' fees.
(b) Claimant Default. Provider may seek dismissal with prejudice and recover reasonable attorneys' fees.

6.3 Attorneys' Fees. Prevailing party in any enforcement action is entitled to reasonable fees and costs.

7. RISK ALLOCATION

7.1 Limitation. Provider's aggregate liability arising from the Claim shall not exceed the Settlement Amount.

7.2 Mutual Release.
(a) "Released Claims" — all past, present, or future claims, demands, causes of action, damages, or liabilities, known or unknown, arising out of or related to the Claim, the medical care at issue, or the Action.
(b) "Released Parties" — the Parties and their parents, subsidiaries, affiliates, insurers, reinsurers, officers, directors, agents, employees, successors, and assigns.
(c) Release. Each Party fully and forever releases the other and all Released Parties from the Released Claims.
(d) Unknown Claims. Claimant understands this Agreement extends to claims unknown or unsuspected as of the Effective Date and expressly assumes that risk.

7.3 Indemnification — Liens. Claimant indemnifies and holds harmless Released Parties from any claim by a Lien Holder (Medicare, MO HealthNet, ERISA, hospital, or otherwise) arising from the Claim.

7.4 § 538.210 Acknowledgment. The Parties acknowledge that any noneconomic component of the Settlement Amount has been negotiated against the backdrop of the cap in RSMo § 538.210 (as annually adjusted by 1.7% under § 538.210.8) and that constitutionality of the post-2015 cap has been addressed in Watson v. State, 545 S.W.3d 909 (Mo. App. 2018). The Settlement Amount reflects a compromise and does not constitute a finding under § 538.210.

7.5 Force Majeure. No liability for delays due to events beyond reasonable control.

8. DISPUTE RESOLUTION

8.1 Governing Law. Missouri law, without regard to conflicts principles.

8.2 Forum. Exclusive jurisdiction in the Circuit Court of [COUNTY], Missouri, which retains jurisdiction to enforce this Agreement following dismissal pursuant to [STIPULATION / ORDER].

8.3 Arbitration (Optional).

At either Party's election within [10] Business Days of the Effective Date, disputes shall be resolved by binding arbitration administered by [AAA / JAMS] before a single neutral in [CITY], Missouri.

8.4 Jury Waiver (Optional). Each Party knowingly waives the right to jury trial in any proceeding arising out of this Agreement.

9. GENERAL PROVISIONS

9.1 Amendments; Waivers. Only in writing, signed by both Parties.
9.2 Assignment. No assignment without prior written consent, except Provider may assign to its Insurer for payment.
9.3 Successors. Binding on successors and permitted assigns.
9.4 Severability. Invalid provisions are narrowly construed; remainder remains in force.
9.5 Entire Agreement. This Agreement is the entire understanding and supersedes prior negotiations.
9.6 Counterparts; Electronic Signatures. Permitted; electronic signatures deemed original.
9.7 Construction. No party is deemed the drafter.

10. EXECUTION BLOCK

IN WITNESS WHEREOF, the Parties have executed this Agreement as of the Effective Date.

Insurer (solely as to funding obligations):
[INSURER NAME] — By: ____________________ Title: ____________ Date: __________

SCHEDULES

• Schedule 3.3 — Known Liens and Subrogation Interests
• Schedule 3.2 — Periodic Payment / Annuity Terms (if applicable)
• Schedule W-9 — IRS Form W-9 for payee

Sources and References

• RSMo § 538.210: https://revisor.mo.gov/main/OneSection.aspx?section=538.210
• RSMo § 538.220: https://revisor.mo.gov/main/OneSection.aspx?section=538.220
• RSMo § 538.225: https://revisor.mo.gov/main/OneSection.aspx?section=538.225
• RSMo § 538.300: https://revisor.mo.gov/main/OneSection.aspx?section=538.300
• Missouri Department of Insurance Medical Malpractice: https://insurance.mo.gov/industry/medmal.php
• Watson v. State, 545 S.W.3d 909 (Mo. App. 2018)
• NPDB Guidebook: https://www.npdb.hrsa.gov