Medical Malpractice Settlement Agreement (Montana)

CONFIDENTIAL SETTLEMENT AGREEMENT AND RELEASE — MEDICAL MALPRACTICE (MONTANA)

PARTIES

Effective Date: [__/__/____]

RECITALS

A. Claimant alleges that on or about [__/__/____], Released Party rendered medical care that resulted in injuries described in [Complaint / MMLP Application No. ____] (the "Claim").

B. Pursuant to MCA § 27-6-101 et seq., the Claim was submitted to the Montana Medical Legal Panel on [__/__/____], and the Panel issued its decision on [__/__/____].

C. The parties deny liability but desire to fully and finally resolve the Claim without further litigation.

D. The parties acknowledge that any noneconomic damages would be subject to the cap set forth in MCA § 25-9-411 (currently $[300,000], adjusted as provided by statute), the constitutionality of which has been challenged but not invalidated as of the Effective Date.

1. SETTLEMENT PAYMENT

1.1 Total Settlement Amount: $[__________] (the "Settlement Sum"), payable by Insurer within [30] days after the later of (a) full execution; (b) receipt of completed IRS Form W-9; (c) lien resolution documentation per § 4.

1.2 Allocation (subject to negotiation; affects tax treatment and lien analysis):
(a) Past/future medical expenses: $[______]
(b) Past/future lost earnings: $[______]
(c) Noneconomic damages (pain, suffering, loss of consortium) — subject to MCA § 25-9-411: $[______]
(d) Wrongful death / survival (if applicable, MCA § 27-1-501 et seq.): $[______]

1.3 Structured Settlement (Optional).
☐ A portion of $[______] shall be funded as a structured settlement annuity through [ASSIGNEE]. Periodic payments are intended to qualify under IRC §§ 104(a)(2) and 130.

2. RELEASE

2.1 In exchange for the Settlement Sum, Claimant fully, finally, and forever releases, acquits, and discharges Released Party, its officers, employees, agents, partners, insurers, reinsurers, successors, and assigns from any and all claims, demands, actions, causes of action, damages, costs, attorneys' fees, expenses, and liabilities of any kind, whether known or unknown, arising out of or related to the Claim and the care described in the Recitals.

2.2 Scope. This release includes negligence, gross negligence, lack of informed consent, wrongful death, survival, loss of consortium, emotional distress, statutory, and common-law claims.

2.3 Unknown Claims Waiver. Claimant expressly waives any rights under any statute or rule of common law providing that a release does not extend to claims unknown at execution.

3. NO ADMISSION OF LIABILITY

3.1 Settlement is a compromise of disputed claims. Released Party expressly denies any liability, negligence, or wrongdoing. This Agreement shall not be construed as an admission for any purpose, in any forum.

4. LIENS, SUBROGATION, AND GOVERNMENT PAYERS

4.1 Medicare (MSP). Claimant represents Medicare eligibility status is: ☐ Eligible ☐ Not eligible ☐ Applied. If eligible, the parties shall comply with 42 USC § 1395y(b)(2) and Section 111 reporting (42 USC § 1395y(b)(8)). Claimant shall: (a) obtain a CMS conditional payment letter; (b) satisfy any Medicare conditional payments; (c) ☐ consider a Medicare Set-Aside (MSA) of $[______] if future medical care related to the injury is reasonably expected.

4.2 Medicaid. Claimant shall resolve any Montana Medicaid lien under MCA § 53-2-612 / 42 USC § 1396p prior to disbursement.

4.3 ERISA / Private Health Plan / Hospital Liens (MCA § 71-3-1114). Claimant shall identify and resolve all such liens.

4.4 Indemnity. Claimant indemnifies and holds Released Party and Insurer harmless from any lien, subrogation, or reimbursement claim arising from the Claim and the Settlement Sum.

5. CONFIDENTIALITY

5.1 The terms, amount, and existence of negotiations are confidential. Disclosure permitted only to: (a) Claimant's attorneys, accountants, tax advisors; (b) immediate family; (c) IRS / lienholders / court as required; (d) as required by law, subpoena, or NPDB reporting.

5.2 NPDB Disclosure. The parties acknowledge that any payment made on behalf of a licensed practitioner in response to a written claim must be reported to the National Practitioner Data Bank per 45 CFR § 60.7. NPDB reporting is required by federal law and is not a breach of this Section.

5.3 Liquidated Damages. Breach of confidentiality results in liquidated damages of $[______], the parties agreeing actual damages are difficult to ascertain.

6. NON-DISPARAGEMENT

6.1 Claimant agrees not to disparage Released Party, its providers, or staff in any public forum, including social media and online review platforms. Truthful statements to licensing boards or in legal proceedings are not breaches.

7. TAX TREATMENT

7.1 Amounts allocated to physical injuries / physical sickness are intended to qualify for exclusion from gross income under IRC § 104(a)(2).

7.2 Amounts allocated to lost wages, punitive damages, or interest are taxable; Insurer shall issue IRS Form 1099 as required. Each party bears its own tax liability and is not relying on the other for tax advice.

8. DISMISSAL AND COURT FILINGS

8.1 Within [10] days of receipt of the Settlement Sum, Claimant shall file a Stipulation of Dismissal With Prejudice in [Cause No. ____, ___ Judicial District Court, ___ County, Montana], each side bearing its own costs.

8.2 If pre-suit, no action shall be filed regarding the Claim.

8.3 Minor / Wrongful Death Approval. If Claimant is a minor or the Claim involves wrongful death or an estate, court approval under MCA § 72-3-613 / Rule 17 / probate court is required prior to disbursement.

9. REPRESENTATIONS

9.1 Claimant represents: (a) capacity to execute; (b) consultation with independent counsel; (c) no assignment of any part of the Claim; (d) disclosure of all known liens; (e) execution is voluntary and informed.

10. GOVERNING LAW AND DISPUTES

10.1 Montana law governs. Disputes over interpretation or enforcement shall be venued in the [___ Judicial District Court, ___ County, Montana].

10.2 Prevailing party in any enforcement action is entitled to reasonable attorneys' fees.

11. MISCELLANEOUS

11.1 Entire Agreement. Supersedes all prior negotiations and writings.
11.2 Amendments. Only in writing signed by all parties.
11.3 Counterparts / E-signatures. Permitted; copies have same effect as originals.
11.4 Severability. If any provision is unenforceable, the remainder continues in effect.

ACKNOWLEDGMENT CHECKLIST

☐ Claimant consulted with independent legal counsel
☐ Settlement Sum and allocation reviewed
☐ MMLP decision received (date: [__/__/____])
☐ Medicare conditional payment letter obtained / not applicable
☐ Medicaid lien resolved / not applicable
☐ Hospital / ERISA / subrogation liens addressed
☐ MSA evaluated (if Medicare beneficiary or reasonably expected)
☐ NPDB reporting obligation acknowledged
☐ Court approval obtained (minor / estate, if applicable)
☐ W-9 / structured settlement documents executed

SIGNATURES

Notary: State of Montana, County of ____. Subscribed and sworn before me this ____ day of __________, 20__. [Notary Seal]

SOURCES AND REFERENCES

• MCA § 25-9-411 (medical malpractice noneconomic damages cap; $300,000 effective March 27, 2025, with 2% annual adjustment beginning Jan 1, 2030)
• MCA § 27-6-101 et seq. (Montana Medical Legal Panel Act — mandatory pre-suit submission)
• Montana Constitution Art. II § 16 (full legal redress)
• MCA § 27-2-205 (3-year limitations / 5-year repose, with discovery and fraudulent concealment exceptions)
• MCA § 27-1-501 et seq. (wrongful death / survival)
• MCA § 71-3-1114 (hospital liens); MCA § 53-2-612 (Medicaid third-party recovery)
• IRC § 104(a)(2); IRC § 130 (structured settlements)
• 42 USC § 1395y(b)(2) and Section 111 (Medicare Secondary Payer)
• 42 USC § 1396p (Medicaid lien)
• 45 CFR § 60.7 (NPDB malpractice payment reporting)