Medical Malpractice Settlement Agreement and Release (New Hampshire)

CONFIDENTIAL SETTLEMENT AGREEMENT AND RELEASE

(New Hampshire Medical Malpractice / Medical Injury Action)

This Confidential Settlement Agreement and Release ("Agreement") is made effective [__/__/____] by and among:

1. RECITALS

1.1 On or about [__/__/____], Claimant received medical care from Released Parties at [facility/location] (the "Subject Care").

1.2 Claimant asserts that the Subject Care constituted an "action for medical injury" within the meaning of N.H. RSA 507-E:1, alleging [brief description of alleged negligence and injury]. Claimant filed (or threatens to file) suit captioned [CAPTION], [Court], Docket No. [______] (the "Action").

1.3 Released Parties deny all liability, deny any breach of the standard of reasonable professional practice (RSA 507-E:2), and deny that any act or omission proximately caused Claimant's alleged injuries.

1.4 To avoid the burden, expense, delay, and uncertainty of litigation — including the screening-panel proceedings under N.H. RSA ch. 519-B — the parties have agreed to compromise and resolve all claims on the terms set forth below.

2. SETTLEMENT PAYMENT

2.1 Total Settlement Amount. Released Parties / Insurer shall pay the gross sum of $[______] ("Settlement Payment") within [30] days of: (a) full execution of this Agreement; (b) delivery of an IRS Form W-9 from Claimant's counsel's trust account; (c) court approval where required (e.g., minor or wrongful-death claims); and (d) lien-resolution confirmation under Section 5.

2.2 Allocation. The parties allocate the Settlement Payment as follows for tax-characterization purposes:

2.3 Tax Treatment. The parties intend that amounts paid on account of personal physical injuries or physical sickness be excludable from gross income under 26 U.S.C. § 104(a)(2). Each party is responsible for its own taxes; no party has provided tax advice to another. Claimant shall hold Released Parties harmless from any tax liability of Claimant.

2.4 Structured Settlement (Optional). ☐ A portion of the Settlement Payment ($[______]) shall fund a qualified assignment under IRC § 130 with [annuity issuer]. Terms in Exhibit B.

2.5 Form of Payment. Payable to "[CLAIMANT'S COUNSEL] IOLTA, as attorney for [CLAIMANT]."

3. NO ADMISSION OF LIABILITY

This Agreement is a compromise of disputed claims. Released Parties expressly deny any negligence, breach of standard of care, or wrongdoing. Nothing herein is an admission of liability for any purpose, including in any subsequent proceeding, licensing matter, or credentialing review.

4. RELEASE

4.1 General Release. Claimant, on behalf of Claimant and Claimant's heirs, executors, administrators, successors, and assigns, hereby releases, acquits, and forever discharges Released Parties and their parents, subsidiaries, affiliates, insurers, reinsurers, officers, directors, employees, agents, attorneys, partners, shareholders, and successors from any and all claims, demands, actions, causes of action, suits, damages (including noneconomic damages, which are not capped in New Hampshire under Carson v. Maurer, 120 N.H. 925 (1980)), costs, attorneys' fees, expenses, and liabilities of every kind, whether known or unknown, arising out of or relating in any way to the Subject Care or the Action.

4.2 Scope. The release includes, without limitation, claims under N.H. RSA ch. 507-E, common-law negligence, lack of informed consent, breach of warranty, EMTALA, statutory claims, wrongful death (RSA 556:12), loss of consortium (RSA 507:8-a), and any claim for punitive or enhanced compensatory damages.

4.3 Unknown Claims. Claimant expressly waives any claim that this release does not extend to unknown or unsuspected claims.

4.4 Dismissal. Within [10] business days of receipt of the Settlement Payment, Claimant shall file a Stipulation of Dismissal with Prejudice of the Action, each side to bear its own costs and fees.

5. LIENS, SUBROGATION, AND THIRD-PARTY INTERESTS

5.1 Claimant's Sole Responsibility. Claimant and Claimant's counsel are solely responsible for identifying, negotiating, and satisfying all liens, subrogation claims, and reimbursement obligations, including:

5.2 Medicare Set-Aside. The parties have considered Medicare's interests. ☐ Claimant is not Medicare-eligible and reasonably not expected to enroll within 30 months. ☐ An MSA in the amount of $[______] has been funded.

5.3 Indemnity. Claimant shall indemnify, defend, and hold harmless Released Parties from any lien, claim, or demand asserted by any third party (including CMS) for reimbursement out of the Settlement Payment, up to the amount received by Claimant.

6. CONFIDENTIALITY

6.1 The existence, terms, and amount of this Agreement are confidential. Permitted disclosures: (a) attorneys, accountants, tax preparers, and financial advisors bound by confidentiality; (b) IRS and other taxing authorities; (c) lienholders; (d) immediate family; (e) court order or subpoena (with prompt notice to the other party); (f) NPDB and NH Board of Medicine reporting required under 42 U.S.C. § 11131 and N.H. RSA 329:17; (g) insurance regulators.

6.2 NPDB / Regulatory Reporting. The parties acknowledge that any payment made by or on behalf of a licensed practitioner in settlement of a written claim alleging medical malpractice must be reported to the National Practitioner Data Bank within 30 days, and to the NH Board of Medicine under RSA 329:17. Such reporting is not a breach of confidentiality.

6.3 No Disparagement. Neither party shall make public disparaging statements regarding the other.

7. COURT APPROVAL (IF REQUIRED)

☐ Minor Claimant. Settlement is subject to approval by the NH [Probate Division / Superior Court] under applicable NH practice. Net proceeds for the minor shall be held in [structured settlement / blocked account / RSA 463 guardianship] until majority.

☐ Wrongful Death (RSA 556). Settlement is subject to approval by the Probate Division and distributed under RSA 556:12 and 556:14.

☐ Incapacitated Adult. Subject to guardian/conservator approval under RSA ch. 464-A.

8. SCREENING PANEL / PENDING PROCEEDINGS

8.1 If a screening panel has been convened under N.H. RSA ch. 519-B and Superior Court Rules 301–311, the parties shall jointly notify the Panel Chair of settlement and request termination of proceedings.

8.2 All Panel materials remain subject to RSA 519-B confidentiality protections.

9. NONECONOMIC DAMAGES — NO STATUTORY CAP

The parties acknowledge that New Hampshire has no statutory cap on noneconomic damages in medical malpractice actions. Any prior or future legislative cap would be subject to the constitutional limitations articulated in Carson v. Maurer, 120 N.H. 925, 424 A.2d 825 (1980). The Settlement Payment reflects the parties' negotiated compromise of all economic and noneconomic damages without reference to any cap.

10. MISCELLANEOUS

10.1 Governing Law. This Agreement is governed by New Hampshire law.

10.2 Venue. Exclusive venue for enforcement: Superior Court for [__] County, New Hampshire.

10.3 Entire Agreement. Supersedes all prior oral or written agreements regarding the subject matter.

10.4 Counterparts; Electronic Signatures. Permitted under N.H. RSA ch. 294-E.

10.5 Authority. Each signatory represents authority to bind the party for whom they sign.

10.6 Voluntary; Counseled. Each party acknowledges (a) reading the entire Agreement; (b) opportunity to consult independent counsel; (c) signing voluntarily; and (d) that no representation outside this Agreement induced execution.

10.7 Severability. Invalidity of any provision shall not affect remaining provisions.

SIGNATURES

Notary (Claimant):

State of New Hampshire, County of [______], ss.
Subscribed and sworn before me this [__] day of [______], 20[__], by [CLAIMANT NAME], known to me or satisfactorily identified.

_______________________
Notary Public / Justice of the Peace
My commission expires: [__/__/____]

EXHIBITS

• Exhibit A — Stipulation of Dismissal with Prejudice
• Exhibit B — Structured Settlement / Qualified Assignment Documents (if applicable)
• Exhibit C — Lien Resolution Documentation (Medicare CPL/Final Demand, Medicaid release, etc.)
• Exhibit D — Court Approval Order (minor / wrongful death / incapacitated adult, if applicable)

Sources and References

• N.H. RSA ch. 507-E — https://gc.nh.gov/rsa/html/LII/507-E/507-E-mrg.htm
• N.H. RSA ch. 519-B & Superior Court Rules 301–311 — https://www.courts.nh.gov/rules-superior-court-state-new-hampshire/medical-malpractice-screening-panels-rsa-519-b
• Carson v. Maurer, 120 N.H. 925, 424 A.2d 825 (1980)
• NPDB Guidebook — https://www.npdb.hrsa.gov/
• Medicare Secondary Payer — https://www.cms.gov/medicare/coordination-benefits-recovery