Medical Malpractice Settlement Agreement (Nevada)

CONFIDENTIAL SETTLEMENT AGREEMENT AND GENERAL RELEASE

(Nevada — Medical Professional Negligence)

This Confidential Settlement Agreement and General Release ("Agreement") is entered into as of [__/__/____] (the "Effective Date") by and among:

(Each a "Party"; collectively, the "Parties.")

1. RECITALS

A. On or about [__/__/____], Claimant received medical care from Released Provider at [FACILITY], in Nevada.
B. Claimant alleges professional negligence under NRS Chapter 41A arising from [DESCRIPTION OF INCIDENT] (the "Incident").
C. A civil action is [pending / contemplated / styled [Case Caption], Case No. [____], in the [____] Judicial District Court, [____] County, Nevada] (the "Action"), and Claimant served an Affidavit of Merit under NRS § 41A.071 dated [__/__/____].
D. The Parties dispute liability and damages and now wish to resolve all claims arising from the Incident without admission of fault.

2. SETTLEMENT CONSIDERATION

2.1 Total Settlement Sum. Released Entity (or its insurer) shall pay the total gross sum of $[________] (the "Settlement Sum"), payable within [thirty (30)] days after the latest of: (a) execution of this Agreement; (b) receipt of an executed IRS Form W-9; (c) court approval (if a minor or wrongful-death claim); and (d) resolution of all healthcare liens.

2.2 Allocation. The Parties allocate the Settlement Sum as follows for tax-characterization purposes:

2.3 Periodic Payments (optional). ☐ The Parties have agreed to fund a structured settlement annuity via [LIFE CARRIER], premium $[____], producing payments per the schedule in Exhibit A, in compliance with 26 U.S.C. §§ 104(a)(2) and 130.

3. RELEASE

3.1 General Release. Releasor, on behalf of Releasor and Releasor's heirs, executors, administrators, successors, and assigns, fully and forever releases the Released Provider, Released Entity, and each of their respective insurers, officers, directors, employees, agents, attorneys, and affiliates (collectively, the "Released Parties") from any and all claims, demands, causes of action, damages, costs, and expenses, known or unknown, arising from or related to the Incident, including all claims under NRS Chapter 41A and common-law claims.

3.2 Unknown Claims. Releasor expressly waives all rights under any statute or common-law rule providing that a release does not extend to unknown claims. Releasor assumes the risk of any later-discovered injury arising from the Incident.

3.3 Covenant Not to Sue. Releasor shall not commence, prosecute, or assist in any action against the Released Parties arising from the Incident.

4. NO ADMISSION OF LIABILITY

This Agreement is a compromise of disputed claims. Released Parties expressly deny any negligence or wrongdoing. Nothing herein is or may be construed as an admission of liability.

5. CONFIDENTIALITY

5.1 The terms, amount, and existence of negotiations are confidential. Permitted disclosures: (a) attorneys, accountants, tax advisors, auditors; (b) spouse; (c) as required by law, subpoena, or court order; (d) to NPDB and any required regulator; (e) to satisfy lien resolution; (f) to enforce this Agreement.
5.2 Breach. Material breach entitles the non-breaching Party to actual damages and equitable relief; liquidated damages of $[____] per disclosure are agreed where actual damages are difficult to quantify.
5.3 No Gag on Care/Regulatory Reporting. Nothing in this Agreement prohibits Releasor from filing a complaint with the Nevada State Board of Medical Examiners, Nevada State Board of Osteopathic Medicine, Nevada State Board of Nursing, Nevada Division of Public and Behavioral Health, CMS, OIG, or other regulator, or from cooperating with any investigation.

6. NPDB AND REGULATORY REPORTING

6.1 The Parties acknowledge that any payment made by or on behalf of a licensed individual practitioner in settlement of a written claim for medical malpractice is reportable to the National Practitioner Data Bank under 45 C.F.R. § 60.7 and 42 U.S.C. § 11131. The reporting obligation rests with the payer/insurer.
6.2 The "corporate shield" exception does not apply to payments made on behalf of a named individual practitioner.

7. LIENS, SUBROGATION, AND MEDICARE/MEDICAID COMPLIANCE

7.1 Lien Warranty. Releasor warrants identification and resolution of all healthcare liens, including Medicare conditional payments (42 U.S.C. § 1395y(b)(2)), Medicaid (Nevada Division of Health Care Financing and Policy), ERISA plans, hospital/provider liens (NRS Chapter 108), and Workers' Compensation.
7.2 MSP / MMSEA Reporting. Released Entity / insurer shall make any Section 111 (42 U.S.C. § 1395y(b)(8)) MMSEA report required.
7.3 MSA. ☐ A Medicare Set-Aside has been established in the amount of $[____] ☐ No MSA required (rationale on file).
7.4 Indemnification. Releasor shall indemnify and hold the Released Parties harmless from any unresolved lien, including double-damages exposure under the MSP Act.

8. TAX TREATMENT

The Parties intend that amounts allocated to personal physical injury or physical sickness be excludable from gross income under 26 U.S.C. § 104(a)(2). The Parties acknowledge that no Released Party has provided tax advice and Releasor has been advised to consult independent tax counsel. IRS Form 1099 reporting (if any) will follow the allocation in Section 2.2.

9. DISMISSAL OF ACTION

Within [ten (10)] business days after receipt of the Settlement Sum, Releasor's counsel shall file a Stipulation and Order of Dismissal with prejudice of the Action, each side bearing its own costs and fees except as set forth herein.

10. REPRESENTATIONS

10.1 Releasor has authority to enter this Agreement; if Releasor represents a minor or decedent, court approval per NRS Chapters 41 and 159A (compromise of minor's claim) or probate court approval has been obtained or will be obtained as a condition precedent to payment.
10.2 Releasor has read this Agreement, has had the opportunity to consult counsel, and signs voluntarily.

11. GENERAL PROVISIONS

11.1 Governing Law. Nevada law (without regard to conflicts principles).
11.2 Venue. [____] Judicial District Court, [____] County, Nevada.
11.3 Severability. Invalid provisions shall be severed; the remainder remains enforceable.
11.4 Entire Agreement; Amendment. This Agreement (with Exhibits) is the entire agreement; modifications must be in writing signed by all Parties.
11.5 Counterparts; E-Signatures. Counterparts and electronic signatures permitted under NRS Chapter 719.

12. SIGNATURES

NOTARY ACKNOWLEDGMENT (NEVADA)

State of Nevada
County of [____________]

This instrument was acknowledged before me on [__/__/____] by [NAME].

_____________________________
Notary Public
My commission expires: [__/__/____]

CHECKLIST

☐ Current NRS § 41A.035 cap verified at Nevada Supreme Court published table.
☐ NPDB report prepared (45 C.F.R. § 60.7) by responsible payer.
☐ Medicare conditional-payment letter and final demand obtained.
☐ Medicaid lien (NV DHCFP) resolved or assignment in place.
☐ Hospital / provider liens (NRS Chapter 108) addressed.
☐ MSA analysis completed (if Medicare beneficiary or with reasonable expectation).
☐ Minor / wrongful-death court approval, if applicable (NRS Chapters 41, 159A).
☐ Affidavit of Merit (NRS § 41A.071) on file.
☐ W-9 obtained; 1099 allocation confirmed.
☐ Structured settlement documents executed (if applicable).

SOURCES AND REFERENCES

• NRS § 41A.035 — Noneconomic damages cap (AB 404 (2023) phase-in: 2024 $430K → 2025 $510K → 2026 $590K → 2027 $670K → 2028 $750K; thereafter +2.1%/yr)
• NRS § 41A.071 — Affidavit of Merit requirement
• NRS § 41.141 — Comparative negligence
• NPDB: 42 U.S.C. § 11131; 45 C.F.R. § 60.7
• MSP: 42 U.S.C. § 1395y(b)(2), (b)(8) (Section 111 reporting)
• IRC § 104(a)(2); § 130 (qualified assignments)
• Nevada Supreme Court, Limitations of Noneconomic Damages, published annual table (NRS § 41A.035(3))