Medical Malpractice Settlement Agreement (Ohio)

MEDICAL MALPRACTICE SETTLEMENT AGREEMENT AND MUTUAL RELEASE

(Ohio)

TABLE OF CONTENTS

1. Document Header
2. Definitions
3. Settlement Consideration & Payment
4. Representations & Warranties
5. Covenants; Confidentiality; Non-Disparagement
6. Default & Remedies
7. Risk Allocation; Mutual Release; Liens
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] (the "Effective Date") by and between:

(a) [CLAIMANT FULL LEGAL NAME], an individual residing at [ADDRESS] ("Claimant"); and

(b) [HEALTHCARE PROVIDER FULL LEGAL NAME], a [Ohio professional medical corporation / hospital / LLC] with its principal place of business at [ADDRESS] ("Provider").

Claimant and Provider are each a "Party" and, collectively, the "Parties."

1.2 Recitals

A. Claimant alleges that Provider's medical care rendered on or about [DATE(S) OF CARE] caused personal injury (the "Claim"), which is or may be the subject of an action styled [CASE CAPTION], pending in the Court of Common Pleas of [COUNTY], Ohio, Case No. [___________] (the "Action").
B. The Parties wish to fully and finally resolve the Claim and the Action without admission of liability, in accordance with Ohio law, including Ohio Rev. Code § 2323.43 (noneconomic-damages cap for medical claims), § 2305.113 (statute of limitations / repose), and § 2317.43 (apology inadmissibility).
C. Provider denies liability and enters this Agreement solely to avoid the burden and expense of further litigation.

NOW, THEREFORE, in consideration of the mutual promises herein, the Parties agree as follows:

2. DEFINITIONS

"Action" — Has the meaning in Recital A.

"Business Day" — Any day other than Saturday, Sunday, or an Ohio state holiday.

"Claim" — Has the meaning in Recital A and includes any "medical claim" as defined in Ohio Rev. Code § 2305.113(E)(3).

"Confidential Information" — Has the meaning in Section 5.2.

"Court" — The Court of Common Pleas of [COUNTY], Ohio, or such other Ohio court of competent jurisdiction.

"Effective Date" — The date set forth in Section 1.1.

"Liens" — Any statutory, contractual, or equitable right of reimbursement asserted against the Settlement Amount, including Medicare (42 U.S.C. § 1395y(b)(2)), Medicaid (Ohio Rev. Code § 5160.37), ERISA plans, hospital liens (Ohio Rev. Code § 3729.01), workers' compensation subrogation (Ohio Rev. Code § 4123.93), and private health-plan rights.

"Noneconomic Damages Cap" — The limits on noneconomic loss set forth in Ohio Rev. Code § 2323.43.

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

"Released Claims" — Has the meaning in Section 7.2(a).

"Released Parties" — Has the meaning in Section 7.2(b).

"Settlement Amount" — The total monetary consideration paid pursuant to Section 3.1.

"Settlement Payment Date" — The date payment is due under Section 3.1.

3. SETTLEMENT CONSIDERATION & PAYMENT

3.1 Payment of Settlement Amount

(a) Provider (or its professional-liability insurer) shall pay the total Settlement Amount of $[SETTLEMENT_AMOUNT] on or before [DATE] (the "Settlement Payment Date") by [wire transfer / certified check] payable to "[Claimant's Counsel] IOLTA Trust Account for the Benefit of [CLAIMANT]" or as otherwise directed in writing.

(b) Allocation (for tax and lien purposes). The Settlement Amount is allocated, in good faith and based on the Parties' agreement, as follows (the Parties acknowledge this allocation is for tax and lien purposes only and is not a determination of liability):

3.2 Structured Settlement (Optional)

☐ The Parties may elect a structured settlement under I.R.C. § 130. If elected, Provider's insurer shall purchase a qualified assignment and annuity from a carrier rated not less than A- by A.M. Best with the schedule and security set forth in Schedule 3.2.

3.3 Dismissal of Action

Within five (5) Business Days after Provider's delivery of the Settlement Amount and Claimant's confirmation of lien resolution under Section 7.3, Claimant shall file an Entry of Dismissal with prejudice of the Action under Ohio R. Civ. P. 41(A), each Party bearing its own fees and costs except as otherwise provided herein.

3.4 Conditions Precedent

Provider's obligation to pay is conditioned upon: (a) execution by all Parties (including spouse, if any, for consortium); (b) delivery of an executed IRS Form W-9 by Claimant's counsel; (c) executed dismissal entry held in escrow pending funding; and (d) reasonable lien-resolution documentation under Section 7.3.

4. REPRESENTATIONS & WARRANTIES

4.1 Mutual Authority. Each Party has full authority to enter into and perform this Agreement.

4.2 No Assignment of Claims. Claimant represents that no portion of the Claim has been assigned, pledged, or conveyed.

4.3 Capacity; Counsel. Claimant represents that Claimant is of full age and sound mind, has had the advice of independent counsel, and enters this Agreement voluntarily.

4.4 Liens Disclosure. Claimant has disclosed all known Liens on Schedule 4.4 and will satisfy them from the Settlement Amount.

4.5 Medicare Status. Claimant ☐ is / ☐ is not a Medicare beneficiary; if applicable, the Parties have considered Medicare's interests consistent with 42 U.S.C. § 1395y(b)(2).

4.6 Survival. Sections 4.1–4.5 survive the Effective Date.

5. COVENANTS; CONFIDENTIALITY; NON-DISPARAGEMENT

5.1 NPDB & Reporting.
(a) The Parties acknowledge that payments made for the benefit of a practitioner in settlement of a written medical-malpractice claim must be reported to the NPDB under 42 U.S.C. § 11131. Provider's insurer shall make any required NPDB report consistent with its statutory obligations.
(b) Provider shall comply with reporting obligations to the State Medical Board of Ohio under Ohio Rev. Code § 3929.302 and Medical Board reporting rules.

5.2 Confidentiality. Except as required by law (including NPDB and Medical Board reporting, court filings, tax filings, and lien resolution), the Parties shall keep the terms and amount of this Agreement confidential. Permitted disclosures: legal/tax/financial advisors, insurers/reinsurers, immediate family, and as compelled by subpoena (with prompt notice to the other Party where lawful).

5.3 Non-Disparagement. Each Party agrees not to make any public statement intended to defame or disparage the other concerning the Claim or the Action. This Section does not restrict truthful statements required by law, regulator request, or judicial proceeding, nor any reports under Section 5.1.

5.4 No Admission of Liability. This Agreement is a compromise of a disputed claim and is not an admission of liability or wrongdoing.

5.5 Notice & Cure. A Party alleging breach shall give written notice and a [10]-Business-Day cure period before exercising remedies under Section 6.

6. DEFAULT & REMEDIES

6.1 Events of Default. (a) Provider fails to deliver payment when due; (b) Claimant fails to file the dismissal within the period in Section 3.3; (c) breach of confidentiality (Section 5.2) or non-disparagement (Section 5.3).

6.2 Remedies.
(a) Provider Default. Upon uncured default, Claimant may file with the Court a stipulated judgment for the unpaid Settlement Amount plus statutory interest under Ohio Rev. Code § 1343.03, plus reasonable attorneys' fees and costs.
(b) Claimant Default. Provider may seek dismissal with prejudice and recover reasonable attorneys' fees incurred to enforce this Agreement.

6.3 Attorneys' Fees. The prevailing Party in any enforcement action shall recover reasonable attorneys' fees and costs.

7. RISK ALLOCATION; MUTUAL RELEASE; LIENS

7.1 Limitation of Liability. Provider's aggregate liability arising from or related to the Claim shall not exceed the Settlement Amount.

7.2 Mutual Release.
(a) Released Claims. "Released Claims" means any and all past, present, or future claims, demands, causes of action, damages, or liabilities — known or unknown, suspected or unsuspected, vested or contingent — arising out of or related to the Claim, the medical care at issue, or the Action, including any medical claim under Ohio Rev. Code § 2305.113, wrongful-death claims under Ohio Rev. Code ch. 2125 (if applicable and signed by all statutory beneficiaries), loss of consortium, and any claim for spoliation or bad faith.
(b) Released Parties. "Released Parties" include the Parties and their respective parents, subsidiaries, affiliates, insurers, reinsurers, officers, directors, agents, employees (including named and unnamed providers, residents, nurses, and staff identified on Schedule 7.2), successors, and assigns.
(c) Release. Each Party fully and forever releases the other Party and all Released Parties from the Released Claims.
(d) Unknown Claims. Claimant understands that the released matters may include unknown or unsuspected claims and expressly assumes that risk; Claimant intends this release to be a full and final accord and satisfaction.

7.3 Liens; Indemnity for Liens.
(a) Claimant shall, from the Settlement Amount, fully resolve all Liens listed on Schedule 4.4 and any later-discovered Liens.
(b) Claimant shall indemnify, defend, and hold harmless Provider and its insurer from any Lien claim asserted against the Settlement Amount, including any Medicare Secondary Payer recovery action.
(c) ☐ The Parties have considered Medicare's interests; ☐ a Medicare Set-Aside ("MSA") is / is not required; if required, the MSA terms are on Schedule 7.3.

7.4 Tax Treatment.
(a) The Parties intend that amounts allocated to personal physical injuries or physical sickness be excludable from Claimant's gross income under I.R.C. § 104(a)(2). Amounts allocated to non-physical injuries, punitive damages, or interest may be taxable.
(b) Each Party is responsible for its own tax obligations and shall consult independent tax counsel. Neither Party has made any tax representation to the other.
(c) Provider shall issue IRS Form 1099 only as required by law.

7.5 No Further Obligations. Other than the obligations expressly set forth herein, no party has any continuing obligation to the other arising out of the Claim.

8. DISPUTE RESOLUTION

8.1 Governing Law. This Agreement is governed by Ohio law without regard to conflict-of-laws principles.

8.2 Forum. Any civil action arising under this Agreement shall be brought exclusively in the Court of Common Pleas of [COUNTY], Ohio, which retains jurisdiction to enforce this Agreement consistent with State ex rel. Cincinnati Enquirer v. Cincinnati Bd. of Educ.

8.3 Arbitration (Optional). ☐ Upon written mutual election within [10] Business Days of the Effective Date, disputes shall be resolved by binding arbitration administered by AAA before a single Ohio-licensed arbitrator under the AAA Commercial Arbitration Rules.

8.4 Jury Trial Waiver (Optional). ☐ The Parties knowingly waive the right to a jury trial in any action arising out of this Agreement.

9. GENERAL PROVISIONS

9.1 Amendments; Waivers. Only in a writing signed by both Parties.

9.2 Assignment. No assignment without written consent, except Provider's insurer may pay directly.

9.3 Successors & Assigns. Binds and benefits the Parties and their permitted successors.

9.4 Severability. If any provision is held invalid, the remainder remains in force.

9.5 Entire Agreement. This Agreement (with Schedules) is the entire understanding and supersedes all prior negotiations.

9.6 Counterparts; E-Signatures. Counterparts and electronic signatures are deemed originals.

9.7 Construction. Headings for convenience; drafter rule waived.

9.8 Notices. Delivered to the addresses in Section 1.1 by personal delivery, overnight courier, or certified mail.

10. EXECUTION BLOCK

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

Notary Acknowledgment (Ohio)

State of Ohio
County of ______________

The foregoing instrument was acknowledged before me this [___] day of [__________], 20[__], by [CLAIMANT NAME], who is personally known to me or has produced [___________] as identification.

_____________________________________
Notary Public — State of Ohio
My commission expires: ________________

SCHEDULES

• Schedule 3.2 — Structured Settlement / Periodic Payment Schedule (if elected)
• Schedule 4.4 — Disclosed Liens and Reimbursement Claims
• Schedule 7.2 — Additional Released Practitioners and Entities
• Schedule 7.3 — Medicare Set-Aside Terms (if applicable)

SOURCES AND REFERENCES

• Ohio Rev. Code § 2323.43 (noneconomic-damages cap): https://codes.ohio.gov/ohio-revised-code/section-2323.43
• Ohio Rev. Code § 2323.451 (affidavit of merit): https://codes.ohio.gov/ohio-revised-code/section-2323.451
• Ohio R. Civ. P. 10(D)(2) (affidavit of merit)
• Ohio Rev. Code § 2305.113 (medical-claim SOL / 4-year repose): https://codes.ohio.gov/ohio-revised-code/section-2305.113
• Ohio Rev. Code § 2317.43 (apology inadmissibility)
• 42 U.S.C. § 11131 (NPDB malpractice-payment reporting)
• 42 U.S.C. § 1395y(b)(2) (Medicare Secondary Payer)
• I.R.C. § 104(a)(2) (personal-injury exclusion)

This template is provided for informational purposes only and should be reviewed by qualified Ohio counsel before use. Verify the current constitutional status of ORC § 2323.43 — challenges are pending in Ohio appellate courts.