Medical Malpractice Settlement Agreement and Mutual Release

MEDICAL MALPRACTICE SETTLEMENT AGREEMENT AND MUTUAL RELEASE

(Oregon)

TABLE OF CONTENTS

1. Document Header
2. Definitions
3. Operative Provisions (Payment / Lien Resolution / Dismissal)
4. Representations & Warranties
5. Covenants & Restrictions (Confidentiality / Non-Disparagement / NPDB)
6. Default & Remedies
7. Risk Allocation (Release / 1542-Equivalent / Tax)
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 made 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 LEGAL NAME], a [LEGAL ENTITY TYPE] organized under the laws of Oregon 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 Provider's medical services 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 Oregon for [COUNTY] County (the "Action").
C. The Parties wish to fully and finally resolve the Claim and the Action without admission of liability, in accordance with Oregon law and applicable federal law (including 42 U.S.C. § 11131-11137 (NPDB) and 42 U.S.C. § 1395y(b)(2) (Medicare Secondary Payer)).

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

2. DEFINITIONS

☐ "Action" — has the meaning in Recital B.

☐ "Business Day" — any day other than Saturday, Sunday, or an Oregon state holiday.

☐ "Claim" — has the meaning in Recital A.

☐ "Confidential Information" — has the meaning in Section 5.2.

☐ "Court" — the Circuit Court of Oregon for [COUNTY] County, or such other court with jurisdiction.

☐ "Effective Date" — has the meaning in Section 1.1.

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

☐ "OTCA" — Oregon Tort Claims Act, ORS 30.260 et seq.

☐ "Released Claims" — has the meaning in Section 7.2.

☐ "Released Parties" — has the meaning in Section 7.2.

☐ "Settlement Amount" — total monetary consideration under Section 3.1.

☐ "Settlement Payment Date" — the date in Section 3.1 by which payment is due.

3. OPERATIVE PROVISIONS

3.1 Payment of Settlement Amount

(a) Provider shall pay (or cause to be paid) to [CLAIMANT / CLAIMANT'S COUNSEL'S TRUST ACCOUNT] the total Settlement Amount of $[SETTLEMENT_AMOUNT] on or before the Settlement Payment Date of [DATE], by [WIRE TRANSFER / CASHIER'S CHECK] payable to [PAYEE].

(b) Allocation. The Settlement Amount encompasses: (i) economic damages; (ii) noneconomic damages (no statutory cap applies to common-law medical malpractice claims under Oregon law per Klutschkowski v. PeaceHealth, 354 Or 150 (2013) — verify current authority); (iii) attorneys' fees and costs; and (iv) all statutory liens, subrogation, or reimbursement claims (e.g., Medicare, Oregon Health Plan / Medicaid, ERISA), subject to Section 3.3.

3.2 Structured Settlement (Optional)

If the Parties elect a Structured Settlement:
(a) Election. Provider's insurer shall purchase a qualified assignment and annuity from an issuer rated not less than A- by A.M. Best.
(b) Schedule. $[AMOUNT] annually beginning [DATE] for [TERM] years; balloon payment of $[AMOUNT] on [DATE].
(c) Present Value. Actuarially equal to the Settlement Amount.
(d) Security. Annuity issuer and assignee shall be jointly and severally liable; no acceleration or commutation absent mutual written consent.

3.3 Lien Resolution (Medicare / Medicaid / ERISA)

(a) MSP Compliance. The Parties have considered Medicare's interests under 42 U.S.C. § 1395y(b)(2) and the Medicare Secondary Payer Act, and have reported (or will report) the settlement consistent with Section 111 of the Medicare, Medicaid, and SCHIP Extension Act.
(b) Medicare Set-Aside. A Medicare Set-Aside in the amount of $[AMOUNT] [IS / IS NOT] established. Where established, funds shall be administered per CMS guidelines.
(c) Oregon Health Plan / Medicaid. Claimant shall satisfy any DHS/OHA lien from settlement proceeds prior to distribution.
(d) ERISA / Private Health Plan Liens. All known liens are listed on Schedule 3.3 and will be resolved at or before distribution.
(e) Claimant indemnifies Provider for any lien Claimant fails to satisfy.

3.4 Dismissal of Action

Within five (5) Court Days after delivery of the Settlement Amount (or funded structured settlement), Claimant shall file a General Judgment of Dismissal with prejudice in the Action, each Party to bear its own fees and costs except as otherwise provided.

3.5 Conditions Precedent

Provider's payment obligation is conditioned upon: (a) full execution; (b) executed IRS Form W-9 by Claimant's counsel; (c) delivery of dismissal documents in escrow with [ESCROW AGENT]; and (d) Medicare query/compliance.

3.6 Pre-Suit Notice Compliance (If Applicable)

The Parties acknowledge that any pre-suit notice or mandatory dispute resolution required by ORS 31.250-31.260 (where applicable) has been satisfied or waived in connection with this settlement.

4. REPRESENTATIONS & WARRANTIES

4.1 Mutual Authority. Each Party represents it has full power and authority to enter and perform this Agreement.

4.2 No Assignment of Claims. Claimant represents no part of the Claim has been assigned, pledged, or conveyed to any third party.

4.3 Liens. Claimant represents all known liens are listed on Schedule 3.3 and will be satisfied from the Settlement Amount.

4.4 Capacity. Claimant represents Claimant is of sound mind and not under any incapacity affecting the validity of this Agreement; if Claimant is a minor or protected person, court approval is being sought.

4.5 Survival. Sections 4.1-4.4 survive for eighteen (18) months following the Effective Date.

5. COVENANTS & RESTRICTIONS

5.1 NPDB / Oregon Medical Board Reporting.

The Parties acknowledge that any payment made on behalf of a licensed practitioner must be reported to the NPDB and applicable Oregon licensing authority. Nothing in this Agreement waives, modifies, or impairs that obligation.

5.2 Confidentiality. Except as required by law (including NPDB and Oregon Medical Board reporting), the Parties shall keep the terms confidential. Permitted disclosures: tax advisors, insurers, immediate family, attorneys, and the Court.

5.3 Non-Disparagement. Neither Party shall make statements intended to defame or disparage the other concerning the Claim or the Action. This Section does not prohibit truthful statements made in legal proceedings or to regulators.

5.4 No Future Treatment. [OPTIONAL] Claimant agrees not to seek treatment from Provider or its affiliated physicians for [CONDITION] absent emergency, subject to professional duties.

5.5 Notice & Cure. A Party alleging breach shall provide written notice and a ten (10) Business Day cure period before exercising any remedy.

6. DEFAULT & REMEDIES

6.1 Events of Default. (a) Provider fails to deliver payment when due; (b) Claimant fails to file dismissal timely; (c) breach of confidentiality under Section 5.2.

6.2 Remedies.
(a) Provider Default. Claimant may move the Court to enter a stipulated judgment for the unpaid Settlement Amount plus interest at 9% per annum (ORS 82.010) or such other applicable statutory rate, attorneys' fees, and costs.
(b) Claimant Default. Provider may seek dismissal with prejudice and recover reasonable attorneys' fees.

6.3 Attorneys' Fees. The prevailing Party is entitled to recover reasonable attorneys' fees and costs under ORS 20.083 and applicable Oregon law.

7. RISK ALLOCATION

7.1 Limitation of Liability. Provider's aggregate liability relating to the Claim shall not exceed the Settlement Amount.

7.2 Mutual Release.
(a) Released Claims — any and all past, present, or future claims, demands, causes of action, damages, or liabilities of every kind, whether known or unknown, suspected or unsuspected, arising out of or related to the Claim, the medical care at issue, or the Action.
(b) Released Parties — the Parties and their respective parents, subsidiaries, affiliates, insurers, reinsurers, officers, directors, agents, employees, successors, and assigns.
(c) Release. Each Party fully and forever releases the other Party and all Released Parties from the Released Claims.

7.3 Unknown Claims Waiver (Oregon).

Each Party expressly intends this release to extend to all claims, whether known or unknown, suspected or unsuspected, including those that, if known, would have materially affected the decision to enter into this Agreement. Each Party knowingly assumes the risk of any later discovery of facts different from or in addition to those now known.

7.4 Tax Treatment. The Parties intend that the portion of the Settlement Amount allocable to personal physical injuries or physical sickness be excludable from gross income under IRC § 104(a)(2). The Parties acknowledge that this Agreement is not tax advice and each Party shall consult independent tax counsel. Each Party is responsible for its own tax obligations.

7.5 No Admission of Liability. This Agreement is a compromise of disputed claims. Neither the offer, payment, nor acceptance of consideration constitutes an admission of liability by any Party.

7.6 Force Majeure. Standard force majeure for events beyond reasonable control; payment obligations are not excused.

8. DISPUTE RESOLUTION

8.1 Governing Law. Oregon law governs without regard to conflict-of-laws principles.

8.2 Forum. Exclusive forum is the Circuit Court of Oregon for [COUNTY] County.

8.3 Arbitration (Optional).

At the election of either Party by written notice within ten (10) Business Days of the Effective Date, disputes shall be submitted to binding arbitration before a retired Oregon Circuit or Appellate judge under [AAA / JAMS] rules. Judgment on the award may be entered in any court of competent jurisdiction.

8.4 Jury Trial Waiver (Optional).

The Parties knowingly and voluntarily waive trial by jury in any proceeding arising out of this Agreement.

9. GENERAL PROVISIONS

9.1 Amendments; Waivers. In writing, signed by both Parties.

9.2 Assignment. No assignment without written consent, except Provider may assign to its insurer for payment.

9.3 Successors & Assigns. Binds and benefits successors and permitted assigns.

9.4 Severability. Invalid provisions narrowly construed; remainder remains in effect.

9.5 Entire Agreement. Supersedes all prior negotiations or agreements.

9.6 Counterparts; Electronic Signatures. Executed in counterparts; electronic signatures (per ORS 84.001-84.061) are deemed original.

9.7 Court Approval (If Required). If Claimant is a minor or protected person, this Agreement is contingent on probate court approval under ORS 126.725 (or applicable statute).

10. EXECUTION BLOCK

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

APPROVED AS TO FORM:

SOURCES AND REFERENCES

• ORS 12.110 (Statute of limitations): https://oregon.public.law/statutes/ors_12.110
• ORS 30.260 et seq. (Oregon Tort Claims Act): https://oregon.public.law/statutes/ors_30.260
• ORS 31.710 (Wrongful death noneconomic damages cap — verify status): https://oregon.public.law/statutes/ors_31.710
• ORS 742.405 (Medical malpractice insurance): https://oregon.public.law/statutes/ors_742.405
• Klutschkowski v. PeaceHealth, 354 Or 150 (2013): https://law.justia.com/cases/oregon/supreme-court/2013/s059869.html
• Lakin v. Senco Products, 329 Or 62 (1999) (cap on noneconomic damages struck down)
• NPDB Guidebook: https://www.npdb.hrsa.gov/