MEDICAL MALPRACTICE SETTLEMENT AGREEMENT
(Pennsylvania – Comprehensive Template)
[// GUIDANCE: This template is drafted for use in settling Pennsylvania medical-malpractice claims. It assumes (1) settlement will be paid by the Provider and/or its Insurer; (2) no injunctive relief is contemplated; (3) the parties will exchange mutual releases; and (4) liability will be capped at the agreed Settlement Amount. Modify all bracketed items before execution.]
TABLE OF CONTENTS
- Document Header
- Definitions
- Operative Provisions
- Representations & Warranties
- Covenants & Restrictions
- Default & Remedies
- Risk Allocation
- Dispute Resolution
- General Provisions
- Execution Block
- Exhibits & Schedules
1. DOCUMENT HEADER
Medical Malpractice Settlement Agreement (“Agreement”) made and entered into effective as of [EFFECTIVE DATE] (the “Effective Date”) by and among:
a. [CLAIMANT FULL LEGAL NAME], [status, e.g., an adult individual / Administrator of the Estate of …], with an address at [ADDRESS] (“Claimant”);
b. [PROVIDER FULL LEGAL NAME], [legal form], licensed to practice [profession] in the Commonwealth of Pennsylvania, with an address at [ADDRESS] (“Provider”); and
c. [INSURER FULL LEGAL NAME], [NAIC #], authorized to transact insurance in Pennsylvania, with an address at [ADDRESS] (“Insurer”).
Claimant, Provider, and Insurer are each a “Party” and together the “Parties.”
1.1 Recitals
A. Claimant has asserted claims arising from alleged medical negligence occurring on or about [DATE(S) OF TREATMENT] at [FACILITY] (the “Incident”).
B. Provider and Insurer deny all liability but desire to resolve the Dispute (defined below) without further litigation.
C. The Parties enter into this Agreement in consideration of the mutual promises herein and other good and valuable consideration, the sufficiency of which is acknowledged.
NOW, THEREFORE, in consideration of the foregoing and the covenants contained herein, the Parties agree as follows:
2. DEFINITIONS
For ease of reference, capitalized terms are defined alphabetically below. Undefined capitalized terms have the meanings assigned in the body of this Agreement.
“Agreement” has the meaning given in the preamble.
“Applicable Law” means all federal, state, and local statutes, regulations, and rules governing the subject matter of this Agreement, including without limitation the Pennsylvania Medical Care Availability and Reduction of Error Act, 40 P.S. § 1303.101 et seq. (“MCARE Act”), and the federal Health Care Quality Improvement Act, 42 U.S.C. § 11131.
“Dispute” means all claims, suits, actions, causes of action, damages (including wrongful-death or survival claims), costs, expenses, and liabilities of any nature arising from the Incident.
“Payment Schedule” has the meaning set forth in Section 3.2.
“Release” has the meaning set forth in Section 7.1.
“Settlement Amount” means the total consideration described in Section 3.1, inclusive of attorneys’ fees, costs, interest, liens, and all forms of damages.
“Structured Settlement” means periodic payments purchased through an annuity contract pursuant to Section 3.2(b).
3. OPERATIVE PROVISIONS
3.1 Consideration & Settlement Amount
Provider and/or Insurer shall pay the Claimant the aggregate Settlement Amount of $[NUMERIC AMOUNT] (the “Settlement Amount”), subject to the liability cap in Section 7.2, and in full satisfaction of the Dispute.
3.2 Payment Mechanics
a. Lump-Sum Option. Unless the Structured Settlement option in Section 3.2(b) is affirmatively elected, the Settlement Amount shall be paid in one lump sum by wire transfer or certified check within [NUMBER] business days after (i) Provider’s receipt of an executed Release and (ii) court approval, if required.
b. Structured Settlement Option. At Claimant’s election, all or part of the Settlement Amount shall be funded through a structured settlement as follows (the “Payment Schedule”):
i. Annuity Issuer: [LIFE-COMPANY NAME] (rated not less than A.M. Best “A” or equivalent).
ii. Assignment Company: [NAME].
iii. Periodic Payments: [Specify amounts & dates].
iv. Commutation/Spendthrift: Payments shall be non-assignable and subject to Pennsylvania Structured Settlement Protection Act, 40 P.S. § 4001 et seq.
[// GUIDANCE: For minors or incapacitated persons, insert required language referencing Pa. R.C.P. 2039 and court-approval procedures in Exhibit __.]
3.3 Conditions Precedent
Provider’s obligation to fund the Settlement Amount is conditioned upon:
a. Execution and delivery of the Release;
b. Delivery of any Medicare/Medicaid lien resolution documentation;
c. Receipt of necessary court approvals under Pa. R.C.P. 2039 or 2206, if applicable; and
d. Receipt of dismissal with prejudice or a praecipe to discontinue the Action described in Section 4.3.
3.4 Dismissal of Action
Within three (3) business days after receipt of cleared funds (or funding of the structured settlement), Claimant shall file a praecipe to discontinue with prejudice the action styled [CAPTION], pending in the [COURT OF COMMON PLEAS, COUNTY], No. [DOCKET #] (the “Action”).
4. REPRESENTATIONS & WARRANTIES
4.1 Mutual Representations. Each Party represents and warrants that:
1. It has full authority, legal right, and capacity to enter into and perform this Agreement.
2. The execution and performance of this Agreement do not and will not violate any other agreement or Applicable Law.
3. No assignment, sale, or transfer of any interest in the Dispute has been made.
4.2 Claimant Representations. Claimant further represents that:
a. Claimant is the sole person entitled to assert the Dispute (or is duly authorized on behalf of the estate/minor).
b. Claimant has made full disclosure of all known liens, assignments, and subrogation interests (collectively “Liens”).
4.3 Provider/Insurer Representations. Provider and Insurer represent that:
a. All necessary corporate or regulatory approvals for entering into this Agreement have been obtained.
b. Professional liability insurance coverage is in effect for the Incident.
4.4 Survival. The representations and warranties in this Section survive the Effective Date and the payment of the Settlement Amount.
5. COVENANTS & RESTRICTIONS
5.1 Confidentiality. Except as required by Applicable Law, court order, or regulatory reporting (Section 5.2), the Parties shall keep the terms of this Agreement strictly confidential.
5.2 Mandatory Reporting.
a. Insurer shall report payment of the Settlement Amount to the National Practitioner Data Bank in compliance with 42 U.S.C. § 11131 and 45 C.F.R. Part 60.
b. Provider shall comply with MCARE Act reporting obligations, including submission of any required reports to the Pennsylvania Insurance Department.
5.3 Non-Disparagement. Each Party shall refrain from any statement intended to harm the professional reputation of another Party regarding the Incident or this settlement.
5.4 Tax Matters. Claimant acknowledges that Provider/Insurer have made no representations regarding tax treatment under 26 U.S.C. § 104 or otherwise. Claimant shall obtain independent tax advice.
5.5 Medicare/Medicaid Compliance. Claimant shall satisfy and hold the Released Parties harmless against any conditional payments, Medicare Set-Asides, or other reimbursement obligations arising from the Incident.
6. DEFAULT & REMEDIES
6.1 Events of Default.
a. Failure to fund the Settlement Amount when due;
b. Failure to execute or deliver required documents;
c. Breach of confidentiality or non-disparagement provisions.
6.2 Cure Period. The defaulting Party shall have five (5) business days after written notice to cure a monetary default and ten (10) business days to cure any non-monetary default.
6.3 Remedies. Upon uncured default, the non-defaulting Party may, at its election:
1. Enforce specific performance;
2. Obtain judgment for any unpaid portion of the Settlement Amount plus interest at [RATE]% per annum;
3. Seek sanctions, costs, and attorneys’ fees incurred in enforcement.
6.4 Attorneys’ Fees. The prevailing Party in any enforcement action shall be entitled to recover reasonable attorneys’ fees and costs.
7. RISK ALLOCATION
7.1 Mutual Release.
Upon receipt of the Settlement Amount, Claimant, on behalf of themself, their heirs, executors, administrators, successors, and assigns (collectively the “Releasors”), irrevocably and unconditionally releases and forever discharges Provider, Insurer, and their respective parents, subsidiaries, affiliates, owners, officers, employees, agents, and insurers (collectively the “Released Parties”) from any and all Disputes, whether known or unknown, suspected or unsuspected, arising from or relating to the Incident.
Provider and Insurer, on behalf of themselves and the Released Parties, release Claimant from all claims arising from the Incident.
[// GUIDANCE: If Medicare final settlement language or CMS waiver is required, insert here.]
7.2 Liability Cap & Damage Limitation.
The Settlement Amount constitutes the entire liability of the Released Parties. Claimant expressly waives any right to punitive damages in excess of the cap set forth in 40 P.S. § 1303.505 (punitive damages limited to 200% of the compensatory award, with 25% payable to the MCARE Fund).
7.3 No Admission of Liability.
This Agreement is a compromise of disputed claims and is not, and shall not be construed as, an admission of liability or fault by any Party.
7.4 Insurance.
Provider represents that the Settlement Amount (inclusive of costs) does not exceed applicable policy limits. No additional insurance obligations are imposed by this Agreement.
7.5 Force Majeure.
No Party shall be liable for delay in performance due to events beyond its reasonable control, provided such Party gives prompt notice and resumes performance as soon as practicable.
8. DISPUTE RESOLUTION
8.1 Governing Law. This Agreement shall be governed by and construed in accordance with the substantive laws of the Commonwealth of Pennsylvania without regard to conflict-of-laws principles.
8.2 Forum Selection. The Parties consent to exclusive jurisdiction and venue in the Court of Common Pleas of [COUNTY], Pennsylvania.
8.3 Optional Arbitration. [ARBITRATION ☐ ELECTED / ☐ NOT ELECTED]
If elected, any dispute arising from this Agreement shall be resolved by binding arbitration under the Pennsylvania Uniform Arbitration Act, 42 Pa.C.S. § 7301 et seq., before a single arbitrator experienced in medical-malpractice matters. Judgment on the award may be entered in any court of competent jurisdiction.
8.4 Optional Jury Waiver. [JURY WAIVER ☐ ELECTED / ☐ NOT ELECTED]
IF ELECTED, EACH PARTY KNOWINGLY AND VOLUNTARILY WAIVES ANY RIGHT TO A TRIAL BY JURY IN ANY ACTION OR PROCEEDING ARISING FROM THIS AGREEMENT OR THE DISPUTE.
9. GENERAL PROVISIONS
9.1 Entire Agreement. This instrument constitutes the entire agreement of the Parties and supersedes all prior negotiations or understandings.
9.2 Amendments & Waivers. No amendment or waiver is effective unless in writing and signed by all Parties. No waiver constitutes a continuing waiver unless expressly stated.
9.3 Assignment. No Party may assign its rights or delegate its duties without the prior written consent of the other Parties, except that Insurer may assign to its reinsurers.
9.4 Successors & Assigns. This Agreement binds and benefits the Parties and their respective successors and permitted assigns.
9.5 Severability. If any provision is held invalid, the remaining provisions shall remain in full force, and the invalid provision shall be reformed to the minimum extent necessary to effectuate the Parties’ intent.
9.6 Headings; Interpretation. Headings are for convenience only and do not affect interpretation. The singular includes the plural and vice versa; “including” means “including without limitation.”
9.7 Counterparts; Electronic Signatures. This Agreement may be executed in counterparts, each of which is deemed an original, and all of which constitute one instrument. Signatures transmitted electronically (e.g., via PDF or DocuSign) are binding to the same extent as original signatures under 15 U.S.C. § 7001 et seq. (E-SIGN Act).
9.8 Further Assurances. Each Party shall execute and deliver any additional documents reasonably necessary to carry out the purposes of this Agreement.
10. EXECUTION BLOCK
IN WITNESS WHEREOF, the Parties have executed this Medical Malpractice Settlement Agreement as of the Effective Date.
| CLAIMANT | PROVIDER | INSURER |
|---|---|---|
| _________ [NAME] |
_________ [NAME & TITLE] For: [PROVIDER] |
_________ [NAME & TITLE] For: [INSURER] |
[Attach corporate resolutions or physician authorization if required.]
NOTARY ACKNOWLEDGMENT (if required)
State of Pennsylvania )
County of ____ ) SS:
Subscribed and sworn before me on //20__, by ________.
Notary Public
My Commission Expires: _____
11. EXHIBITS & SCHEDULES
Exhibit A – Mutual Release (if executed separately)
Exhibit B – Payment Schedule/Annuity Contract (Structured Settlement)
Exhibit C – Lien Resolution Affidavit
Exhibit D – Court Approval Order (if minor or estate claim)
[// GUIDANCE: Delete or add exhibits to match transaction specifics.]
© [YEAR] Senior Legal Drafting Services. All rights reserved. This template is provided for professional use only and is not legal advice.