Virginia Medical Malpractice Settlement Agreement and Release

VIRGINIA MEDICAL MALPRACTICE SETTLEMENT AGREEMENT AND RELEASE

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

RELEASOR / CLAIMANT: [________________________________], residing at [________________________________] ("Claimant"); [☐ individually / ☐ as Administrator of the Estate of [________________________________], deceased, pursuant to Va. Code § 8.01-55] ;

RELEASED PARTIES:

• [________________________________], M.D., Virginia License No. [____________] ("Healthcare Provider");
• [________________________________], a [Virginia / foreign] [professional corporation / hospital / health system] ("Facility");
• [________________________________] Insurance Company ("Insurer"); and
• their respective officers, directors, employees, agents, partners, affiliates, successors, assigns, insurers, reinsurers, and attorneys (collectively, "Released Parties").

Claimant and Released Parties are collectively the "Parties."

RECITALS

A. Claimant alleged that on or about [__/__/____] (the "Date of Negligent Act"), Released Parties provided medical care that breached the Virginia standard of care, causing personal injury [or death], as set forth in [Complaint Caption / Pre-Suit Demand] (the "Claim").

B. Pursuant to Va. Code § 8.01-20.1, Claimant [☐ obtained / ☐ would be required to obtain] expert certification of merit prior to service of process.

C. Claimant filed (or threatened to file) the Claim in [Circuit Court for ____________ County, Virginia] [Case No. ____________].

D. Released Parties deny all liability. The Parties wish to compromise the Claim to avoid the cost and uncertainty of litigation.

1. SETTLEMENT CONSIDERATION

1.1 Total Settlement Amount. Released Parties (through Insurer) shall pay Claimant the total sum of $[__________] (the "Settlement Amount"). The Parties acknowledge that the Settlement Amount is within the applicable Virginia damages cap under Va. Code § 8.01-581.15 for acts occurring on the Date of Negligent Act ([__/__/____]); the cap for that period is $[__________] (current cap: $2.70 million for acts 7/1/2025–6/30/2026; $50,000 increase each July 1).

1.2 Payment Structure.

☐ Lump Sum: $[__________] within [____] days of the latest of (i) full execution; (ii) court approval (if required); (iii) Medicare/Medicaid lien resolution per Section 4.

☐ Structured Settlement: Initial cash payment of $[__________] plus periodic payments per Exhibit A (qualified assignment under 26 U.S.C. § 130).

1.3 Allocation. The Settlement Amount is allocated as follows for tax and lien purposes:

1.4 Tax Treatment. The Parties intend that amounts paid on account of personal physical injuries or sickness be excludable from gross income under 26 U.S.C. § 104(a)(2). Each Party shall consult independent tax counsel; this Agreement is not tax advice.

2. COURT APPROVAL (If Required)

2.1 Approval Required. Court approval is required if any of the following apply:

☐ Claimant is a minor or incapacitated person (Va. Code § 8.01-424; Va. Code § 8.01-9)
☐ Wrongful death settlement under Va. Code § 8.01-55 (approval and apportionment among statutory beneficiaries)
☐ Conservator / fiduciary on behalf of incapacitated adult

2.2 Filing. Counsel for Claimant shall promptly petition the [Circuit Court for ____________ County] for approval, apportionment, and (where applicable) appointment of a guardian ad litem.

3. RELEASE OF CLAIMS

3.1 General Release. In consideration of the Settlement Amount, Claimant fully and forever releases, acquits, and discharges Released Parties from any and all claims, demands, actions, causes of action, damages, costs, attorneys' fees, expenses, and liabilities of every kind, whether known or unknown, suspected or unsuspected, arising out of or in any way related to the Claim and the Date of Negligent Act.

3.2 Joint Tortfeasor Effect. Pursuant to Va. Code § 8.01-35.1, this release of Released Parties shall not discharge any other tortfeasor unless its terms so provide, but shall reduce any claim against other tortfeasors to the extent provided by statute.

3.3 Reserved Claims. [☐ None / ☐ The following claims are expressly reserved: [________________________________]].

3.4 Covenant Not to Sue. Claimant covenants not to bring, file, or prosecute any action against Released Parties relating to the Claim.

3.5 Indemnity. Claimant shall indemnify Released Parties against any subrogation, lien, or contribution claim asserted by any third party against Released Parties arising from the Claim (subject to the lien resolution procedures in Section 4).

4. LIENS, SUBROGATION, AND MEDICARE/MEDICAID

4.1 Medicare Secondary Payer (MSP). The Parties acknowledge obligations under 42 U.S.C. § 1395y(b)(2) and 42 C.F.R. Part 411. Claimant represents Claimant [☐ is / ☐ is not] a Medicare beneficiary. If a beneficiary, Claimant shall (i) provide CMS with notice through the BCRC/CRC, (ii) obtain a Final Demand or Conditional Payment Letter, and (iii) satisfy Medicare's recovery claim from the Settlement Amount before disbursement to Claimant.

4.2 Medicare Set-Aside (MSA). Future medicals MSA: [☐ Not required / ☐ MSA of $[__________] funded per Exhibit B].

4.3 Medicaid Lien. Pursuant to Va. Code § 8.01-66.9 and § 38.2-3445.01, the Virginia Department of Medical Assistance Services lien is [☐ N/A / ☐ $[__________], to be satisfied at closing].

4.4 Section 111 Reporting. Insurer shall comply with Mandatory Insurer Reporting under 42 U.S.C. § 1395y(b)(8).

4.5 ERISA / Private Health Plan Liens. Claimant's counsel shall resolve any ERISA or private health-plan subrogation claims (e.g., US Airways v. McCutchen, 569 U.S. 88 (2013)).

4.6 Hospital / Provider Liens. Any Va. Code § 8.01-66.2 lien shall be satisfied from the Settlement Amount.

5. NPDB AND REGULATORY REPORTING

5.1 NPDB Reporting. The Parties acknowledge that any payment by or on behalf of a healthcare practitioner in settlement of a written claim must be reported to the National Practitioner Data Bank under 45 C.F.R. § 60.7 within 30 days. Insurer/Facility shall comply with such reporting; Claimant shall not impede or restrict such reporting. Provisions purporting to prevent NPDB reporting are void.

5.2 Virginia Board of Medicine. Insurer shall report as required under Va. Code § 38.2-2228.1 and § 54.1-2400.6.

5.3 No Effect on Discipline. This Agreement does not preclude any state Board action or peer review proceeding.

6. CONFIDENTIALITY AND NON-DISPARAGEMENT

6.1 Confidentiality of Terms. The financial terms of this Agreement shall remain confidential except disclosures (i) required by law (including NPDB, Medicare, tax, court approval); (ii) to attorneys, accountants, tax advisors, and lienholders; (iii) to immediate family bound by similar confidentiality; (iv) to enforce this Agreement.

6.2 Non-Disparagement. The Parties shall not make disparaging statements about each other. Nothing herein restricts truthful communications with regulators, the Virginia Board of Medicine, law enforcement, accreditation bodies, or as required by law.

6.3 No Gag on Patient Safety Reporting. Nothing in this Agreement is intended to restrict reporting of patient safety concerns to any governmental authority or accreditation body, and any such restriction would be void as against public policy.

7. NO ADMISSION OF LIABILITY

This Agreement is a compromise of disputed claims. Released Parties expressly deny liability and any admission of fault, wrongdoing, or substandard care.

8. GENERAL PROVISIONS

8.1 Governing Law. This Agreement is governed by the laws of the Commonwealth of Virginia.

8.2 Venue. Exclusive venue in the Circuit Court for [____________] County, Virginia.

8.3 Entire Agreement. This Agreement, including Exhibits, is the entire agreement and supersedes all prior negotiations.

8.4 Amendment. Written and signed by all Parties.

8.5 Severability. Unenforceable provisions shall be reformed or severed.

8.6 Counterparts; Electronic Signatures. Permitted under Va. Code § 59.1-479 et seq.

8.7 Voluntary Execution. Each Party acknowledges (i) reading this Agreement; (ii) having opportunity to consult counsel; (iii) signing voluntarily.

SIGNATURES

NOTARIZATION (Claimant)

Commonwealth of Virginia, [____________] County/City, to wit:

The foregoing instrument was acknowledged before me this [__/__/____] by [________________________________].

Notary Public: [__________________________] Registration No.: [____________] Commission Expires: [__/__/____]

EXHIBITS

• Exhibit A — Structured Settlement Schedule and Qualified Assignment
• Exhibit B — Medicare Set-Aside Allocation (if applicable)
• Exhibit C — Lien Resolution Documentation
• Exhibit D — Court Order Approving Settlement (minor/wrongful death, if applicable)

SOURCES AND REFERENCES

• Va. Code § 8.01-581.15 (Med-mal cap; $2.70M for acts 7/1/2025–6/30/2026): https://law.lis.virginia.gov/vacode/title8.01/chapter21.1/section8.01-581.15/
• Va. Code § 8.01-20.1 (Expert certification): https://law.lis.virginia.gov/vacode/title8.01/chapter3/section8.01-20.1/
• Va. Code § 8.01-35.1 (Joint tortfeasor release)
• Va. Code § 8.01-55 (Wrongful death apportionment)
• Va. Code § 8.01-66.2, § 8.01-66.9 (Hospital and Medicaid liens)
• 42 U.S.C. § 1395y(b); 42 C.F.R. Part 411 (Medicare Secondary Payer)
• 45 C.F.R. Part 60 (NPDB Reporting); 42 U.S.C. §§ 11131-11137
• 26 U.S.C. § 104(a)(2) (Tax exclusion for personal physical injury)

This template is for informational purposes only and is not legal, tax, or medical advice. Confirm the applicable Va. Code § 8.01-581.15 cap based on the date of the alleged negligent act and complete Medicare/Medicaid/ERISA lien resolution before disbursement.