Personal Injury Retainer Agreement

CONTINGENCY FEE RETAINER AGREEMENT

Personal Injury Representation

AGREEMENT DATE: [________________________________]

PARTIES TO THIS AGREEMENT

ATTORNEY:
Name: [________________________________]
Firm: [________________________________]
Address: [________________________________]
City, State, Zip: [________________________________]
Phone: [________________________________]
Email: [________________________________]
State Bar Number: [________________________________]

CLIENT:
Name: [________________________________]
Address: [________________________________]
City, State, Zip: [________________________________]
Phone: [________________________________]
Email: [________________________________]

RECITALS

A. Client has sustained personal injuries and/or damages arising from an incident that occurred on or about [DATE OF INCIDENT] (the "Incident").

B. Client desires to retain Attorney to represent Client in pursuing claims for compensation for injuries and damages arising from the Incident.

C. Attorney is willing to represent Client on the terms and conditions set forth in this Agreement.

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

1. SCOPE OF REPRESENTATION

1.1 Matters Covered

Attorney agrees to represent Client in connection with claims arising from the Incident, including but not limited to:

☐ Bodily injury claims against at-fault parties
☐ Property damage claims
☐ Uninsured/Underinsured motorist claims
☐ Medical payments/Personal Injury Protection claims
☐ Loss of consortium claims (if applicable)
☐ Wrongful death claims (if applicable)
☐ Other: [________________________________]

1.2 Matters Not Covered

This Agreement does NOT include representation for:

☐ Workers' compensation claims (separate retainer required)
☐ Social Security Disability claims (separate retainer required)
☐ Criminal matters arising from the Incident
☐ Appellate proceedings (separate agreement required)
☐ Collection of judgments (separate agreement required)
☐ Subrogation defense (separate agreement required)
☐ Other: [________________________________]

1.3 Additional Parties

☐ This Agreement covers claims on behalf of the following additional parties:
[________________________________]
[________________________________]

2. CONTINGENCY FEE STRUCTURE

2.1 Attorney's Fee

Client agrees to pay Attorney the following contingency fee calculated on the gross recovery obtained:

Standard Fee Schedule:

Alternative Fee Schedule (if applicable):

2.2 Definition of Gross Recovery

"Gross Recovery" means the total of all amounts received on Client's behalf, including but not limited to:

• Settlement payments
• Jury verdicts
• Arbitration awards
• Judgments
• Policy limits payments
• Insurance benefits (where permitted by law)
• Any other compensation received

2.3 Calculation of Fee

The contingency fee shall be calculated on the gross recovery BEFORE deduction of:

• Costs and expenses
• Liens (medical, Medicare, Medicaid, ERISA, workers' compensation)
• Subrogation claims
• Any other deductions

Alternative (if required by jurisdiction):
☐ The contingency fee shall be calculated on the net recovery AFTER deduction of costs and expenses.

2.4 Fee if No Recovery

If no recovery is obtained, Client owes Attorney NO attorney's fees. However, Client remains responsible for costs and expenses as described in Section 3.

3. COSTS AND EXPENSES

3.1 Types of Costs

Attorney will advance the following costs and expenses necessary to prosecute Client's claims:

3.2 Cost Responsibility

Select one:

☐ Option A - Costs Deducted from Recovery: All costs and expenses advanced by Attorney shall be deducted from any recovery obtained. If no recovery is obtained, Client shall not be responsible for repayment of advanced costs.

☐ Option B - Client Responsible Regardless of Outcome: Client is responsible for all costs and expenses regardless of the outcome of the case. If no recovery is obtained, Client shall reimburse Attorney for all costs advanced within [30] days of case conclusion.

☐ Option C - Hybrid: Client is responsible for costs only if recovery is obtained, except for the following costs which Client must pay regardless of outcome: [________________________________]

3.3 Cost Approval

☐ Attorney may incur costs up to $[________] without prior Client approval.
☐ Costs exceeding $[________] require Client's written approval.
☐ Expert witness fees exceeding $[________] require Client's written approval.

3.4 Third-Party Litigation Financing

☐ Client authorizes Attorney to obtain third-party litigation financing if needed to advance costs, subject to Client's approval of financing terms.

4. LIEN RESOLUTION AND MEDICARE/MEDICAID COMPLIANCE

4.1 Lien Identification

Attorney will make reasonable efforts to identify all liens and subrogation claims against the recovery, including:

☐ Medicare conditional payments
☐ Medicaid liens
☐ ERISA health plan subrogation claims
☐ Workers' compensation liens
☐ Medical provider liens (hospital, physician, chiropractor)
☐ Child support liens
☐ Veterans Administration liens
☐ TRICARE/military health liens
☐ State or federal government liens
☐ Attorney liens from prior counsel
☐ Litigation funding liens

4.2 Medicare Secondary Payer Compliance

Client acknowledges and agrees:

(a) If Client is a Medicare beneficiary, or becomes eligible for Medicare within 30 months of settlement, Medicare must be reimbursed for injury-related payments.

(b) Attorney will obtain a final demand letter from Medicare/CMS before disbursing settlement funds.

(c) Settlement disbursement may be delayed until Medicare's interests are resolved.

(d) Attorney may establish a Medicare Set-Aside (MSA) account if required for future medical expenses.

(e) Failure to properly reimburse Medicare may result in denial of future Medicare benefits and personal liability.

4.3 Lien Negotiation

Attorney will use reasonable efforts to negotiate reduction of valid liens. Client understands that:

(a) Medicare liens may be reduced for procurement costs (attorney fees and costs).

(b) ERISA plan liens are subject to federal law and may not be reducible.

(c) Hospital liens may be subject to state law limitations.

(d) Medicaid liens may be subject to anti-lien provisions (Ahlborn limitations).

4.4 Lien Resolution Fees

☐ No additional fee is charged for lien negotiation.
☐ A fee of [___]% of the lien reduction achieved will be charged for lien negotiation.

5. DISTRIBUTION OF SETTLEMENT PROCEEDS

5.1 Order of Distribution

Settlement proceeds shall be distributed in the following order:

1. Costs and expenses advanced by Attorney
2. Attorney's contingency fee
3. Satisfaction of valid liens and subrogation claims
4. Medicare Set-Aside (if required)
5. Balance to Client

5.2 Settlement Statement

Prior to disbursement, Attorney will provide Client with a detailed Settlement Statement showing:

• Gross recovery amount
• Attorney's fee calculation
• Itemized costs and expenses
• Lien amounts and any negotiated reductions
• Medicare Set-Aside (if applicable)
• Net amount to Client

5.3 Trust Account

All settlement funds will be deposited in Attorney's client trust account and held until proper distribution can be made.

6. CLIENT'S RESPONSIBILITIES

6.1 Cooperation

Client agrees to:

(a) Provide truthful and complete information to Attorney.

(b) Keep Attorney informed of current contact information.

(c) Respond promptly to Attorney's communications.

(d) Attend all scheduled appointments, depositions, hearings, and trial.

(e) Provide all documents, records, and information requested by Attorney.

(f) Not discuss the case with opposing parties, their attorneys, or their insurance representatives without Attorney's knowledge.

(g) Not sign any documents related to the case without Attorney's review.

(h) Follow Attorney's reasonable advice regarding medical treatment and documentation.

6.2 Medical Treatment

Client agrees to:

(a) Seek appropriate medical treatment for injuries.

(b) Follow treating physicians' recommendations.

(c) Keep all medical appointments.

(d) Not provide false information to healthcare providers.

(e) Sign medical records authorizations as needed.

6.3 Communication with Insurance Companies

Client agrees NOT to:

(a) Give recorded statements to any insurance company without Attorney's consent.

(b) Accept any settlement offer without Attorney's review.

(c) Sign any release or settlement documents without Attorney's approval.

(d) Cash any checks from insurance companies without Attorney's knowledge.

7. ATTORNEY'S RESPONSIBILITIES

7.1 Duties

Attorney agrees to:

(a) Represent Client competently and diligently.

(b) Keep Client reasonably informed about the status of the case.

(c) Promptly respond to Client's reasonable requests for information.

(d) Explain matters to the extent necessary for Client to make informed decisions.

(e) Abide by Client's decisions regarding settlement and objectives of representation.

(f) Hold Client's information confidential as required by law.

(g) Comply with all applicable Rules of Professional Conduct.

7.2 No Guarantee of Outcome

Client acknowledges that Attorney has made no promises or guarantees regarding the outcome of this matter. The evaluation of any claim depends on facts discovered during investigation and litigation, and Attorney's assessment may change as the case progresses.

8. SETTLEMENT AUTHORITY

8.1 Client's Authority

Client retains the sole authority to:

(a) Accept or reject any settlement offer.

(b) Decide whether to file a lawsuit.

(c) Decide whether to accept a structured settlement.

(d) Decide whether to proceed to trial.

8.2 Settlement Recommendations

Attorney will provide recommendations regarding settlement offers but the final decision rests with Client. Client agrees to give reasonable consideration to Attorney's advice.

8.3 Structured Settlements

If a structured settlement is offered, Attorney will explain the terms, tax consequences, and present value. Any structured settlement must be approved by Client in writing.

9. TERMINATION

9.1 Client's Right to Terminate

Client may terminate this Agreement at any time by written notice to Attorney. Upon termination:

(a) Client shall pay Attorney the reasonable value of services rendered (quantum meruit) at Attorney's standard hourly rate of $[____] per hour.

(b) Client shall reimburse Attorney for all costs advanced.

(c) Attorney shall provide Client with all files and documents.

(d) Attorney may file a charging lien to protect the fee interest.

9.2 Attorney's Right to Withdraw

Attorney may withdraw from representation for good cause, including but not limited to:

(a) Client's failure to cooperate or follow reasonable advice.

(b) Client's failure to pay costs as agreed.

(c) Client's insistence on pursuing frivolous claims.

(d) Client's material misrepresentation of facts.

(e) Breakdown of the attorney-client relationship.

(f) Conflict of interest.

(g) Client's failure to stay in communication.

Upon withdrawal, Attorney shall give reasonable notice, file appropriate motions if litigation is pending, and protect Client's interests to the extent required by law.

9.3 Fee Upon Termination

If Client terminates this Agreement or Attorney withdraws for good cause, and Client subsequently recovers on the claims, Attorney shall be entitled to:

☐ The full contingency fee as if Attorney had completed the representation.
☐ A reasonable fee based on quantum meruit for services rendered.
☐ A proportionate share of the contingency fee based on work completed.

10. DISPUTE RESOLUTION

10.1 Fee Disputes

Any dispute regarding Attorney's fees shall be resolved by:

☐ Binding arbitration under the rules of [________________________________]
☐ State Bar fee arbitration program (if available)
☐ Mediation followed by binding arbitration

10.2 Malpractice Claims

This Agreement does not limit Client's right to pursue a legal malpractice claim against Attorney. Client acknowledges the right to consult with another attorney regarding any potential malpractice claim.

11. ASSOCIATED COUNSEL

11.1 Referral and Co-Counsel

Attorney may associate or refer this matter to other qualified attorneys with Client's consent. Any fee division shall comply with applicable Rules of Professional Conduct and shall not increase the total fee to Client.

11.2 Disclosure

If this case was referred by another attorney, Client acknowledges:

Referring Attorney: [________________________________]
Fee Split: Attorney [___]% / Referring Attorney [___]%

12. FILE RETENTION

Upon conclusion of this matter, Attorney will retain Client's file for [____] years, after which time the file may be destroyed without further notice. Client may request a copy of the file at any time during the retention period. Client is responsible for any copying costs.

13. ELECTRONIC COMMUNICATION

Client consents to communication via:

☐ Email to: [________________________________]
☐ Text message to: [________________________________]
☐ Client portal at: [________________________________]

Client acknowledges that electronic communications may not be secure and waives any claim arising from the use of such communications.

14. GENERAL PROVISIONS

14.1 Entire Agreement

This Agreement constitutes the entire agreement between the parties regarding the subject matter hereof and supersedes all prior discussions and agreements.

14.2 Amendments

This Agreement may only be modified by a written document signed by both parties.

14.3 Governing Law

This Agreement shall be governed by the laws of the State of [________________________________].

14.4 Severability

If any provision of this Agreement is found to be invalid or unenforceable, the remaining provisions shall continue in full force and effect.

14.5 Counterparts

This Agreement may be executed in counterparts, including by electronic signature.

15. ACKNOWLEDGMENTS

CLIENT ACKNOWLEDGES:

☐ I have read this entire Agreement and understand its terms.

☐ I have had the opportunity to ask questions about this Agreement.

☐ I understand that Attorney is being paid on a contingency basis and will receive a percentage of any recovery.

☐ I understand that I am responsible for costs as outlined in Section 3.

☐ I understand that there is no guarantee of any recovery.

☐ I understand that liens and subrogation claims may reduce my recovery.

☐ I understand my responsibilities as a client under this Agreement.

☐ I have received a copy of this signed Agreement.

☐ I was advised of my right to consult with another attorney before signing.

SIGNATURES

CLIENT:

Signature: _________________________________ Date: ______________

Printed Name: _________________________________

CO-CLIENT (if applicable):

Signature: _________________________________ Date: ______________

Printed Name: _________________________________

ATTORNEY:

Signature: _________________________________ Date: ______________

Printed Name: _________________________________

State Bar Number: _________________________________

EXHIBIT A: CONTINGENCY FEE DISCLOSURE

STATE-REQUIRED DISCLOSURES:

[________________________________]
[________________________________]
[________________________________]
[________________________________]

EXHIBIT B: CONFLICT WAIVER (if applicable)

☐ Not Applicable

☐ Applicable - See attached Conflict Waiver signed by Client.

Description of Conflict: [________________________________]

OFFICE USE ONLY