PERSONAL INJURY SETTLEMENT AGREEMENT AND MUTUAL RELEASE

(Idaho Law – [EFFECTIVE DATE])

TABLE OF CONTENTS

1. Document Header
2. Definitions
3. Operative Provisions
4. Representations & Warranties
5. Covenants & Restrictions
6. Default & Remedies
7. Risk Allocation
8. Dispute Resolution
9. General Provisions
10. Execution Block

1. DOCUMENT HEADER

1.1 Parties.
 (a) “[Plaintiff/Releasor]” – [FULL LEGAL NAME], an individual residing at [ADDRESS].
 (b) “[Defendant/Releasee]” – [FULL LEGAL NAME], a [ENTITY TYPE & STATE OF ORGANIZATION], having its principal place of business at [ADDRESS].

1.2 Effective Date. This Agreement is effective as of [DATE] (the “Effective Date”).

1.3 Recitals.
 (a) A dispute has arisen out of an incident occurring on [DATE OF INCIDENT] in [LOCATION], resulting in alleged personal injuries to Plaintiff/Releasor (the “Claim”).
 (b) The Parties desire to resolve fully and finally the Claim and any related matters without admission of liability, pursuant to the terms and conditions set forth herein.
 (c) For valuable consideration, the receipt and sufficiency of which are acknowledged, the Parties agree as follows.

2. DEFINITIONS

Unless otherwise indicated, capitalized terms have the meanings set forth below and apply equally to singular and plural forms.

“Agreement” – This Personal Injury Settlement Agreement and Mutual Release, including all exhibits and schedules.

“Claim” – The personal injury claim described in Recital 1.3(a), together with any and all losses, damages, expenses, attorneys’ fees, costs, liens, and subrogation interests arising from or related to the incident.

“Court Approval” – Approval issued by a court of competent jurisdiction as required under Idaho law for settlements involving minors or legally incapacitated persons, or structured settlements requiring judicial review.

“Payment Deadline” – [DATE / NUMBER OF DAYS] after the later of (i) the Effective Date or (ii) satisfaction of any Conditions Precedent set forth in §3.3.

“Releasees” – Defendant/Releasee and its past, present, and future parents, subsidiaries, affiliates, insurers, reinsurers, officers, directors, employees, agents, shareholders, successors, and assigns.

“Releasor” – Plaintiff/Releasor and, where applicable, Releasor’s heirs, executors, administrators, legal representatives, successors, and assigns.

“Settlement Amount” – The total consideration described in §3.2.

“Structured Settlement” – A periodic payment arrangement compliant with the Idaho Structured Settlement Protection Act and other applicable law.

3. OPERATIVE PROVISIONS

3.1 Conditions Precedent.
 (a) Execution of this Agreement by all Parties.
 (b) Receipt by Releasees of an executed [IRS Form W-9 / W-8] from Releasor.
 (c) Court Approval, if applicable.

3.2 Consideration; Settlement Amount.
 (a) Lump Sum Option. Releasees shall pay Releasor USD $[AMOUNT] by wire transfer or check on or before the Payment Deadline.
 (b) Structured Settlement Option. In lieu of a lump sum, the Parties may elect a Structured Settlement with guaranteed periodic payments totaling USD $[AMOUNT] funded through an annuity issued by [ANNUITY PROVIDER]. The annuity contract shall name Releasor (or Releasor’s estate) as payee, be non-assignable, and comply with all Idaho structured-settlement requirements.
 (c) Allocation. Unless otherwise required by court order, the Settlement Amount is allocated [INSERT ALLOCATION—e.g., “$ to bodily injury, $ to property damage, $___ to attorneys’ fees”].

3.3 Delivery of Settlement Documents. Concurrent with execution, Releasor shall deliver:
 (i) An executed Stipulation for Dismissal with Prejudice, in a form acceptable to Releasees; and
 (ii) Any lien-holder releases or satisfactions described in §5.3.

3.4 Dismissal of Litigation. Within [3] business days after confirmed receipt of the Settlement Amount, counsel for Releasor shall file the Stipulation for Dismissal with the [IDAHO DISTRICT COURT, COUNTY].

3.5 Taxes. The Parties agree that no portion of the Settlement Amount constitutes wages, and Releasees shall issue any tax reporting forms consistent with this characterization. Releasor is solely responsible for any tax liabilities arising from the Settlement Amount. [// GUIDANCE: Personal injury compensatory damages for physical injuries are generally excludable from gross income; confirm client’s tax position.]

4. REPRESENTATIONS & WARRANTIES

4.1 Mutual Representations. Each Party represents and warrants that:
 (a) Authority. It has full legal right, power, and authority to enter into and perform under this Agreement.
 (b) No Assignment. It has not assigned or transferred any interest in the Claim or any rights to recovery therein.
 (c) No Reliance. It enters into this Agreement based on its own investigation and not in reliance upon any statement or representation by any other Party except as expressly set forth herein.

4.2 Releasor’s Additional Representations.
 (a) Medicare/Medicaid. Releasor is [check one]: ☐ not a Medicare beneficiary ☐ a Medicare beneficiary (HICN: [NUMBER]). If a beneficiary, Releasor will satisfy all Medicare reimbursement obligations.
 (b) Minor or Incapacitated Person. If Releasor is a minor or lacks legal capacity, the individual signing below on Releasor’s behalf has full authority as [parent/guardian ad litem/conservator], and Court Approval has been or will be obtained prior to disbursement of settlement funds.

4.3 Survival. All representations and warranties survive the Effective Date and Settlement Amount payment.

5. COVENANTS & RESTRICTIONS

5.1 Mutual Release.
 (a) Upon Releasees’ payment of the Settlement Amount, Releasor irrevocably and unconditionally releases and forever discharges Releasees from the Claim and from all actions, causes of action, liabilities, obligations, costs, expenses, and damages of every kind, whether known or unknown, foreseen or unforeseen, that Releasor ever had, now has, or may hereafter have arising out of or relating to the Claim or the incident.
 (b) Upon execution of this Agreement, Releasees release Releasor from any claims for costs or sanctions arising out of the litigation of the Claim.

5.2 Confidentiality. The terms of this Agreement and all settlement negotiations are confidential and shall not be disclosed except: (i) as required by law or court order; (ii) to tax, accounting, or legal advisors bound by confidentiality; (iii) to obtain Court Approval or enforce this Agreement.

5.3 Liens & Subrogation. Releasor shall satisfy and hold Releasees harmless from any liens, subrogation interests, or reimbursement claims related to medical expenses, workers’ compensation, or governmental benefits.

5.4 Non-Disparagement. The Parties shall refrain from any statement, written or oral, that disparages the other Party concerning the Claim.

6. DEFAULT & REMEDIES

6.1 Events of Default.
 (a) Failure by Releasees to pay the Settlement Amount on or before the Payment Deadline.
 (b) Breach of any material covenant, representation, or warranty herein.

6.2 Cure Period. A defaulting Party has [10] business days after written notice of default to cure.

6.3 Remedies.
 (a) Monetary. If Releasees default, Releasor may reinstate the litigation or enter judgment for the unpaid Settlement Amount plus interest at [___]% per annum.
 (b) Specific Performance. The Parties acknowledge monetary damages may be inadequate; therefore, specific performance is an available remedy.
 (c) Attorneys’ Fees. The prevailing Party in any action to enforce this Agreement is entitled to reasonable attorneys’ fees and costs.

7. RISK ALLOCATION

7.1 Indemnification by Releasor. Releasor shall indemnify, defend, and hold harmless Releasees from any claim, lien, or subrogation interest asserted by any third party to the extent arising from Releasor’s failure to satisfy obligations under §5.3.

7.2 Limitation of Liability. Releasees’ aggregate liability under this Agreement is limited to the Settlement Amount. In no event shall either Party be liable for incidental, consequential, punitive, or exemplary damages.

7.3 Force Majeure. No Party is liable for delay or failure to perform caused by events beyond its reasonable control (e.g., natural disasters, governmental acts); provided that the affected Party gives prompt notice and resumes performance as soon as practicable.

8. DISPUTE RESOLUTION

8.1 Governing Law. This Agreement is governed by the internal laws of the State of Idaho, excluding conflict-of-laws principles.

8.2 Forum Selection. The state courts located in [COUNTY], Idaho have exclusive jurisdiction and venue over any dispute arising from or related to this Agreement.

8.3 Arbitration & Jury Waiver. The Parties expressly agree that mandatory arbitration and jury trial waivers are not applicable.

9. GENERAL PROVISIONS

9.1 Entire Agreement. This Agreement, including any exhibits, constitutes the entire understanding of the Parties and supersedes all prior negotiations.

9.2 Amendments; Waivers. Any amendment or waiver must be in a signed writing referring specifically to this Agreement. No waiver is deemed a continuing waiver.

9.3 Assignment. No Party may assign its rights or delegate its obligations without the prior written consent of the other Party, except that Releasees may assign rights to insurers or structured-settlement obligors.

9.4 Severability. If any provision is held invalid or unenforceable, the remaining provisions remain in full force, and the invalid provision is reformed to the minimum extent necessary to render it valid.

9.5 Counterparts; Electronic Signatures. This Agreement may be executed in counterparts, each of which is deemed an original. Signatures delivered by electronic means (e.g., PDF, DocuSign) are binding.

9.6 Headings. Section headings are for convenience only and do not affect interpretation.

9.7 Successors & Assigns. This Agreement binds and benefits the Parties and their respective successors and permitted assigns.

9.8 Construction. The Parties participated jointly in the drafting; ambiguities shall not be construed against either Party.

10. EXECUTION BLOCK

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

[OPTIONAL NOTARIZATION BLOCK – use if required for structured settlements or minor approvals]

State of Idaho )
County of ______) ss.

On this ___ day of __, 20, before me, the undersigned, a Notary Public in and for said state, personally appeared [NAME], known to me to be the person whose name is subscribed to this instrument, and acknowledged that he/she executed the same for the purposes therein contained.

My commission expires: _______

Notary Public

[// GUIDANCE:

1. Minor Settlement Approval – If Releasor is a minor, insert language conditioning effectiveness on “entry of an order approving this settlement by the [Idaho District Court, Juvenile Division]” and attach the proposed petition for approval as Exhibit A.

2. Release Enforceability – Idaho courts require clear, conspicuous language to waive unknown or future claims. The broad language in §5.1(a) is intentionally bold and unconditional; maintain all-caps or bold formatting when finalizing for signature.

3. Structured Settlement Rules – For any periodic payment plan, attach (i) the annuity contract, (ii) qualified assignment documentation, and (iii) an affidavit of compliance with the Idaho Structured Settlement Protection Act as exhibits.

4. Medicare Compliance – If Releasor is or may become a Medicare beneficiary, consider adding a Medicare Set-Aside Allocation (MSA) provision and submission requirements.

5. Liens – Verify and list known lienholders in a schedule; require Releasor’s counsel to issue payoff letters prior to disbursement.

6. Service Providers – Coordinate with claims administrators and annuity brokers early to confirm funding timelines that satisfy the Payment Deadline.

]