Personal Injury Settlement Agreement - Illinois

PERSONAL INJURY SETTLEMENT AGREEMENT AND RELEASE

This Agreement is made on [DATE] between [CLAIMANT FULL NAME] ("Claimant") and [DEFENDANT FULL LEGAL NAME] ("Defendant"). The parties wish to resolve Claimant's claims arising from the incident on [INCIDENT DATE] at [LOCATION] ("Incident"), including the action captioned [COURT, CASE NAME, AND CASE NUMBER, OR "NO ACTION FILED"]. Defendant denies liability. The parties agree as follows:

1. Settlement amount and payment

Defendant will pay $[AMOUNT] in one payment to [PAYEE AND DELIVERY INSTRUCTIONS]. For an action covered by 735 ILCS 5/2-2301, Defendant will tender this release for Claimant's review within the statute's 14-day period. Claimant will tender the signed release and, where applicable, the court approval and known third-party recovery or subrogation documents addressed by § 2-2301(b) and (c). Defendant will pay within 30 days after Claimant's tender of the executed release and all applicable documents. Any different payment terms expressly agreed by the parties are [NONE OR SPECIFY CLEARLY]. Section 2-2301 has exceptions and permits the parties to agree otherwise; confirm its coverage before relying on its statutory deadlines.

Payment will be deemed received when the funds have cleared. Defendant will identify the settlement and claim number on the payment: [CLAIM NUMBER OR "NONE"].

2. Claimant's release

Upon receipt of the full settlement amount, Claimant releases Defendant and [SPECIFICALLY IDENTIFY OTHER PERSONS OR ENTITIES TO BE RELEASED, IF ANY] from Claimant's claims for bodily injury and related damages arising from the Incident, whether asserted or unasserted, known or unknown on the date of this Agreement. This release concerns only the Incident and does not release duties created by this Agreement or claims belonging to anyone who has not signed it.

Claimant has had the opportunity to review this release with counsel and understands that injuries or losses from the Incident may develop or become clearer later. Claimant intends this release to include Claimant's own later-discovered injury claims arising from the Incident once full payment is received.

3. Known third-party interests

Known healthcare, attorney, governmental, insurer, or other asserted recovery interests are listed below. The parties will identify and exchange the applicable documents and payment arrangements required for these interests under 735 ILCS 5/2-2301(c). This Agreement does not extinguish a third party's rights merely because that party is not a signer. Claimant and Defendant will handle payment of the listed interests as follows: [SPECIFY WHO WILL PAY EACH INTEREST, FROM WHICH FUNDS, AND ANY HOLD-BACK OR JOINT-PAYEE ARRANGEMENT].

4. Court approval and dismissal

If a court order is required for this settlement, Claimant or the authorized representative will tender the order to Defendant under 735 ILCS 5/2-2301(b). A representative compromising a ward's claim must obtain court leave as provided by 755 ILCS 5/19-8. The parties will cooperate in seeking any necessary approval. If an action is pending, Claimant will file or join a dismissal with prejudice of the released claims within [NUMBER] days after cleared full payment, subject to the court's order.

5. Other terms

No party admits fault or wrongdoing. Illinois law governs this Agreement. Each party bears its own attorney fees and costs unless expressly stated here: [NONE OR SPECIFY]. A change must be in writing signed by Claimant and Defendant. This Agreement is the complete settlement of Claimant's claims described above.

Claimant

Signature: [________________________________] Date: [__/__/____]

Printed name: [________________________________]

Defendant

Signature: [________________________________] Date: [__/__/____]

Printed name and title: [________________________________]

Entity, if applicable: [________________________________]

Authorized representative, if applicable

Signature: [________________________________] Date: [__/__/____]

Printed name, capacity, and court-order reference: [________________________________]