PERSONAL INJURY SETTLEMENT AGREEMENT

(Michigan – Court-Approved Form)

[// GUIDANCE: This template is drafted for use in Michigan personal-injury matters. It incorporates Michigan-specific requirements for releases, structured settlements, and minor-claim approvals under the Michigan Court Rules. Customize all bracketed items, delete inapplicable alternatives, and obtain court approval where required.]

TABLE OF CONTENTS

I. Definitions
II. Settlement Payments
III. Mutual Release of Claims
IV. Representations & Warranties
V. Covenants
VI. Default & Remedies
VII. Risk Allocation
VIII. Dispute Resolution
IX. General Provisions
X. Execution & Acknowledgment

I. DEFINITIONS

For purposes of this Agreement, the following terms have the meanings set forth below. Capitalized terms used in any Section shall have the meanings assigned in this Article I.

1.1 “Accident” means the incident that allegedly caused Claimant’s injuries, occurring on or about [DATE] at or near [LOCATION].

1.2 “Agreement” means this Personal Injury Settlement Agreement and Mutual Release, including all Exhibits and Schedules.

1.3 “Claimant” means [FULL LEGAL NAME], [individually / and as Parent and Next Friend of Minor, _____] and any heirs, representatives, successors, and assigns.

1.4 “Defendant” means [FULL LEGAL NAME OF DEFENDANT] and all Released Parties.

1.5 “Effective Date” means the later of (a) the date this Agreement is signed by all Parties, or (b) the date of entry of a court order approving the settlement if required.

1.6 “Parties” means, collectively, Claimant and Defendant (each, a “Party”).

1.7 “Released Claims” has the meaning set forth in Section III.2.

1.8 “Released Parties” has the meaning set forth in Section III.1.

1.9 “Settlement Amount” means the total consideration described in Section II.1, inclusive of all damages, costs, liens, attorney fees, interest, and expenses.

1.10 “Structured Settlement” means the periodic-payment arrangement, if any, described in Section II.2.

II. SETTLEMENT PAYMENTS

2.1 Settlement Consideration.
a. Defendant shall pay Claimant the Settlement Amount of $[NUMERIC AMOUNT] (“Settlement Amount”).
b. Payment shall be made by [check / wire transfer] to “[LAW FIRM TRUST ACCOUNT / CLAIMANT]” on or before [DATE].

2.2 Structured Settlement (Optional).
a. [If elected] A portion of the Settlement Amount, $[STRUCTURED PORTION], shall fund a Structured Settlement providing periodic payments pursuant to an annuity contract issued by [ANNUITY ISSUER] (the “Annuity”).
b. The Annuity shall provide payments of $[AMT] on [FREQUENCY] beginning [DATE] and continuing through [DATE].
c. The Parties designate [ASSIGNEE] as the qualified assignee to purchase the Annuity consistent with applicable Michigan structured-settlement laws and federal tax requirements.

[// GUIDANCE: For structured settlements, confirm compliance with the federal Periodic Payment Settlement Tax Act and Michigan’s Structured Settlement Protection Act. Court approval is required for any assignment of structured-settlement payment rights by a payee.]

2.3 Minor Settlement Approval (if applicable).
a. Where Claimant is a minor, the Parties shall promptly file a “Petition for Approval of Minor Settlement” with the [NAME OF COURT] pursuant to the Michigan Court Rules.
b. Payment of any settlement funds for the benefit of a minor shall be:
i. deposited into a restricted account titled in the minor’s name, OR
ii. funded through a court-approved annuity,
as ordered by the court.

2.4 Tax Treatment. The Parties acknowledge that damages for personal physical injuries are generally excluded from gross income under 26 U.S.C. § 104(a)(2). Claimant is solely responsible for any tax consequences arising from the settlement.

2.5 No Admission. Payment of the Settlement Amount is a compromise of disputed claims and shall not be construed as an admission of liability.

III. MUTUAL RELEASE OF CLAIMS

3.1 Released Parties. “Released Parties” means Defendant, its past, present, and future parents, subsidiaries, affiliates, insurers, reinsurers, successors, assigns, officers, directors, employees, and agents.

3.2 Released Claims. Claimant, for good and valuable consideration, hereby releases and forever discharges the Released Parties from any and all actions, causes of action, claims, demands, damages, costs, expenses, compensation, and suits of any kind whatsoever, known or unknown, suspected or unsuspected, arising out of or in any way connected with the Accident or the injuries alleged therein (“Released Claims”).

3.3 Waiver of Unknown Injuries. Claimant expressly waives any and all rights under any statute or common-law doctrine that might otherwise limit this release to known or existing injuries. Claimant understands and assumes the risk that future injuries or damages may later become known.

3.4 Covenant Not to Sue. Claimant covenants that neither Claimant nor anyone acting on Claimant’s behalf will initiate or maintain any civil action, arbitration, or administrative proceeding against any Released Party concerning any Released Claim.

3.5 Defendant’s Release. Defendant releases Claimant from any and all claims arising out of the Accident, including subrogation or contribution claims, except for obligations expressly arising under this Agreement.

3.6 Medicare/Medicaid Compliance.
a. Claimant affirms that all conditional payments, liens, or obligations, if any, asserted by Medicare, Medicaid, or any other governmental or private payor will be satisfied or otherwise resolved from the Settlement Amount.
b. Claimant agrees to indemnify and hold the Released Parties harmless from any claim, demand, penalty, or assessment by a governmental agency related to such liens or conditional payments.

IV. REPRESENTATIONS & WARRANTIES

4.1 Capacity and Authority. Each Party represents that it has full capacity, power, and authority to execute, deliver, and perform this Agreement. If executed on behalf of a minor, the undersigned adult represents that he or she is the lawful parent, guardian, or next friend with full authority to bind the minor.

4.2 No Assignment. Claimant represents that no claim, right, or cause of action released herein has been assigned or pledged to any third party.

4.3 Independent Judgment. Each Party acknowledges that it (a) has carefully read and fully understands this Agreement, (b) has consulted or had the opportunity to consult independent counsel, and (c) enters this Agreement voluntarily and without duress.

4.4 True and Complete Information. Each Party warrants that all information provided in connection with settlement negotiations, including representations concerning liens and subrogation interests, is true, complete, and accurate in all material respects.

4.5 Survival. The representations and warranties in this Article IV shall survive the Effective Date.

V. COVENANTS

5.1 Cooperation. The Parties shall execute such additional documents and take such further actions as may be reasonably necessary to carry out the intent and purpose of this Agreement.

5.2 Confidentiality (Optional). Except as required by law or court order, the Parties agree to keep the terms and conditions of this Agreement strictly confidential. Disclosures to immediate family members, tax or legal advisers, or insurers are permitted, provided they agree to maintain confidentiality.

5.3 Non-Disparagement. The Parties shall refrain from making any statement reasonably likely to disparage the reputation or business interests of any other Party in connection with the Accident or this settlement.

VI. DEFAULT & REMEDIES

6.1 Events of Default. The following shall constitute an “Event of Default”:
a. Failure of Defendant to pay the Settlement Amount (or any periodic payment under a Structured Settlement) when due;
b. Material breach of any covenant in Section V.

6.2 Notice and Cure. The non-defaulting Party shall provide written notice specifying the nature of the default. The defaulting Party shall have ten (10) calendar days to cure the default following receipt of such notice.

6.3 Remedies. If the default is not timely cured, the non-defaulting Party may:
a. seek entry of judgment for the unpaid amounts, plus interest at the statutory rate from the due date;
b. recover reasonable attorney fees and costs incurred in enforcing the Agreement; and
c. pursue any other remedy available at law or in equity consistent with this Agreement.

VII. RISK ALLOCATION

7.1 Mutual Release as Exclusive Remedy. Except for enforcement of this Agreement, the releases in Article III constitute the Parties’ exclusive remedy and cap all liability arising out of the Accident.

7.2 Limitation of Liability. The aggregate liability of Defendant with respect to the Accident shall not exceed the Settlement Amount.

7.3 Indemnification. Each Party shall indemnify, defend, and hold harmless the other Party from and against any claim by a third party arising from the indemnifying Party’s breach of this Agreement, including any claim for reimbursement of liens or conditional payments.

7.4 Force Majeure. No Party shall be liable for delay in performance caused by events beyond its reasonable control (e.g., natural disasters, acts of war, or governmental action); provided, such Party promptly notifies the other of the event and resumes performance as soon as practicable.

VIII. DISPUTE RESOLUTION

8.1 Governing Law. This Agreement shall be governed by and construed in accordance with the substantive laws of the State of Michigan, without regard to its conflict-of-laws rules.

8.2 Forum Selection. The Parties irrevocably submit to the exclusive jurisdiction of the state courts located within [COUNTY], Michigan, for any action or proceeding to enforce or interpret this Agreement.

8.3 Arbitration. The Parties agree that arbitration is not required. Nothing herein shall preclude the Parties from voluntarily agreeing to binding arbitration after a dispute arises.

8.4 Preservation of Rights. Nothing in this Article VIII limits either Party’s right to seek entry of judgment, injunctive relief, or other equitable remedies in a Michigan state court to enforce this Agreement.

IX. GENERAL PROVISIONS

9.1 Entire Agreement. This Agreement constitutes the entire understanding between the Parties concerning the subject matter and supersedes all prior negotiations and agreements, whether oral or written.

9.2 Amendment & Waiver. No amendment or waiver of any provision shall be effective unless in writing and signed by all Parties. A waiver of any provision on one occasion shall not be deemed a waiver of any other provision.

9.3 Severability. If any provision of this Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force, and the invalid provision shall be reformed to the minimum extent necessary to render it valid.

9.4 Assignment. No Party may assign or delegate its rights or obligations under this Agreement without the prior written consent of the other Party, except that Defendant may assign its payment obligations to a qualified assignee for a Structured Settlement.

9.5 Successors & Assigns. Subject to Section 9.4, this Agreement shall bind and benefit the Parties and their respective heirs, personal representatives, successors, and permitted assigns.

9.6 Counterparts; Electronic Signatures. This Agreement may be executed in multiple counterparts, each of which is deemed an original, and all of which together constitute one instrument. Signatures transmitted by facsimile, email (PDF), or electronic signature platform shall be deemed originals.

9.7 Headings. Article and Section headings are for convenience only and shall not affect interpretation.

X. EXECUTION & ACKNOWLEDGMENT

IN WITNESS WHEREOF, the Parties hereto have executed this Personal Injury Settlement Agreement and Mutual Release as of the Effective Date.

[If Minor:]
I certify that I am the [parent/guardian/next friend] of [MINOR NAME] and that I have full authority to execute this Agreement on the minor’s behalf.

[Name], [Relationship]
Date: _________

NOTARY ACKNOWLEDGMENT (if required)

State of Michigan )
County of __ ) ss.

On this _ day of _, 20__, before me, the undersigned Notary Public, personally appeared _______, known to me (or satisfactorily proven) to be the person whose name is subscribed to within this instrument and acknowledged that he/she executed the same for the purposes therein contained.

Notary Public, State of Michigan
My Commission Expires: _
Acting in the County of _

EXHIBIT A – PAYMENT SCHEDULE

[Attach Annuity illustration or lump-sum payment details.]

EXHIBIT B – COURT ORDER APPROVING MINOR SETTLEMENT

[Attach conformed copy upon entry.]

[// GUIDANCE: File the fully executed Agreement and supporting exhibits with the court only if court approval is required (e.g., minor or legally incapacitated claimant). Maintain a separate confidential version if the Agreement contains confidentiality provisions.]