PERSONAL INJURY SETTLEMENT AND RELEASE AGREEMENT

(North Dakota – Template)

[// GUIDANCE: This template is drafted for use in North Dakota personal-injury matters. Bracketed text and blue-highlighted comments identify customizable provisions. Remove all guidance notes and brackets before final execution.]

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
11. Schedule 1 – Payment Terms (Lump-Sum / Structured)
12. Schedule 2 – Liens & Subrogation Interests

1. DOCUMENT HEADER

1.1 Title

Personal Injury Settlement and Mutual Release Agreement (the “Agreement”)

1.2 Parties

This Agreement is entered into by and between:

(a) [CLAIMANT NAME], an individual [and natural parent/guardian of [MINOR NAME]] with a principal residence at [ADDRESS] (“Claimant”); and

(b) [DEFENDANT NAME], a [corporation/individual] with a principal address at [ADDRESS] (“Released Party”).

Claimant and Released Party are each a “Party” and, collectively, the “Parties.”

1.3 Recitals

A. On or about [DATE OF INCIDENT], Claimant allegedly sustained personal injuries and other damages arising out of an incident located at [LOCATION] (the “Incident”).
B. Claimant has asserted, or may assert, personal-injury claims against Released Party (the “Action”).
C. Without admission of liability, the Parties desire to fully and finally settle all disputes arising from the Incident on the terms set forth herein.

1.4 Effective Date & Governing Jurisdiction

This Agreement becomes effective on the date last signed by the Parties (the “Effective Date”) and shall be governed by the substantive tort law of the State of North Dakota.

2. DEFINITIONS

“Action” – the actual or potential civil proceeding(s) relating to the Incident.
“Claim(s)” – any past, present, or future cause of action, demand, or damage of whatever nature arising out of or related to the Incident.
“Court” – the District Court of the State of North Dakota having subject-matter jurisdiction over the Action.
“Effective Date” – as defined in Section 1.4.
“Liens” – any statutory, contractual, or equitable right of reimbursement, including but not limited to Medicare, Medicaid, ERISA, workers’ compensation, and medical-provider liens.
“Minor” – any settling individual under eighteen (18) years of age.
“Released Claims” – as defined in Section 3.2.
“Released Parties” – Released Party and its past, present, and future parents, subsidiaries, affiliates, officers, directors, employees, agents, insurers, reinsurers, and assigns.
“Settlement Amount” – the total consideration described in Section 3.1 and Schedule 1.
“Structured Settlement” – periodic payment arrangement established under Schedule 1, if elected.

3. OPERATIVE PROVISIONS

3.1 Consideration; Payment Mechanics

(a) Settlement Amount. Released Party shall pay Claimant the total sum of [US$ AMOUNT] (inclusive of attorneys’ fees and costs) in accordance with Schedule 1.
(b) Funding Deadline. Payment shall be funded no later than [NUMBER] calendar days following (i) execution of this Agreement by all Parties, and (ii) receipt by Released Party of any Court approval required under Section 3.4.
(c) Conditions Precedent. Payment is conditioned on Claimant’s delivery of:
 (i) an executed original of this Agreement;
 (ii) duly executed dismissal with prejudice of the Action; and
 (iii) Court-approved guardianship or compromise order, if applicable.

3.2 Mutual Release of Claims

(a) Release by Claimant. Upon receipt of the Settlement Amount, Claimant irrevocably releases and forever discharges each of the Released Parties from any and all Released Claims, whether known or unknown, suspected or unsuspected, that Claimant ever had, now has, or hereafter may have, arising out of or related to the Incident.
(b) Release by Released Party. Upon payment of the Settlement Amount, Released Party releases Claimant from all counterclaims, contribution actions, or indemnity claims related to the Incident.
(c) Scope. The Released Claims include, without limitation, all claims for bodily injury, pain and suffering, medical expenses, lost wages, loss of consortium, property damage, punitive or exemplary damages, and any derivative claims.
(d) Waiver of Unknown Claims. Claimant expressly waives any rights under principles of law that would otherwise limit the scope of this release to claims actually known or suspected at the time of executing this Agreement.
[// GUIDANCE: Under North Dakota law, releases must be supported by clear, conspicuous language. Use bold or CAPS where needed if circumstances warrant heightened conspicuousness.]

3.3 No Admission of Liability

This Agreement constitutes a compromise settlement. Neither execution nor performance shall be construed as an admission of liability, fault, or wrongdoing by any Party.

3.4 Minor Settlement Approval (If Applicable)

(a) Court Approval Required. Where a Minor’s claims are compromised, this Agreement is contingent upon entry of an order approving the settlement pursuant to N.D. R. Civ. P. 17(c) and any applicable guardianship statutes.
(b) Appointment of Guardian ad Litem. The Parties shall cooperate in obtaining appointment of a guardian ad litem if required.
(c) Structured Payments for Minors. Any Structured Settlement for the benefit of a Minor shall (i) designate the Minor as payee, (ii) prohibit acceleration, assignment, or commutation, and (iii) comply with all North Dakota structured-settlement protection statutes.

3.5 Structured Settlement (If Elected)

(a) Assignment and Annuity. Released Party may satisfy all or part of the Settlement Amount by purchasing an annuity contract from a qualified assignment company, with payments to Claimant as set forth in Schedule 1.
(b) Qualified Funding. The Structure shall be intended to qualify for income-tax exclusion under Internal Revenue Code § 104(a)(2).
(c) Non-Commutation. Claimant shall have no right to accelerate, assign, pledge, or otherwise encumber Structure payments, except as permitted by North Dakota law.

4. REPRESENTATIONS & WARRANTIES

4.1 Claimant
(a) Capacity and Authority to Contract;
(b) Sole Ownership of Claims; no prior assignment;
(c) No bankruptcy pending or contemplated;
(d) Advice of Counsel: Claimant has consulted with independent counsel and understands the legal effect of this Agreement.

4.2 Released Party
(a) Corporate authority (if entity);
(b) Execution constitutes valid and binding obligation;
(c) No conflicting agreements prohibit settlement.

4.3 Survival. All representations and warranties survive execution and delivery of this Agreement.

5. COVENANTS & RESTRICTIONS

5.1 Dismissal of Action. Within three (3) business days after receipt of the Settlement Amount (or Court approval, if later), Claimant shall file a stipulation for dismissal with prejudice, each party to bear its own costs.

5.2 Confidentiality [OPTIONAL]. Except as required by law, Claimant shall keep the terms of this Agreement confidential.
[// GUIDANCE: Confidentiality of personal-injury settlements is generally enforceable in ND but may be voided for public-policy reasons in limited circumstances.]

5.3 Liens & Subrogation.
(a) Claimant is solely responsible for satisfying all Liens listed in Schedule 2.
(b) Claimant shall indemnify Released Parties against any Liens not disclosed in Schedule 2.

5.4 Cooperation in Approvals. The Parties shall cooperate in obtaining any court or governmental approval required for this settlement, including Medicare/Medicaid compliance documentation, if applicable.

6. DEFAULT & REMEDIES

6.1 Failure to Pay. If Released Party fails to fund the Settlement Amount within the deadline in Section 3.1(b), Claimant may:
 (a) enforce specific performance of this Agreement, plus interest at [RATE]% per annum, or
 (b) declare the Agreement null and void and reinstate the Action.

6.2 Breach of Confidentiality. In the event of an uncured breach of Section 5.2, the non-breaching Party may seek monetary damages or injunctive relief.

6.3 Attorney Fees & Costs. The prevailing Party in any action to enforce this Agreement shall recover reasonable attorney fees and costs.

7. RISK ALLOCATION

7.1 Indemnification for Liens. Claimant shall defend, indemnify, and hold harmless Released Parties from any claim or demand for reimbursement of Liens not satisfied from the Settlement Amount.

7.2 Limitation of Liability. The total liability of Released Parties in connection with the Incident shall not exceed the Settlement Amount.

7.3 Force Majeure. No Party shall be liable for delay in performance caused by events beyond its reasonable control, provided such Party gives prompt notice and resumes performance as soon as practicable.

8. DISPUTE RESOLUTION

8.1 Governing Law. This Agreement is governed by the substantive laws of the State of North Dakota, without regard to conflict-of-laws principles.

8.2 Forum Selection. Any dispute arising under this Agreement shall be resolved exclusively in the District Court of [COUNTY], State of North Dakota.

8.3 Arbitration & Jury Trial. The Parties hereby acknowledge that arbitration and jury-trial waiver provisions are not applicable under the metadata instructions.

9. GENERAL PROVISIONS

9.1 Entire Agreement. This Agreement constitutes the entire agreement between the Parties and supersedes all prior negotiations and agreements concerning the subject matter hereof.

9.2 Amendment; Waiver. No amendment or waiver is effective unless in writing and signed by all Parties. Waiver of any breach does not constitute waiver of any other or subsequent breach.

9.3 Assignment. No Party may assign its rights or delegate its duties without the prior written consent of all other Parties, except that Released Party may assign obligations to a qualified assignment company for purposes of a Structured Settlement.

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

9.5 Successors & Assigns. This Agreement binds and inures to the benefit of the Parties and their respective heirs, executors, administrators, successors, and permitted assigns.

9.6 Counterparts; Electronic Signatures. This Agreement may be executed in any number of counterparts, each of which is deemed an original, and all of which together constitute one instrument. Signatures delivered by electronic means shall be deemed original and binding.

10. EXECUTION BLOCK

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

[If Minor:]
Signature of Parent/Guardian: ___
Name: ___
Date: ______

[// GUIDANCE: Determine under ND law whether notarization or witness attestation is advisable for releases involving minors or large settlement amounts. Insert acknowledgment blocks if required.]

11. SCHEDULE 1 – PAYMENT TERMS

Choose one of the following options (delete non-applicable):

1. Lump-Sum Payment:
    Amount: US$ [__]
    Payment Method: [Wire transfer / Certified check] to [Trust Account Name].
    Funding Date: [__].

2. Structured Settlement:
    Total Present Value: US$ [_]
    Payee: [CLAIMANT / MINOR NAME]
    Periodic Payments:
    • $[_] on [DATE] and annually thereafter for [__] years.
    • $[____] lump-sum on [DATE].
    Annuity Issuer: [COMPANY NAME], rated not less than A- by A.M. Best.
    Qualified Assignment Company: [NAME], assuming Released Party’s payment obligation.

12. SCHEDULE 2 – LIENS & SUBROGATION INTERESTS

1. Medicare Conditional Payment Amount: $[____]
2. Medicaid: $[____]
3. Private Health Insurance: $[____]
4. Hospital/Provider Liens: $[____]
5. Workers’ Compensation Carrier: $[____]
6. Other: $[____]

[// GUIDANCE: Insert “None” where no lien exists. Failure to list a lien shifts responsibility to Claimant under Section 7.1.]