PERSONAL INJURY SETTLEMENT AGREEMENT
(Mutual Release of All Claims – State of Nevada)
[// GUIDANCE: This template is drafted to be “plug-and-play.” Replace all bracketed capitalized placeholders before circulation. Delete all guidance boxes prior to execution.]
TABLE OF CONTENTS
- Document Header
- Definitions
- Operative Provisions
- Representations & Warranties
- Covenants & Restrictions
- Default & Remedies
- Risk Allocation
- Dispute Resolution
- General Provisions
- Execution Block
1. DOCUMENT HEADER
1.1 Title; Parties.
This Personal Injury Settlement Agreement and Mutual Release (this “Agreement”) is entered into by and between [PLAINTIFF FULL LEGAL NAME], an individual (“Claimant”), and [DEFENDANT FULL LEGAL NAME], a [corporation/limited liability company/individual] (“Respondent,” and together with Claimant, the “Parties,” and each a “Party”).
1.2 Effective Date.
This Agreement is effective as of [EFFECTIVE DATE] (the “Effective Date”).
1.3 Recitals.
A. A dispute arose out of an incident occurring on or about [DATE OF INCIDENT] in [LOCATION] (the “Incident”), resulting in alleged personal injuries to Claimant.
B. Claimant filed or threatened to file litigation styled [CASE CAPTION / COURT / DOCKET NO.] (the “Action”).
C. The Parties desire to fully and finally settle the Action and any other Claims (as defined below) on the terms set forth herein, without admission of liability.
NOW, THEREFORE, in consideration of the mutual covenants and promises herein, the sufficiency of which is acknowledged, the Parties agree as follows:
2. DEFINITIONS
[// GUIDANCE: Definitions are alphabetical; use consistently.]
“Action” – see Recital B.
“Agreement” – this Personal Injury Settlement Agreement.
“Claimant” – see §1.1.
“Claims” – all past, present, or future claims, demands, causes of action, damages, losses, costs, attorneys’ fees, liens, subrogation interests, penalties, or liabilities of any kind, whether known or unknown, suspected or unsuspected, arising from or relating to the Incident.
“Confidential Information” – the terms, conditions, and existence of this Agreement and any non-public information exchanged during settlement negotiations.
“Court Approval” – the approval required under NRS 41.200 or any successor statute for settlements involving minors or incapacitated persons.
“Effective Date” – see §1.2.
“Party” / “Parties” – see §1.1.
“Respondent” – see §1.1.
“Settlement Amount” – the total consideration described in §3.2.
“Structured Settlement” – periodic payment arrangement, if elected under §3.3.
3. OPERATIVE PROVISIONS
3.1 Settlement; Dismissal.
(a) The Parties agree to a complete and final settlement of the Claims.
(b) Within three (3) business days after Claimant’s receipt of good funds per §3.2, Claimant shall file a dismissal with prejudice of the Action, each Party to bear its own attorneys’ fees and costs unless otherwise provided herein.
3.2 Consideration.
(a) Respondent shall pay Claimant the total gross sum of [US$____] (the “Settlement Amount”), allocated as follows:
(i) [US$____] to Claimant; and
(ii) [US$____] to [LAW FIRM TRUST/IOLTA ACCOUNT] for attorneys’ fees and costs.
(b) Payment shall be made by [wire transfer/certified funds] on or before [PAYMENT DEADLINE].
3.3 Structured Settlement (Optional).
(a) Election. If the Parties elect a Structured Settlement, the Settlement Amount shall be funded as periodic payments through an assignment to a qualified third-party assignee compliant with Internal Revenue Code §130 and Nevada Structured Settlement laws.
(b) Terms Schedule. Payment amounts, due dates, beneficiary designations, and guaranteed periods are set forth on Schedule 1.
(c) Qualified Assignment. Respondent may make a “qualified assignment” of its periodic payment obligations; Claimant shall execute all documents reasonably required to accomplish the assignment.
(d) Non-Acceleration; Non-Transferability. Claimant may not accelerate, defer, increase, decrease, anticipate, sell, assign, or encumber any Structured Settlement payment except as permitted under Nevada’s Structured Settlement Transfer statutes.
3.4 Conditions Precedent.
Payment obligations are conditioned upon (i) Claimant’s execution and delivery of this Agreement, and (ii) receipt of [IRS Form W-9, Medicare/Medicaid lien documentation, Court Approval if §5.2 applies].
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 this Agreement.
(b) No Assignment. It has not sold, assigned, transferred, conveyed, or otherwise disposed of any Claim released herein.
(c) Voluntary Execution. It has read this Agreement, understands its legal effect, and executes it voluntarily, without duress or undue influence, after consulting or having had the opportunity to consult independent counsel.
4.2 Survival. The representations and warranties in this §4 survive the Effective Date and any dismissal of the Action.
5. COVENANTS & RESTRICTIONS
5.1 Mutual Release.
(a) Upon Claimant’s receipt of the Settlement Amount (or first Structured Settlement payment), each Party irrevocably releases and forever discharges the other Party (including all parents, subsidiaries, affiliates, officers, directors, employees, insurers, reinsurers, agents, heirs, successors, and assigns) from any and all Claims.
(b) This release extends to Claims which the releasing Party does not know or suspect to exist, expressly waiving all rights under Nevada law with respect to such unknown Claims.
5.2 Minor or Incapacitated Claimant.
If Claimant is a minor or incapacitated person, the settlement is subject to Court Approval pursuant to NRS 41.200. Funds shall be deposited, administered, or structured only as approved by the court. Any conflicting provision herein is automatically conformed to the court’s order.
[// GUIDANCE: Attach petition and proposed order as separate pleadings when filing with the court.]
5.3 Liens & Subrogation.
Claimant shall satisfy or resolve all valid medical liens, governmental reimbursement claims (including Medicare/Medicaid conditional payments), and subrogation interests. Claimant agrees to indemnify and hold Respondent harmless from any unpaid liens or reimbursement claims arising from the Incident.
5.4 Confidentiality.
Except as required by law or court order, the Parties shall not disclose Confidential Information to any third party other than (i) immediate family, (ii) accountants, tax, or legal advisors who agree to keep it confidential, or (iii) as necessary to enforce this Agreement.
6. DEFAULT & REMEDIES
6.1 Events of Default.
(a) Respondent’s failure to deliver the Settlement Amount in good funds by the deadline in §3.2.
(b) Claimant’s failure to dismiss the Action as required by §3.1(b).
6.2 Notice & Cure.
The non-defaulting Party shall provide written notice of default; the defaulting Party has five (5) business days to cure.
6.3 Remedies.
If not timely cured:
(a) Claimant may enter judgment for the unpaid Settlement Amount plus interest at the statutory rate;
(b) Respondent may move to dismiss the Action with prejudice and recover reasonable attorneys’ fees incurred in enforcing this Agreement; and
(c) Either Party may seek specific performance.
6.4 Attorneys’ Fees & Costs.
In any proceeding to enforce this Agreement, the prevailing Party is entitled to recover reasonable attorneys’ fees, court costs, and expenses.
7. RISK ALLOCATION
7.1 Mutual Release – Exclusive Remedy.
The releases in §5.1 are the sole and exclusive remedies for all Claims; liability is capped at the Settlement Amount.
7.2 No Admission.
Nothing in this Agreement constitutes an admission of liability or wrongdoing by any Party.
7.3 Force Majeure.
No Party is liable for delay or failure in performance caused by events beyond its reasonable control, excluding payment obligations.
8. DISPUTE RESOLUTION
8.1 Governing Law.
This Agreement is governed by and construed in accordance with the laws of the State of Nevada, without regard to conflict-of-laws principles.
8.2 Forum Selection.
The Parties consent to exclusive jurisdiction and venue in the state courts of [COUNTY], Nevada for any action arising out of or relating to this Agreement or its enforcement.
8.3 Waiver of Jury Trial.
[NOT APPLICABLE – intentionally omitted per metadata.]
8.4 Injunctive Relief.
[NOT APPLICABLE – intentionally omitted.]
8.5 Arbitration.
[NOT APPLICABLE – intentionally omitted.]
9. GENERAL PROVISIONS
9.1 Entire Agreement.
This Agreement contains the entire understanding of the Parties and supersedes all prior negotiations and writings.
9.2 Amendment; Waiver.
No amendment or waiver is effective unless in a writing signed by all Parties. A waiver on one occasion is not a waiver on any other occasion.
9.3 Assignment.
No Party may assign its rights or delegate its duties without prior written consent of the other Party, except as expressly permitted in §3.3(c).
9.4 Severability.
If any provision is held invalid, the remaining provisions remain enforceable, and the invalid provision is reformed to the minimum extent necessary to make it valid.
9.5 Successors & Assigns.
This Agreement binds and benefits the Parties and their respective successors and assigns.
9.6 Counterparts; Electronic Signatures.
This Agreement may be executed in counterparts (including PDF or electronic signatures), each of which is deemed an original and all of which together constitute one instrument.
9.7 Headings & Construction.
Headings are for convenience only and do not affect interpretation. The Parties drafted this Agreement jointly; no presumption against the drafter applies.
9.8 Notices.
All notices must be in writing and delivered by hand, overnight courier, certified mail (return receipt requested), or email with confirmation, to the addresses set forth below or such other address designated by written notice.
10. EXECUTION BLOCK
IN WITNESS WHEREOF, the Parties have executed this Agreement as of the Effective Date.
CLAIMANT
[NAME]
Address:
[STREET ADDRESS]
[CITY, STATE ZIP]
Email: [EMAIL]
RESPONDENT
By: _____
Name: [AUTHORIZED SIGNATORY]
Title: [TITLE]
[DEFENDANT LEGAL NAME]
Address:
[STREET ADDRESS]
[CITY, STATE ZIP]
Email: [EMAIL]
[OPTIONAL NOTARY ACKNOWLEDGMENT BLOCK – include if required by local court rules or for minor settlement approval filings.]
Schedule 1 – Structured Settlement Payment Schedule
[Insert payment dates, amounts, payee, and guaranteed period. Attach life company illustration if applicable.]
[// GUIDANCE: Attach Exhibit A (Dismissal with Prejudice Form) and any required lien resolution letters as further exhibits for ease of filing.]