PERSONAL INJURY SETTLEMENT AGREEMENT

AND MUTUAL RELEASE OF ALL CLAIMS

(Ohio – Governed by State Tort Law)

[// GUIDANCE: This template is drafted for Ohio personal-injury matters. Replace all bracketed placeholders before execution and delete all guidance comments.]

TABLE OF CONTENTS

1. Document Header ………………………………………………………………………………… 2
2. Definitions ……………………………………………………………………………………………… 3
3. Operative Provisions …………………………………………………………………………… 5
4. Representations & Warranties …………………………………………………………… 7
5. Covenants & Restrictions …………………………………………………………………… 8
6. Default & Remedies …………………………………………………………………………… 9
7. Risk Allocation …………………………………………………………………………………… 10
8. Dispute Resolution …………………………………………………………………………… 11
9. General Provisions …………………………………………………………………………… 12
10. Execution Block ………………………………………………………………………………… 14

(Page numbers assume final formatting.)

1. DOCUMENT HEADER

1.1 Parties.
This Personal Injury Settlement Agreement and Mutual Release of All Claims (this “Agreement”) is entered into as of [EFFECTIVE DATE] (the “Effective Date”) by and between:

(a) [PLAINTIFF FULL LEGAL NAME], an individual with a principal address at [ADDRESS] (“Releasor”); and

(b) [DEFENDANT FULL LEGAL NAME], a [corporation/partnership/individual] with a principal address at [ADDRESS] (“Releasee”).

Releasor and Releasee are each a “Party” and, collectively, the “Parties.”

1.2 Recitals.
A. An incident occurring on or about [DATE OF INCIDENT] at or near [LOCATION] allegedly caused Releasor to sustain personal injuries and other damages (the “Incident”).
B. Releasor asserts actual and potential claims arising out of, related to, or in any way connected with the Incident (collectively, the “Claims”).
C. Releasee expressly denies all liability but desires to resolve the Claims.
D. The Parties wish to settle fully and finally all Claims on the terms set forth herein, intending this Agreement to be binding and enforceable.

NOW, THEREFORE, in consideration of the mutual promises, releases, covenants, and other valuable consideration described herein, the sufficiency of which is hereby acknowledged, the Parties agree as follows:

2. DEFINITIONS

For purposes of this Agreement, the following terms shall have the meanings set forth below. Terms defined in the singular include the plural and vice-versa. All cross-references refer to Sections of this Agreement unless expressly stated otherwise.

“Claim” or “Claims” has the meaning provided in Recital B.

“Confidential Information” means the terms of this Agreement and all non-public facts concerning the Incident, Releasor’s medical condition, medical expenses, or any other personal or proprietary information disclosed in connection with the settlement.

“Court Approval” means approval of this Agreement by the Probate Division of the Court of Common Pleas having jurisdiction over Releasor, as required under Ohio Rev. Code § 2111.18 where Releasor is a minor or incompetent person.

“Effective Date” has the meaning provided in Section 1.1.

“Final Order” means a final, non-appealable order, judgment, or decree.

“Gross Settlement Amount” has the meaning provided in Section 3.1(a).

“Incident” has the meaning provided in Recital A.

“Minor” means any natural person who has not attained the age of eighteen (18) years as of the Effective Date.

“Party” or “Parties” has the meaning provided in Section 1.1.

“Payee” has the meaning provided in Section 3.1(a).

“Releasee” has the meaning provided in Section 1.1(b) and, for avoidance of doubt, includes all Releasees as defined in Section 3.2(a).

“Releasor” has the meaning provided in Section 1.1(a) and, for avoidance of doubt, includes all Releasors as defined in Section 3.2(b).

“Structured Settlement” means periodic payment arrangements within the meaning of 26 U.S.C. §§ 104(a)(2), 130.

3. OPERATIVE PROVISIONS

3.1 Settlement Consideration.
(a) Payment Obligation. Releasee shall pay to [NAME OF PAYEE] (the “Payee”) the total sum of $[SETTLEMENT AMOUNT].00 (the “Gross Settlement Amount”) within [NUMBER] business days after the later of (i) the Effective Date, or (ii) receipt by Releasee of a fully executed original of this Agreement, any required Court Approval, and a properly completed Form W-9 for the Payee.

(b) Allocation. Unless otherwise required by law, the Parties agree that the Gross Settlement Amount constitutes damages on account of personal physical injuries or physical sickness within the meaning of 26 U.S.C. § 104(a)(2), and no portion is wages or punitive damages.

(c) Structured Settlement. [If elected:] A portion of the Gross Settlement Amount shall be funded via a Structured Settlement as set forth in Exhibit A. [// GUIDANCE: Insert annuity terms, funding dates, assignment provisions, and qualified assignment language required by 26 U.S.C. § 130.]

(d) Liens and Subrogation. Releasor shall be solely responsible for satisfaction of all valid liens, subrogated interests, or reimbursement claims, including Medicare, Medicaid, ERISA, or private health insurer liens. Releasor shall indemnify, defend, and hold Releasee harmless from any such claims.

3.2 Mutual Release.
(a) Release by Releasor. Upon receipt of the Gross Settlement Amount (or commencement of the Structured Settlement, if applicable), Releasor, on behalf of himself/herself and his/her heirs, executors, administrators, agents, successors, and assigns (collectively, the “Releasors”), irrevocably and unconditionally releases and forever discharges Releasee and its past, present, and future parents, subsidiaries, affiliates, insurers, reinsurers, officers, directors, shareholders, employees, agents, representatives, successors, and assigns (collectively, the “Releasees”) from any and all past, present, or future Claims, whether known or unknown, accrued or contingent, arising out of or relating to the Incident.

(b) Release by Releasee. In consideration of the releases and covenants herein, Releasee, on behalf of itself and the Releasees, irrevocably and unconditionally releases the Releasors from any and all claims, demands, or causes of action arising out of or relating to the Incident, excluding obligations under this Agreement.

(c) Ohio Rev. Code § 2305.19 Waiver. Releasor expressly waives the right to refile any dismissed actions under Ohio’s saving statute, Ohio Rev. Code § 2305.19, with respect to the Claims.

(d) Unknown Claims. Each Party understands and acknowledges that it may hereafter discover facts in addition to, or different from, those now known or believed to be true, but it is the intention of the Parties to fully, finally, and forever settle all Claims, known or unknown. Accordingly, such releases shall remain in effect as full and complete general releases notwithstanding the discovery of such additional or different facts.

3.3 Conditions Precedent.
(a) Court Approval (Minor or Incompetent Releasor). If Releasor is a Minor or an incompetent person, this Agreement shall be subject to and contingent upon Court Approval pursuant to Ohio Rev. Code § 2111.18. The Parties shall cooperate in good faith to obtain such approval.

(b) Dismissal With Prejudice. Within five (5) business days after confirmation of receipt of the Gross Settlement Amount and satisfaction of Section 3.3(a), Releasor shall file a stipulation dismissing with prejudice any lawsuit arising from the Incident.

3.4 Taxes. Each Party shall be responsible for its own federal, state, and local tax obligations, if any, arising out of this Agreement. Each Party acknowledges that no tax advice has been provided by the other Party.

4. REPRESENTATIONS & WARRANTIES

4.1 Authority. Each Party represents and warrants that it has full power and authority to enter into and perform this Agreement, and that no further authorization is necessary.

4.2 No Additional Assignments. Releasor represents and warrants that Releasor has not assigned or transferred, or purported to assign or transfer, to any third party any Claim released herein.

4.3 Independent Counsel. Each Party acknowledges that it (a) has had the opportunity to consult with independent legal counsel; (b) fully understands the terms and consequences of this Agreement; and (c) is entering into this Agreement voluntarily and without duress.

4.4 Accuracy. Each Party represents that no statement or omission made in connection with this settlement constitutes fraud or intentional misrepresentation.

4.5 Survival. The representations and warranties in this Section 4 shall survive the Effective Date and consummation of the settlement.

5. COVENANTS & RESTRICTIONS

5.1 Confidentiality.
(a) Non-Disclosure. The Parties shall keep Confidential Information strictly confidential and shall not disclose it to any third party except: (i) as required by law or court order; (ii) to tax, legal, or financial advisors who agree to maintain confidentiality; or (iii) to enforce this Agreement.

(b) Non-Disparagement. The Parties agree not to make any disparaging or derogatory statements regarding the other Party relating to the Incident.

[// GUIDANCE: Consider adding liquidated damages for breach of confidentiality if desired.]

5.2 No Admission of Liability. This Agreement constitutes a compromise of disputed claims and shall not be construed as an admission of liability by any Party.

5.3 Cooperation. The Parties shall execute all further documents and take any additional actions reasonably necessary to give effect to this Agreement.

6. DEFAULT & REMEDIES

6.1 Events of Default.
(a) Failure to Pay. Releasee’s failure to timely pay the Gross Settlement Amount or commence the Structured Settlement as required constitutes a default.
(b) Breach of Confidentiality. Any material breach of Section 5 constitutes a default.
(c) Material Misrepresentation. Any material breach of Section 4.4 constitutes a default.

6.2 Notice and Cure. The non-defaulting Party shall give written notice specifying the nature of the default. The defaulting Party shall have five (5) business days to cure a monetary default and ten (10) business days to cure any other default.

6.3 Remedies.
(a) Specific Performance. The non-defaulting Party may seek specific performance or injunctive relief to enforce the terms of this Agreement.
(b) Monetary Damages. The non-defaulting Party may recover direct damages resulting from the default, subject to Section 7.2 (Limitation of Liability).
(c) Attorney Fees. The prevailing Party in any action to enforce this Agreement shall be entitled to recover reasonable attorney fees and costs.

7. RISK ALLOCATION

7.1 Indemnification for Liens. Releasor shall indemnify, defend, and hold Releasee harmless from any and all lien, subrogation, or reimbursement claims described in Section 3.1(d).

7.2 Limitation of Liability. The maximum liability of Releasee (and the Releasees) to Releasor (and the Releasors) arising out of or relating to the Incident shall not exceed the Gross Settlement Amount. In no event shall either Party be liable for punitive, consequential, or exemplary damages arising from this Agreement.

7.3 Force Majeure. Neither Party shall be liable for any delay or failure to perform caused by events beyond its reasonable control, including acts of God, war, terrorism, or governmental actions; provided, however, that this Section shall not excuse payment obligations already matured.

8. DISPUTE RESOLUTION

8.1 Governing Law. This Agreement and any dispute arising hereunder shall be governed by and construed in accordance with the laws of the State of Ohio, without regard to conflict-of-laws principles.

8.2 Forum Selection. The Parties submit to the exclusive jurisdiction of the state courts located in [COUNTY], Ohio, and waive any objection based on inconvenient forum.

8.3 Jury Trial. Each Party retains all rights to trial by jury; no jury waiver is intended or effected.

8.4 Injunctive Relief. Nothing in this Section shall limit either Party’s right to seek provisional or injunctive relief in any court of competent jurisdiction.

9. GENERAL PROVISIONS

9.1 Entire Agreement. This Agreement constitutes the entire agreement between the Parties with respect to the subject matter and supersedes all prior understandings, whether written or oral.

9.2 Amendments and Waivers. No amendment or waiver of any provision of this Agreement shall be effective unless in writing and signed by all Parties. No waiver shall constitute a waiver of any other provision or subsequent breach.

9.3 Assignment. Neither Party may assign or delegate its rights or duties under this Agreement without the prior written consent of the other Party, except that Releasee may assign its payment obligations under a Structured Settlement to a qualified assignment company pursuant to 26 U.S.C. § 130.

9.4 Successors and Assigns. This Agreement shall be binding upon and inure to the benefit of the Parties and their respective successors and permitted assigns.

9.5 Severability. If any provision is held invalid or unenforceable by a court of competent jurisdiction, the remaining provisions shall remain in full force and effect, and the invalid provision shall be reformed to the minimum extent necessary to be enforceable.

9.6 Counterparts; Electronic Signatures. This Agreement may be executed in counterparts, each of which shall be deemed an original and all of which together constitute one instrument. Signatures transmitted by electronic means (e.g., PDF, DocuSign, or fax) shall be deemed original.

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

9.8 Construction. The Parties have jointly participated in drafting this Agreement and, therefore, it shall not be construed against either Party as drafter.

10. EXECUTION BLOCK

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

RELEASOR

[PLAINTIFF NAME]
Date: _________

[Optional Notary Acknowledgment]

RELEASEE

By: _____
Name: [AUTHORIZED SIGNATORY]
Title: [TITLE]
Date: _________

[Corporate seal, if applicable]

EXHIBIT A

(Structured Settlement Terms)
[// GUIDANCE: Insert qualified assignment agreement, payment schedule, payee designations, and irrevocable annuity provisions.]

[// GUIDANCE: For minor settlements, attach additional probate court forms required by local rule and include signature lines for guardian and approval order.]