PERSONAL INJURY SETTLEMENT AGREEMENT AND MUTUAL RELEASE

(Rhode Island)

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

1. DOCUMENT HEADER

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

1. [INJURED PARTY LEGAL NAME], an individual with a principal address at [ADDRESS] (“Releasor”), and
2. [RESPONSIBLE PARTY LEGAL NAME], a [TYPE OF ENTITY / INDIVIDUAL] with a principal address at [ADDRESS] (“Releasee”).

Releasor and Releasee are hereinafter each referred to individually as a “Party” and collectively as the “Parties.”

Recitals

A. On or about [DATE OF INCIDENT], Releasor alleges that he/she sustained personal injuries and damages arising out of an incident that occurred at [LOCATION] (the “Incident”).
B. Releasee denies any liability but desires to resolve all claims arising from the Incident.
C. The Parties wish to fully and finally settle, compromise, and discharge any and all Claims (as defined below) upon the terms and conditions set forth herein, in compliance with Rhode Island law, including but not limited to rules governing release enforceability, structured settlements, and, where applicable, court approval of settlements involving minors.

NOW, THEREFORE, in consideration of the mutual covenants, promises, and payments contained herein, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Parties agree as follows:

2. DEFINITIONS

For purposes of this Agreement, capitalized terms shall have the meanings set forth below. Defined terms appear alphabetically.

“Claim(s)” means any and all past, present, or future claims, demands, causes of action, damages, costs, expenses, liens, rights, or liabilities of any nature whatsoever, whether known or unknown, asserted or unasserted, suspected or unsuspected, in law or equity, relating to or arising out of the Incident.

“Court Approval” means approval by a court of competent jurisdiction in the State of Rhode Island, as required for settlements involving a minor or incapacitated person under applicable law.

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

“Periodic Payments” means any structured settlement, annuity, or other scheduled disbursement of the Settlement Amount pursuant to Section 3.3(b).

“Settlement Amount” means the total consideration to be paid by or on behalf of Releasee to or for the benefit of Releasor as set forth in Section 3.3.

“Structured Settlement Rules” means all applicable federal and Rhode Island statutory or regulatory requirements governing the establishment, protection, and potential transfer of structured settlements, including any state Structured Settlement Protection Act.

3. OPERATIVE PROVISIONS

3.1 Settlement and Mutual Release

(a) Release by Releasor. Upon receipt of the Settlement Amount in full, Releasor, on behalf of himself/herself and his/her heirs, executors, administrators, successors, and assigns, hereby irrevocably and unconditionally releases and forever discharges Releasee and Releasee’s past, present, and future parents, subsidiaries, affiliates, owners, officers, directors, partners, members, employees, agents, insurers, reinsurers, and successors (collectively, the “Releasee Parties”) from any and all Claims.

(b) Release by Releasee. In consideration of the mutual covenants herein, Releasee, on behalf of itself and the Releasee Parties, hereby releases Releasor and Releasor’s heirs, executors, administrators, successors, and assigns from any and all Claims relating to the Incident.

(c) Scope. The mutual releases in this Agreement include a waiver of rights under any statute or common-law doctrine that would otherwise limit the release of unknown Claims.

[// GUIDANCE: Rhode Island recognizes broad releases so long as clear, conspicuous, and supported by consideration. This mutual release language is drafted to satisfy those standards.]

3.2 No Admission of Liability

Nothing herein shall be construed as an admission of liability, wrongdoing, or negligence by any Party; all such liability is expressly denied.

3.3 Consideration and Payment Terms

(a) Lump-Sum Option. Releasee shall pay to Releasor a one-time lump-sum payment of $[AMOUNT] (the “Settlement Amount”) within [NUMBER] business days after:
(i) execution of this Agreement by all Parties; and
(ii) satisfaction of all conditions precedent set forth in Section 3.4.

(b) Structured Settlement Option. In lieu of (a), the Parties may elect to fund the Settlement Amount, in whole or in part, through Periodic Payments described in Schedule A (Structured Settlement Payment Schedule). All Periodic Payments shall:
1. Comply with the Structured Settlement Rules;
2. Be funded through an annuity contract issued by a qualified assignment company rated at least [MINIMUM RATING] by A.M. Best; and
3. Be irrevocably assigned to Releasor (or an approved trust or guardian ad litem) subject to Court Approval if required.

[// GUIDANCE: Keep Schedule A blank for counsel to complete with annuity issuer, payment dates, and amounts. Include protections such as spend-thrift trust language for minors.]

3.4 Conditions Precedent

The following are conditions precedent to Releasee’s payment obligation:
1. Execution and delivery of this Agreement by all Parties;
2. Receipt of any lienholder consents, lien satisfactions, or Medicare/Medicaid conditional payment resolutions;
3. If Releasor is a Minor or legally incapacitated, entry of a final, non-appealable order granting Court Approval; and
4. Receipt by Releasee (or its insurer) of a completed IRS Form W-9 from Releasor.

3.5 Taxes

Releasor acknowledges and agrees that he/she is solely responsible for any federal, state, or local tax liabilities associated with the Settlement Amount, except to the extent payments qualify for exclusion from gross income under I.R.C. § 104(a)(2).

4. REPRESENTATIONS & WARRANTIES

4.1 Mutual Representations. Each Party represents and warrants that:
(a) Authority. It has full power and authority to enter into and perform this Agreement, and the person signing on its behalf is duly authorized.
(b) No Assignment of Claims. It has not assigned or otherwise transferred any Claim released herein.
(c) Independent Counsel. It has had the opportunity to obtain independent legal advice and enters this Agreement voluntarily, free from duress or undue influence.

4.2 Releasor-Specific Representations. Releasor further represents that:
(a) Capacity. Releasor is of legal age and competent, or, if a Minor, is represented by a duly appointed parent/guardian ad litem authorized by the Court.
(b) Lien Disclosure. Releasor has disclosed to Releasee all known liens, subrogation claims, or third-party interests related to the Incident.

Survival. The representations and warranties in this Section shall survive the Effective Date and the consummation of the transactions contemplated herein.

5. COVENANTS & RESTRICTIONS

5.1 Confidentiality. The Parties shall maintain the confidentiality of this Agreement and its terms, except: (i) as required by law or court order; (ii) to enforce or defend this Agreement; (iii) to tax, accounting, or legal advisors; or (iv) to obtain necessary Court Approval.

5.2 Non-Disparagement. The Parties agree not to make any statement intended to disparage or harm the reputation of the other Party in relation to the Incident or this settlement.

5.3 Cooperation on Liens and Medicare Compliance. Releasor shall cooperate with Releasee in satisfying or resolving all Medicare, Medicaid, ERISA, workers’ compensation, and other statutory or contractual reimbursement obligations.

6. DEFAULT & REMEDIES

6.1 Events of Default. An “Event of Default” occurs if:
(a) Releasee fails to timely pay the Settlement Amount; or
(b) Releasor breaches the confidentiality or non-disparagement covenants.

6.2 Cure Period. The defaulting Party shall have ten (10) business days after written notice to cure an Event of Default.

6.3 Remedies.
(a) Monetary Default by Releasee. Releasor may obtain a judgment for the unpaid Settlement Amount plus interest at the Rhode Island statutory prejudgment rate from the date payment was due, together with reasonable attorneys’ fees and costs incurred in enforcement.
(b) Non-Monetary Default by Releasor. Releasee may seek injunctive relief and recover damages, including attorneys’ fees and costs.

[// GUIDANCE: Rhode Island enforces fee-shifting where contractually agreed. Ensure any fee clause is bilateral and reasonable to avoid unconscionability arguments.]

7. RISK ALLOCATION

7.1 Indemnification & Hold Harmless.
(a) By Releasor. Releasor shall indemnify and hold harmless Releasee from any lien, claim, or subrogation interest that remains unsatisfied in violation of Section 5.3.
(b) By Releasee. Releasee shall indemnify and hold harmless Releasor from claims arising from Releasee’s failure to fund the Settlement Amount.

7.2 Limitation of Liability. Except for a Party’s indemnification obligations or breach of confidentiality, each Party’s aggregate liability under this Agreement shall not exceed the Settlement Amount.

7.3 Force Majeure. No Party shall be liable for delay or failure in performance caused by events beyond its reasonable control, including acts of God, war, or governmental regulation, provided the affected Party gives prompt notice and resumes performance as soon as practicable.

8. DISPUTE RESOLUTION

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

8.2 Forum Selection. The Parties irrevocably submit to the exclusive jurisdiction of the state courts located in [COUNTY], Rhode Island, for any action arising out of or relating to this Agreement.

8.3 Arbitration & Jury Waiver. The Parties expressly agree that:
(a) No arbitration provisions apply; and
(b) No jury waiver is provided herein.

9. GENERAL PROVISIONS

9.1 Entire Agreement. This Agreement constitutes the entire understanding among the Parties concerning the subject matter and supersedes all prior or contemporaneous agreements.

9.2 Amendment & Waiver. No amendment or waiver shall be effective unless in writing and signed by all Parties. A waiver of any breach shall not be deemed a waiver of any subsequent breach.

9.3 Assignment. No Party may assign or delegate its rights or obligations without the prior written consent of the other Party, except Releasee may assign its payment obligations to a qualified assignment company for funding any Periodic Payments.

9.4 Successors & Assigns. This Agreement binds and benefits the Parties and their respective successors and permitted assigns.

9.5 Severability. If any provision is held invalid or unenforceable, the remaining provisions shall remain in full force, and the invalid portion shall be deemed modified to the minimum extent necessary to make it valid.

9.6 Counterparts; Electronic Signatures. This Agreement may be executed in counterparts, each of which is deemed an original, and all of which together constitute one instrument. Signatures delivered electronically or by facsimile shall be deemed original.

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

10. EXECUTION BLOCK

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

[NOTARY ACKNOWLEDGMENT, if required]

Schedule A

STRUCTURED SETTLEMENT PAYMENT SCHEDULE
(To be completed if Section 3.3(b) applies.)

[// GUIDANCE: Counsel should ensure compliance with Rhode Island court procedures for structured settlements, including filing of affidavits, actuarial statements, and proposed orders of approval.]

[// GUIDANCE:
1. Minor Settlement Approval – Superior or Probate Court approval (R.I. Super. R. Civ. P. 17(c)) is generally required. Add a separate approval page or proposed order if applicable.
2. Medicare Secondary Payer Compliance – Consider adding a Medicare Set-Aside arrangement if future medical expenses are contemplated.
3. Confidentiality – Rhode Island courts may scrutinize overly broad confidentiality clauses in cases involving public interest. Tailor Section 5.1 accordingly.
4. Lien Resolution – Obtain final lien letters and keep them for at least seven (7) years.
]