Personal Injury Settlement Agreement - Rhode Island

RHODE ISLAND PERSONAL-INJURY SETTLEMENT AGREEMENT AND RELEASE

This form is for a negotiated settlement of identified personal-injury claims by a claimant whose capacity and authority have been confirmed. It is not a minor-settlement petition, guardianship or conservatorship filing, estate or wrongful-death settlement, structured-settlement transfer petition, tax opinion, benefit-compliance opinion, lien opinion, or court order.

1. PRE-SIGNING REVIEW

A. Claimant, Capacity, and Authority

Do not assume that a parent, spouse, guardian, attorney, insurer, or other person may release claims that person does not own or lacks authority to settle.

B. Rhode Island Minor-Claim Gate

R.I. Gen. Laws § 33-15.1-1(b) makes a release binding on a minor when the release amount does not exceed $10,000 and it is given by both parents, a parent or guardian with legal custody, or the adult spouse of a minor spouse. The statute does not supply this same rule for an amount above $10,000.

If the claimant is a minor:

• Settlement amount: $[________]
• Person signing for the minor: [________________________________]
• Legal-custody or guardianship basis: [________________________________]
• Counsel's written determination of the required approval, guardian, restricted-deposit, annuity, or other protective procedure: [________________________________]

If an action is pending, R.I. Super. Ct. R. Civ. P. 17(c) also governs representation of an infant or incompetent person in that action. Do not use this agreement as a substitute for any required motion, petition, appointment, findings, order, bond, account, or restricted-distribution document.

C. Parties, Incident, and Claim Scope

Do not use “all persons,” “all affiliates,” “all insurers,” or similar expanding language unless the intended members are understood and supported by the bargain.

2. AGREEMENT

This Personal-Injury Settlement Agreement and Release (the “Agreement”) is made on [__/__/____] by and between:

• Claimant: [FULL LEGAL NAME] (“Claimant”); and
• Paying Party: [FULL LEGAL NAME] (“Paying Party”).

The persons and entities identified in Schedule 1 are the “Released Parties.” No other person or entity is released merely because that person or entity may relate to a party, insurer, claim, or Incident.

Recitals

A. An incident occurred on [__/__/____] at [LOCATION] (the “Incident”).

B. Claimant asserts the claims identified in Schedule 1. The Released Parties deny liability and dispute [LIABILITY, CAUSATION, DAMAGES, COVERAGE, OR OTHER ISSUES].

C. The parties wish to resolve the identified claims without trial and without an admission of liability.

For the consideration and promises stated below, the parties agree:

3. SETTLEMENT CONSIDERATION AND CLOSING

3.1 Settlement Amount

Paying Party shall pay a total of $[________] (the “Settlement Amount”) through the following components:

No entry in this table is, by itself, a tax, lien, benefit, fiduciary, or approval determination.

3.2 Closing Conditions and Payment

Payment is due [____] days after Paying Party receives all items selected below that actually apply:

☐ This Agreement signed by every required person

☐ Current authenticated payment instructions and any payer-requested tax form

☐ Approval and authority documents listed in Schedule 3

☐ Reimbursement, holdback, or direct-payment documents listed in Schedule 2

☐ Dismissal documents held under Section 8

☐ Other: [________________________________]

Payment shall be delivered to [CLAIMANT / COUNSEL TRUST ACCOUNT / COURT-RESTRICTED ACCOUNT / FUNDING ENTITY / OTHER] by [CHECK / WIRE / OTHER]. Payment is complete when [DEFINE CLEARED-FUNDS EVENT].

3.3 Periodic Payments, If Negotiated

☐ No periodic-payment arrangement applies.

☐ A separately reviewed funding and payment schedule is attached as Schedule 5. It identifies every payment, payee, due date, obligor, assignee if any, annuity issuer if any, beneficiary provision, and controlling funding document.

R.I. Gen. Laws chapter 27-9.3 defines a “transfer” as a later sale, assignment, pledge, hypothecation, or other alienation or encumbrance of structured-settlement payment rights for consideration. Section 27-9.3-4 requires advance Superior Court approval for that transfer. Those transfer rules do not themselves supply the terms for creating the original periodic-payment settlement. Original funding, assignment, tax, security, beneficiary, and approval terms require separate drafting.

3.4 No Admission

This Agreement compromises disputed claims. Payment and execution are not admissions of fault, liability, causation, damages, coverage, or wrongdoing.

4. CLAIMANT'S RELEASE

Upon the cleared-funds event in Section 3.2, Claimant releases the Released Parties from the claims that:

1. Claimant owns and has authority to release;
2. Arise from the Incident; and
3. Fall within the selected scope below.

Select one reviewed scope and delete the others:

☐ Identified-claims release: only the claims listed as released in Schedule 1

☐ Incident-based release: all claims Claimant owns against the Released Parties arising from the Incident, whether currently known or unknown, except the reservations in Schedule 1

☐ Other negotiated scope: [________________________________]

The release does not include:

• Obligations created by this Agreement;
• Claims or parties reserved in Schedule 1;
• Rights Claimant lacks authority to release;
• Claims belonging independently to another person or entity; or
• [OTHER EXCLUSIONS].

Optional Reciprocal Release

☐ No reciprocal release is given.

☐ Upon the cleared-funds event, Paying Party releases Claimant only from these identified claims owned by Paying Party: [________________________________].

5. OTHER TORTFEASORS AND CONTRIBUTION

Under R.I. Gen. Laws § 10-6-7, a release of one joint tortfeasor does not discharge another tortfeasor unless the release says so; the claimant's claim against the others is reduced by the consideration paid for the release; and the released tortfeasor is relieved from contribution liability to another joint tortfeasor.

Select and complete one reviewed direction:

☐ Settling parties only. This Agreement releases only the Released Parties identified in Schedule 1. Claimant reserves claims against every other person or entity, subject to the reduction and contribution effects of § 10-6-7.

☐ Additional parties included. The release also discharges the following persons or entities: [IDENTIFY EACH OR USE A REVIEWED OBJECTIVE CATEGORY].

☐ No possible joint-tortfeasor issue identified. Basis: [________________________________].

6. CLAIMANT REPRESENTATIONS

Claimant represents, as of signing, that:

1. Claimant has reviewed this Agreement and had the opportunity to consult independent counsel;
2. Claimant signs voluntarily and has authority to release the selected claims;
3. Claimant has not assigned the released claims except as disclosed in Schedule 2;
4. Claimant has disclosed known pending actions, settlements, bankruptcy matters, benefit claims, assignments, and reimbursement demands that may affect authority or payment; and
5. Schedule 2 identifies the known reimbursement, lien, assignment, and benefit issues reviewed for settlement administration.

These representations do not turn Claimant into an insurer of undiscovered third-party demands. Any holdback, direct-payment, cooperation, defense, settlement-control, reimbursement, or indemnity obligation must be written specifically in Schedule 2.

7. REIMBURSEMENT, LIENS, BENEFITS, AND DISTRIBUTION

Medical providers, benefit programs, health plans, insurers, attorneys, assignees, bankruptcy estates, or others may assert payment or reimbursement interests. This Agreement does not determine the validity, priority, amount, waiver, compromise, or satisfaction of any such interest.

Select the reviewed administration method:

☐ Claimant and counsel will hold $[________] in trust pending documented resolution of the Schedule 2 items.

☐ Paying Party will issue the separate payments listed in Schedule 2.

☐ The order or restricted-distribution document listed in Schedule 3 will control.

☐ Other procedure: [________________________________].

No party may state that an asserted interest has been resolved unless the settlement file contains the written basis for that conclusion.

8. PENDING ACTION AND DISMISSAL

If an action is pending:

1. The parties will sign the dismissal document identified in Schedule 4;
2. [CLAIMANT'S COUNSEL / ESCROW AGENT] will hold it pending the cleared-funds event and any required approval;
3. It will be filed within [____] business days after those events; and
4. It will state [WITH PREJUDICE / OTHER REVIEWED DISPOSITION], with costs allocated as follows: [________________________________].

This Agreement does not dismiss an action by itself.

9. OPTIONAL CONFIDENTIALITY AND COMMUNICATION TERMS

Delete this section if no communication restriction was negotiated.

☐ The Settlement Amount and nonpublic terms will be kept confidential, except for disclosures to counsel, tax or financial advisers, insurers, reinsurers, auditors, regulators, courts, benefit programs, reimbursement claimants, or others reasonably necessary to administer or enforce the settlement, and disclosures required by law, subpoena, court order, or professional duty.

☐ In response to outside inquiries, the parties will state only: [________________________________].

☐ No non-disparagement obligation applies.

☐ This narrowly defined non-disparagement term applies: [________________________________].

Nothing in this section prohibits truthful testimony, legal-process compliance, regulatory cooperation, benefit reporting, tax reporting, reimbursement resolution, professional-responsibility compliance, or private communications with legal, financial, medical, or tax advisers.

10. BREACH, INTEREST, AND ENFORCEMENT

If a party alleges breach, that party shall give written notice describing the breach and requested cure to [ADDRESS OR EMAIL]. The cure period is [____] days, except when delay would defeat the obligation's purpose or a court orders otherwise.

Available remedies are those stated in this Agreement and supplied by applicable law. The parties do not agree to automatic rescission, automatic reinstatement of released claims, automatic prevailing-party fees, a settlement-amount liability cap, force-majeure relief from a payment obligation, no-bond injunctive relief, or indemnification unless a reviewed term below states otherwise:

[INSERT SPECIFIC NEGOTIATED REMEDY, FEE, SECURITY, OR INDEMNITY TERM / None].

Do not label 12% as an automatic “prejudgment rate” for late settlement payment. R.I. Gen. Laws § 9-21-10 addresses interest added upon a civil judgment for pecuniary damages and says it does not apply until entry of judgment or to a contractual obligation where interest is already provided. Section 6-26-1 separately addresses postjudgment interest and interest in business transactions where interest is secured or paid. If the parties negotiate interest on an unpaid settlement installment, state the rate, accrual date, base, compounding rule, and any grace period expressly:

☐ No contractual late-payment interest.

☐ Interest at [____]% per year, [SIMPLE / COMPOUNDED AS FOLLOWS], on [DEFINE BASE], beginning [DATE OR EVENT], subject to counsel's review of applicable law.

11. GENERAL TERMS

1. Governing law. Rhode Island law governs this Agreement, except when another law necessarily controls a federal, benefit, tax, bankruptcy, fiduciary, or other issue.
2. Forum. Any forum-selection term is [________________________________ / None]. A pending court may retain authority as permitted by its orders and law.
3. Entire agreement. This Agreement and its schedules contain the complete settlement terms concerning the released claims.
4. Amendment. A change must be in a writing signed by every party whose rights or duties are changed and must receive any required approval.
5. Severability. If a provision is unenforceable, the remaining terms continue only to the extent consistent with the material settlement bargain and applicable law.
6. Counterparts and electronic signatures. The parties agree to conduct this transaction by [WET INK / APPROVED ELECTRONIC PLATFORM / OTHER]. Under R.I. Gen. Laws §§ 42-127.1-5 and 42-127.1-7, the electronic-transactions rules apply only when each party agrees to use electronic means, and a signature or record may not be denied legal effect solely because it is electronic. Any court, fiduciary, insurer, or settlement-administration format remains controlling.
7. No drafting presumption. The Agreement reflects negotiation by the parties and counsel as applicable.
8. Headings. Headings organize the document and do not expand the release.

12. SIGNATURES

Claimant

• Name: [________________________________]
• Signature: [________________________________]
• Date: [__/__/____]

Claimant's Representative, if any

• Name and title: [________________________________]
• Authority: [________________________________]
• Signature: [________________________________]
• Date: [__/__/____]

Paying Party

• Name: [________________________________]
• Signatory and title: [________________________________]
• Signature: [________________________________]
• Date: [__/__/____]

Counsel Acknowledgment, if used

• Counsel for Claimant: [________________________________]
• Signature: [________________________________]

• Date: [__/__/____]

• Counsel for Paying Party: [________________________________]

• Signature: [________________________________]
• Date: [__/__/____]

SCHEDULE 1 — RELEASED PARTIES, CLAIMS, AND RESERVATIONS

SCHEDULE 2 — REIMBURSEMENT, LIEN, ASSIGNMENT, AND BENEFIT TRACKER

SCHEDULE 3 — CAPACITY, AUTHORITY, AND APPROVAL DOCUMENTS

SCHEDULE 4 — PAYMENT AND DISMISSAL CLOSING CHECKLIST

☐ Final Agreement signed

☐ Authority and approval conditions completed

☐ Payment instructions authenticated

☐ Settlement funds received and cleared

☐ Required direct payments and holdbacks funded

☐ Dismissal filed, if applicable

☐ Filed dismissal or closing order received

☐ Final distribution statement completed

☐ Settlement file retains supporting reimbursement and authority documents

SCHEDULE 5 — PERIODIC-PAYMENT TERMS, IF ANY

Attach and reconcile every funding, assignment, annuity, beneficiary, and approval document. Do not use this schedule for a later sale or other transfer of existing structured-settlement payment rights.

SOURCES AND REFERENCES

• Rhode Island General Assembly — R.I. Gen. Laws § 10-6-7
• Rhode Island General Assembly — R.I. Gen. Laws § 33-15.1-1
• Rhode Island General Assembly — R.I. Gen. Laws § 27-9.3-2
• Rhode Island General Assembly — R.I. Gen. Laws § 27-9.3-4
• Rhode Island General Assembly — R.I. Gen. Laws § 9-21-10
• Rhode Island General Assembly — R.I. Gen. Laws § 6-26-1
• Rhode Island General Assembly — R.I. Gen. Laws § 42-127.1-5
• Rhode Island General Assembly — R.I. Gen. Laws § 42-127.1-7
• Rhode Island Judiciary — Superior Court Rules of Civil Procedure, Rule 17(c)