Personal Injury Settlement Agreement - South Dakota

PERSONAL INJURY SETTLEMENT AGREEMENT AND RELEASE

State of South Dakota

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

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

(a) [PARTY A FULL LEGAL NAME], an individual with a primary residence at [ADDRESS] (“Claimant”); and

(b) [PARTY B FULL LEGAL NAME], a [ENTITY TYPE & STATE OF FORMATION] with its principal place of business at [ADDRESS] (“Respondent”).

1.2 Recitals.
A. On or about [DATE OF INCIDENT], Claimant allegedly sustained personal injuries (the “Injuries”) arising from an incident occurring at [LOCATION] (the “Incident”).
B. Claimant has asserted claims (the “Claims”) against Respondent for damages related to the Incident.
C. The Parties desire to resolve the identified Claims on the terms set forth in this Agreement, subject to any express reservation in Section 7.1.
D. The Parties acknowledge the receipt and sufficiency of the consideration described herein and intend to be legally bound.

1.3 Governing Law & Forum. South Dakota law governs this Agreement. Any dispute arising under it shall be brought in a court with subject-matter jurisdiction and proper venue under applicable law.

2. DEFINITIONS

For purposes of this Agreement, the following terms shall have the meanings set forth below; capitalized terms used but not defined elsewhere shall have the meanings assigned in this Section 2.

“Agreement” has the meaning given in Section 1.

“Annuity Contract” means an annuity policy, if any, identified in Section 3.3 and Exhibit A.

“Claim(s)” has the meaning given in Recital B.

“Claimant” has the meaning given in Section 1.1(a).

“Court Approval” means any approval order required for this Claimant and settlement under applicable law, identified in Section 3.4.

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

“Injuries” has the meaning given in Recital A.

“Minor” means [MINOR’S FULL LEGAL NAME], date of birth [DOB], if the Claimant is under the age of majority.

“Parties” means Claimant and Respondent, collectively; and “Party” means either one of them.

“Respondent” has the meaning given in Section 1.1(b).

“Settlement Amount” has the meaning given in Section 3.2.

“Structured Settlement” means the periodic-payment arrangement described in Section 3.3.

3. OPERATIVE PROVISIONS

3.1 Conditions Precedent. Respondent's payment obligation begins after (a) all Parties and any required authorized representative have signed this Agreement; (b) any required Court Approval has been obtained and a copy delivered to Respondent; and (c) the lien payment or holdback plan in Section 5.1 and Exhibit B has been completed. A Party shall promptly notify the other when a condition is satisfied.

3.2 Settlement Consideration. Respondent (or its identified insurer, [NAME]) shall provide total settlement consideration of $[________] (the “Settlement Amount”) as follows. The parties shall complete the amounts so that the lump-sum payment and any funded periodic-payment obligation together equal the Settlement Amount:
(a) Lump-Sum Payment: $[________], payable to [PAYEE AND DELIVERY METHOD] within [____] business days after satisfaction of Section 3.1.
(b) Periodic Payments: ☐ None. ☐ An obligation funded with $[________] as described in Section 3.3 and Exhibit A.

3.3 Structured Settlement (Optional). If periodic payments are selected, [RESPONDENT / INSURER / OTHER NAMED OBLIGOR] shall fund the payment schedule in Exhibit A through [ISSUER AND POLICY OR FUNDING DESCRIPTION] by [__/__/____]. A proposed assignment of the periodic-payment obligation requires a separate written assumption identifying the assignee, payment security, and any release of the original obligor, signed by the affected Parties. No tax result or statutory qualification is promised by this Section.

3.4 Approval and Capacity (If Applicable). Claimant is ☐ an adult with capacity ☐ a minor ☐ a person acting through an authorized representative: [NAME AND AUTHORITY]. The Parties shall identify any required approval, representative, payment restriction, or court order before signing: [DETAILS OR “NONE”]. If approval is required, no release becomes effective and no payment is due until the order is entered. Payment for a minor or represented person shall follow the governing order and the payee instructions in Section 3.2.

3.5 Tax Matters. The Parties identify the amounts allocated to each claim or payment type, if any, in [ATTACHED ALLOCATION / “NO AGREED ALLOCATION”]. Neither Party guarantees that any amount is excluded from income or that an allocation controls tax treatment. Each Party shall meet its own tax reporting and payment duties under applicable law and may consult tax counsel before signing.

3.6 No Admission of Liability. This Agreement represents a compromise of disputed claims, and neither execution nor performance constitutes an admission of liability by Respondent, which liability is expressly denied.

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.
(b) No Assignment. It has not assigned or transferred any Claim released herein.
(c) Independent Advice. It has had the opportunity to obtain independent legal and financial advice regarding this Agreement.

4.2 Claimant-Specific Representations. Claimant further represents that:
(a) Capacity. Claimant or the representative identified in Section 3.4 has authority to sign this Agreement, subject to any required Court Approval.
(b) Recovery Interests. Claimant has disclosed the known liens, subrogation interests, and governmental reimbursement claims listed in Exhibit B, after reasonable inquiry.

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

5. COVENANTS & RESTRICTIONS

5.1 Recovery Interests. Exhibit B identifies each known lien, subrogation claim, or governmental reimbursement interest, the party responsible for resolving it, any amount paid directly at closing, and any holdback. The Parties shall comply with any duties imposed by applicable law. An unresolved amount shall be handled under the written holdback instructions in Exhibit B; this Agreement does not extinguish a third party's rights.

5.2 Confidentiality. Except as required by law or for tax, accounting, or Court Approval purposes, the Parties shall keep the terms of this Agreement strictly confidential.

5.3 Non-Disparagement. The Parties shall refrain from any public statement that disparages the other Party in connection with the Incident.

5.4 Press Releases. Neither Party shall issue a press release without the prior written consent of the other Party.

6. DEFAULT & REMEDIES

6.1 Default Notice. A Party claiming a material failure to perform shall give written notice identifying the obligation and facts of nonperformance.

6.2 Cure Period. The receiving Party shall have [____] calendar days after receipt of notice to cure, unless the Parties agree in writing to a different period.

6.3 Remedies. After an uncured default, a Party may seek a remedy available under this Agreement and applicable law. This Section does not itself award specific performance, interest, court costs, or attorney fees.

7. RISK ALLOCATION

7.1 Claimant Release. After payment of the lump sum in Section 3.2, funding of any selected periodic-payment obligation under Section 3.3, and satisfaction of any required Court Approval, Claimant releases [LIST RESPONDENT AND OTHER SPECIFIC RELEASED PERSONS OR ENTITIES] from claims arising from the Incident described in Section 1.2 that relate to these identified injuries and losses: [DESCRIBE EACH INJURY AND LOSS]. Specifically contemplated future developments of those injuries are released only if described here: [DETAILS OR “NONE”]. Under SDCL 20-7-11, a general release does not extend to a claim Claimant did not know or suspect to exist when signing if knowledge of it would have materially affected the settlement; this Section does not purport to release such a claim. It does not cover an unrelated later event, a claim to enforce this Agreement, or any claim expressly reserved here: [RESERVED CLAIMS OR “NONE”]. A representative signs and releases only to the extent authorized by law and any required court order.

7.2 Recovery Interest Allocation. The Parties' responsibilities for known and later identified recovery interests are those stated in Exhibit B and applicable law. Claimant shall reimburse Respondent only for a valid recovery interest that Respondent actually pays because Claimant breached an express obligation allocated to Claimant in Exhibit B, and only to the extent permitted by law. No Party promises to defeat or extinguish a third party's independent right.

7.3 No Settlement Cap on Enforcement. The Settlement Amount is the agreed consideration for the release; it is not an automatic cap on liability for breach of this Agreement or for a claim expressly reserved in Section 7.1.

7.4 Changes to Payment. A delay or change to the payment schedule requires a written amendment signed by the Parties, subject to any required Court Approval.

8. DISPUTE RESOLUTION

8.1 Good-Faith Negotiation. A Party may request good-faith negotiations to resolve a controversy under this Agreement. Negotiation is not a condition to seeking timely relief from a court.

8.2 Forum. A lawsuit arising under this Agreement shall be brought in a court with subject-matter jurisdiction and proper venue under applicable law.

8.3 Non-Availability of Jury Waiver or Arbitration. The Parties expressly decline to waive jury trial rights and do not agree to mandatory arbitration.

9. GENERAL PROVISIONS

9.1 Entire Agreement. This document constitutes the entire agreement between the Parties regarding the subject matter and supersedes all prior agreements or understandings, written or oral.

9.2 Amendment & Waiver. No amendment or waiver of any provision shall be effective unless in writing and signed by all Parties. A waiver on one occasion shall not constitute a waiver on any subsequent occasion.

9.3 Assignment. No Party may assign its rights or delegate its obligations under this Agreement without the other Party's prior written consent, except as expressly documented under Section 3.3 for a periodic-payment obligation.

9.4 Severability. If a provision is held unenforceable, the remaining provisions continue to the extent they can operate consistently with the Parties' settlement purpose and applicable law.

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

9.6 Headings. Section headings are for convenience only and shall not affect interpretation.

9.7 Counterparts; Electronic Signatures. The Parties agree to execute this Agreement electronically and may sign counterparts. Under SDCL §§ 53-12-8 and 53-12-13, an electronic signature is not denied legal effect solely because it is electronic. Any additional signature, representative, or approval requirement still applies.

10. EXECUTION BLOCK

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

EXHIBIT A — PERIODIC PAYMENT SCHEDULE (IF SELECTED)

☐ No periodic payments are part of this settlement.

☐ The following periodic payments are part of this settlement:

Obligor: [________________________________]

Annuity issuer or other funding source: [________________________________]

Policy or funding reference: [________________________________]

Funding due date: [__/__/____]

Evidence of funding to be delivered to Claimant: [________________________________]

EXHIBIT B — RECOVERY INTERESTS AND HOLDBACKS

List each known lien, subrogation claim, or governmental reimbursement interest. Write “none known after reasonable inquiry” if none is known. Add rows as needed.

Funds held pending resolution, holder, and release conditions: [________________________________]

Direct payments from the Settlement Amount, if any: [________________________________]