PERSONAL INJURY SETTLEMENT AGREEMENT AND RELEASE

State of South Dakota

[// GUIDANCE: Delete all guidance comments before final execution. Replace every bracketed term (e.g., [PARTY A]) with matter-specific information.]

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”).

[// GUIDANCE: Add additional Respondents/Insurers as needed.]

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 fully and finally compromise, settle, and release all Claims on the terms set forth in this Agreement to avoid the burden, expense, and uncertainty of litigation.
D. The Parties acknowledge the receipt and sufficiency of the consideration described herein and intend to be legally bound.

1.3 Governing Law & Jurisdiction. This Agreement shall be governed by and construed in accordance with the tort and contract laws of the State of South Dakota, without regard to conflicts-of-law principles. Any action arising out of or relating to this Agreement shall be filed exclusively in the state courts of competent jurisdiction located in [COUNTY], South Dakota.

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 any qualified funding asset or annuity policy issued pursuant to Section 3.3.

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

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

“Court Approval” means entry of a final order by a South Dakota circuit court approving this Agreement pursuant to the procedural rules governing settlements involving minors or incapacitated persons, if applicable.

“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. The obligations of the Parties under this Agreement are expressly conditioned upon:
(a) Execution of this Agreement by all Parties (and, if applicable, their parents, guardians, or conservators);
(b) Court Approval, if required; and
(c) Receipt of all required lien resolutions and confirmations described in Section 5.3.

3.2 Settlement Consideration. Respondent (or its insurer) shall pay total consideration of [US $ ___] (the “Settlement Amount”) as follows:
(a) Lump-Sum Payment. [US $ ___] payable to [PAYEE] within [__] business days after satisfaction of the conditions precedent.
(b) Periodic Payments (if elected). See Section 3.3.

[// GUIDANCE: Insert detailed Medicare Set-Aside language if the Claimant is, or may become, a Medicare beneficiary.]

3.3 Structured Settlement (Optional).
(a) Designation. The Parties agree that [PERCENTAGE OR AMOUNT] of the Settlement Amount shall fund a Structured Settlement through the purchase of an Annuity Contract issued by [QUALIFIED ASSIGNEE/ANNUITY ISSUER].
(b) Payment Schedule. Periodic payments shall be made according to the schedule set forth in Exhibit A.
(c) Authorization. Claimant irrevocably authorizes Respondent (or its insurer) to assign its obligation to make periodic payments to a qualified assignee in accordance with applicable structured-settlement rules.

3.4 Minor Settlement Approval (If Applicable).
(a) Guardian ad Litem. Where the Claimant is a Minor, the Parties shall petition the court for appointment of a guardian ad litem (“GAL”) and for Court Approval of this Agreement.
(b) Deposit of Funds. Upon Court Approval, any cash portion allocated to the Minor shall be deposited into a federally insured blocked account or structured settlement, as directed by the court.
(c) Reporting. The GAL shall file the required post-settlement report within [__] days of distribution.

3.5 Tax Characterization. The Parties intend that all amounts paid constitute damages on account of personal physical injuries or sickness and therefore be excludable from the recipient’s gross income under 26 U.S.C. § 104(a)(2). Each Party shall be responsible for its own tax reporting and liabilities.

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 and warrants that:
(a) Capacity. If Claimant is a Minor or otherwise lacks capacity, this Agreement will be executed by a duly appointed parent, guardian, conservator, or GAL.
(b) Medical Bills & Liens. Claimant has disclosed all known medical liens, subrogation interests, and governmental reimbursement claims.

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 Lien Resolution. Claimant covenants to obtain, satisfy, or compromise all valid healthcare, governmental, or other liens arising from the Incident and to indemnify Respondent against any unresolved lien claims as provided in Section 7.2.

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 Events of Default. A Party shall be in default if it fails to perform any material obligation under this Agreement within [__] days after receipt of written notice of such failure.

6.2 Cure Period. The defaulting Party shall have [__] days after notice to cure the default.

6.3 Remedies. Upon an uncured default, the non-defaulting Party may:
(a) Seek specific performance;
(b) Obtain judgment for any unpaid portion of the Settlement Amount; and
(c) Recover reasonable attorney fees and costs incurred in enforcing this Agreement.

7. RISK ALLOCATION

7.1 Release of Claims (Mutual). Upon receipt of the Settlement Amount and satisfaction of the conditions precedent, each Party, for itself and its heirs, executors, representatives, successors, and assigns, hereby fully and forever releases, acquits, and discharges the other Party and its parents, subsidiaries, affiliates, insurers, reinsurers, officers, directors, employees, agents, and attorneys from any and all past, present, and future claims, demands, actions, causes of action, damages, costs, expenses, and liabilities of every kind whatsoever, whether known or unknown, suspected or unsuspected, in any way arising out of or relating to the Incident, the Injuries, or the Claims.

[// GUIDANCE: South Dakota law generally enforces broad releases when the language is clear and conspicuous. Consider boldface or ALL-CAPS in final versions intended for pro se parties to enhance enforceability.]

7.2 Indemnification. Each Party shall indemnify, defend, and hold harmless the other Party from and against any claim, lien, or demand (including reasonable attorney fees) arising from the indemnifying Party’s breach of its representations, warranties, or covenants under this Agreement.

7.3 Limitation of Liability. The total liability of Respondent with respect to the Claims shall not exceed the Settlement Amount.

7.4 Force Majeure. No Party shall be liable for failure or delay in performance caused by events beyond its reasonable control, including acts of God, war, terrorism, or governmental action, provided that such Party gives prompt written notice and uses commercially reasonable efforts to resume performance.

8. DISPUTE RESOLUTION

8.1 Good-Faith Negotiation. The Parties shall attempt in good faith to resolve any controversy arising out of this Agreement through negotiations for at least [30] days before initiating litigation.

8.2 Forum Selection. Any lawsuit arising under or relating to this Agreement shall be commenced exclusively in the state courts located in [COUNTY], South Dakota, and each Party irrevocably submits to the personal jurisdiction of such courts.

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 prior written consent of the other Party, except that Respondent or its insurer may assign obligations to make periodic payments to a qualified assignee in accordance with Section 3.3.

9.4 Severability. If any provision is held invalid or unenforceable, the remaining provisions shall remain in full force to the maximum extent permitted by law, and the invalid provision shall be reformed to the minimum extent necessary to effectuate the Parties’ intent.

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. This Agreement may be executed in multiple counterparts, each of which shall be deemed an original, and all of which together constitute one instrument. Signatures transmitted electronically (e.g., via PDF or approved e-signature platform) shall be deemed original signatures.

10. EXECUTION BLOCK

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

[// GUIDANCE:
1. If Claimant is a Minor, insert signature blocks for parent/guardian and GAL, along with court approval lines.
2. Add notarization or witness attestation if local practice or insurer requires.
3. Attach Exhibit A: Structured Settlement Payment Schedule, and Exhibit B: Court Approval Order (if applicable).]