Release of All Claims - District of Columbia

RELEASE OF ALL CLAIMS

(District of Columbia)

1. PARTIES

This Release of All Claims (this "Release") is made and entered into as of [__/__/____] by and between:

Releasor: [________________________________], an individual residing at [________________________________] ("Releasor"); and

Releasee(s): [________________________________], residing/located at [________________________________] ("Releasee"), together with the Releasee's insurer, [INSURER NAME] ("Insurer"), Claim No. [____________], Policy No. [____________].

The Releasor and the Releasee are each a "Party" and together the "Parties."

2. RECITALS

A. On or about [__/__/____], at or near [LOCATION OF INCIDENT], in the District of Columbia, an incident occurred in which the Releasor allegedly sustained bodily injury, property damage, and other losses (the "Incident").

B. The Releasor asserts that the Incident and resulting losses were caused by the Releasee. The Releasee denies liability and disputes the nature and extent of the Releasor's alleged damages.

C. The Parties desire to fully and finally compromise, settle, and resolve all disputed claims arising out of the Incident, without further litigation, upon the terms set forth in this Release.

3. CONSIDERATION

In consideration for this Release, the Releasee and/or Insurer shall pay [RELEASOR / QUALIFIED GUARDIAN OR OTHER AUTHORIZED RECIPIENT] the total sum of [AMOUNT IN WORDS] Dollars ($[__________]) (the "Settlement Sum"), subject to Section 12 when applicable. The Releasor acknowledges receipt and sufficiency of the Settlement Sum upon payment. The Settlement Sum is the sole and entire consideration for this Release; no other promise or representation has been made except as expressly stated herein.

4. RELEASE OF ALL CLAIMS (KNOWN AND UNKNOWN)

4.1 General Release. Effective upon payment of the Settlement Sum, the Releasor, on behalf of the Releasor and the Releasor's heirs, executors, administrators, successors, and assigns, releases the Releasee, the Insurer, and their respective agents, servants, employees, officers, directors, principals, predecessors, successors, heirs, assigns, insurers, and reinsurers (collectively, the "Released Parties") from claims the Releasor owns against the Released Parties arising from the Incident, including claims for injury, property loss, damages, expenses, and fees, whether known or unknown, suspected or unsuspected, or based on consequences later discovered. This clause covers claims arising from the Incident; it does not release claims based on a different event or another person's independently owned claims.

4.2 Unknown Claims Acknowledged. The Releasor understands that injuries or losses attributed to the Incident may develop or be discovered after signing. The Releasor intends the release in Section 4.1 to include the Releasor's claims against the Released Parties based on those later-discovered consequences, subject to applicable law.

5. EFFECT ON OTHER TORTFEASORS; RESERVATION OF RIGHTS

5.1 Contribution. In the District of Columbia, contribution among joint tortfeasors is an equitable remedy established by case precedent. A contribution claim requires an established joint-tortfeasor relationship; the effect of a settlement depends on the parties, terms, and proceedings. See The George Washington University v. Bier, 946 A.2d 372 (D.C. 2008). This Release does not decide any contribution claim between other persons.

5.2 Reservation. This Release discharges only the Released Parties defined in Section 4.1. The Releasor reserves claims against any other person or entity who may be liable for the Incident, subject to applicable law and any credit for this settlement.

5.3 Credit. Any credit or setoff for the Settlement Sum in a claim against a nonsettling person will be determined under applicable District of Columbia law by the court handling that claim.

6. NO ADMISSION OF LIABILITY

This Release is a compromise of disputed claims. Neither the payment of the Settlement Sum nor the execution of this Release shall be construed as an admission of liability or wrongdoing by any Released Party, all such liability being expressly denied.

7. LIENS, MEDICARE / MEDICAID, AND ASSERTED-INTEREST RESOLUTION

7.1 Asserted-Interest Inventory. Identify each asserted interest, holder, amount, dispute status, and proposed payoff, holdback, escrow, or direct-payment instruction in [ATTACHMENT / DETAILS]. Listing an interest does not admit its validity, amount, priority, or allocation.

7.2 Medicare Secondary Payer. If Medicare made conditional payments for injury-related items or services, the parties shall identify the payment and reimbursement record, the responsible primary plan, and the agreed resolution procedure under 42 U.S.C. § 1395y(b)(2). This Release makes no representation that Medicare's interests have been resolved without the supporting record. (Check if applicable.)
☐ The Releasor is a Medicare beneficiary.
☐ The Releasor is not currently a Medicare beneficiary. Expected Medicare enrollment, if known: [DATE / UNKNOWN].
☐ A liability future-medical allocation of [$__________] has been documented after matter-specific review.

7.3 Asserted-Interest Resolution. Record each asserted lien, reimbursement, or recovery interest and the agreed payoff, direct payment, holdback, escrow, or dispute procedure in [ATTACHMENT / DETAILS]. No blanket indemnity, defense duty, penalty shift, or attorney-fee obligation is created by this form; any negotiated allocation must be separately stated and reviewed.

8. DERIVATIVE AND CONSORTIUM CLAIMS

The Releasor releases only derivative claims owned by the Releasor. No spouse, family member, dependent, or other claimant's independent cause of action is released by the Releasor's signature. To settle another person's claim, identify that claimant, claim, and consideration in a signed addendum and have that person sign below as an additional Releasor. Any unlisted or unsigned independent claim remains outside this Release.

9. REPRESENTATIONS AND WARRANTIES

The person signing for the Releasor represents, to that person's knowledge, that:

a. has not assigned, pledged, or transferred any claim released herein to any other person or entity;

b. the Releasor is legally competent to execute this Release, or the signer is an authorized representative identified in Section 12;

c. has been afforded the opportunity to consult independent legal counsel of the Releasor's choosing and either has done so or has knowingly waived that right;

d. has read this Release in its entirety, understands its terms, and executes it freely and voluntarily, without duress or undue influence; and

e. relies solely upon the Releasor's own judgment and not upon any representation by the Released Parties as to the nature or permanence of the Releasor's injuries.

10. CONFIDENTIALITY (OPTIONAL)

☐ Confidentiality elected. The Parties agree to keep the terms and amount of this settlement confidential and shall not disclose them except as required by law, to professional advisors, or to enforce this Release.

☐ Confidentiality not elected.

11. GOVERNING LAW

This Release shall be governed by and construed in accordance with the laws of the District of Columbia, without regard to its conflict-of-laws principles. Any dispute arising under this Release shall be brought in the Superior Court of the District of Columbia.

12. MINOR'S / PROTECTED PERSON'S COMPROMISE

Minor claimant. If an action on behalf of or against the minor is pending, D.C. Code § 21-120(a) requires approval by a judge of that court for the settlement to be valid. Under § 21-120(b), if the net money and property due the minor from the action exceeds $3,000 after fees, costs, and related expenses, a person receiving it for the minor must first be appointed and qualified as guardian of the minor's estate. Identify the action, representative, net amount, approval order, and qualified recipient before payment or dismissal. A release for the minor becomes effective only after the required approval and representative steps are completed.

Adult whose capacity or representation is at issue. Section 21-120 is a minor-settlement statute; it does not itself impose a blanket approval rule for an adult. Under D.C. Superior Court Civil Rule 17(c), a general guardian, committee, conservator, or like fiduciary may sue or defend for an incompetent person, and the court must appoint a guardian ad litem or issue another appropriate order to protect an unrepresented minor or incompetent person. Do not execute or fund this Release for an adult whose capacity is at issue until D.C. counsel identifies the duly authorized representative and any case-specific approval or protective order required by current law.

Minor's / protected person's name: [________________________________] Date of birth: [__/__/____]
Representative's name and capacity: [________________________________]
Court and case number (if applicable): [________________________________]
Order approving settlement dated: [__/__/____]
Net money and property due minor after expenses: [$__________]
Qualified guardian of estate receiving funds, if required: [________________________________]

13. EXECUTION

The Releasor, or the authorized representative identified below, has read this Release, understands its terms, and signs it voluntarily.

RELEASOR

Signature: [________________________________]
Printed Name: [________________________________]
Capacity, if signing for Releasor: [________________________________]
Date: [__/__/____]

ADDITIONAL RELEASOR (only if identified in a signed claim addendum)

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

NOTARY ACKNOWLEDGMENT

District of Columbia ) ss.

On this [____] day of [__________], [____], before me personally appeared [________________________________], known to me (or satisfactorily proven) to be the person whose name is subscribed to the foregoing instrument, and acknowledged that he/she executed the same for the purposes therein contained.

Signature: [________________________________]
Notary Public, District of Columbia
My commission expires: [__/__/____]

Sources and References

• D.C. Code § 21-120 — Settlement on behalf of a minor (D.C. Council Code)
• The George Washington University v. Bier, No. 05-CV-775 (D.C. Apr. 18, 2008)
• D.C. Superior Court Rules of Civil Procedure — Rule 17(c)
• Medicare Secondary Payer Act, 42 U.S.C. § 1395y(b)