AntecK7 All American 7755 Posts user info edit post |
You want something like a Settlement Agreement and Release agreement.
This Settlement Agreement and Release (the "Settlement Agreement") is made and entered into this _____ day of ____________________, 2004, by and between: Plaintiff: Insured: Insurer: Recitals A.. Plaintiff filed a Claim against "Insured" in the Court of_________, County of ___________________ , State of_____________________, Civil Action File No.:___________________, (the "Claim"), which Claim arose out of certain alleged negligent acts or omissions by Insured. In the Claim, Plaintiff sought to recover monetary damages as a result of that certain occurrence on or about________________, at____________________, which resulted in physical/personal injuries to__________________. B. Insurer is the liability insurer of the Insured, and as such, would be obligated to pay any claim made or judgment obtained against Insured which is covered by its policy with Insured. C. The parties desire to enter into this Settlement Agreement in order to provide for certain payments in full settlement and discharge of all claims which have, or might be made, by reason of the incident described in Recital A above, upon the terms and conditions set forth below. Agreement The parties agree as follows: 1.0 Release and Discharge 1.1 In consideration of the payments set forth in Section 2, Plaintiff hereby completely releases and forever discharges Insured and Insurer from any and all past, present or future claims, demands, obligations, actions, causes of action, wrongful death claims, rights, damages, costs, losses of services, expenses and compensation of any nature whatsoever, whether based on tort, contract or other theory of recovery, which the Plaintiff now has, or which may hereafter accrue or otherwise be acquired, on account of, or may in any way grow out of the incident described in Recital A above, including, without limitation, any and all known or unknown claims for bodily and personal injuries to Plaintiff, or any future wrongful death claim of Plaintiff's representatives or heirs, which have resulted or may result from the alleged acts or omissions of the Insured. 1.2 This release and discharge shall also apply to Insured's and Insurer's past, present and future officers, directors, stockholders, attorneys, agents, servants, representatives, employees, subsidiaries, affiliates, partners, predecessors and successors in interest, and assigns and all other persons, firms or corporations with whom any of the former have been, are now, or may hereafter be affiliated. 1.3 This release, on the part of the Plaintiff, shall be a fully binding and complete settlement among the Plaintiff, the Insured and the Insurer, and their heirs, assigns and successors. 1.4 The Plaintiff acknowledges and agrees that the release and discharge set forth above is a general release. Plaintiff expressly waives and assumes the risk of any and all claims for damages which exist as of this date, but of which the Plaintiff does not know or suspect to exist, whether through ignorance, oversight, error, negligence, or otherwise, and which, if known, would materially affect Plaintiff's decision to enter into this Settlement Agreement. The Plaintiff further agrees that Plaintiff has accepted payment of the sums specified herein as a complete compromise of matters involving disputed issues of law and fact. Plaintiff assumes the risk that the facts or law may be other than Plaintiff believes. It is understood and agreed to by the parties that this settlement is a compromise of a doubtful and disputed claim, and the payments are not to be construed as an admission of liability on the part of Insured, by whom liability is expressly denied. 2.0 Payments In consideration of the release set forth above, the Insurer on behalf of the Insured agrees to pay to the individual(s) named below ("Payee(s)") the sums outlined in Section 2 below: 2.1 Payments due at the time of settlement as follows: The sum of _______ Dollars ($________) shall be paid to ____________________ as follows: 2.2 Periodic payments made according to the schedule as follows (the "Periodic Payments"): To: 3/12/2015 7:17:57 PM |