Car Accident Settlement Agreement Form


This is a sample mutual release and settlement agreement for a car accident case. This is type of agreement is entered into between a plaintiff (or claimant) and the at-fault driver and their insurance company when an auto accident case gets settled out of court. The agreement prevents the plaintiff continuing to pursue any claims related to the accident in exchange for payment of the agreed settlement amount.


THIS SETTLEMENT AGREEMENT AND RELEASE (“Settlement Agreement”) is entered into between  [NAME OF PLAINTIFF(s)] (hereinafter “Plaintiff”), by and through  [NAME OF DEFENDANT ] (hereinafter “Defendant”), and  [NAME OF INSURER] (hereinafter “Insurer”).


    (A) Plaintiff sought to recover monetary damages from Defendant as a result of an auto accident that occurred on [DATE OF ACCIDENT] at [LOCATION OF ACCIDENT] (the “Auto Accident”) which resulted in personal injury and/or physical injury to the Plaintiff.

    (B)  The Insurer is the liability insurer of the Defendant and as such would be obligated to pay any judgment and/or settlement obtained against the Defendant which is covered by its policy.

    (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 are or might have been the subject of the Complaint, upon the terms and conditions set forth herein.


FOR AND IN CONSIDERATION OF the payment to Plaintiff of the sum of $                     , (receipt of which is now acknowledged), Plaintiff completely releases and forever discharges the Defendant and Insurer, of and from any and all past, present or future claims, demands, obligations, actions, causes of action, rights, damages, costs, loss of services, expenses and compensation which the Plaintiff now has, or which may hereafter accrue or otherwise be acquired by plaintiff, on account of, or in any way growing out of, or which are the subject of, the Auto Accident allegedly caused by Defendant’s negligence. 

This release contains the ENTIRE AGREEMENT between the parties hereto, and the terms of this release are contractual and not a mere recital.

I have carefully read the preceding release and know the contents. I sign the same as my own free act.