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Car accident paid for out of pocket

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inimicaljords

Junior Member
What is the name of your state? TN

I had a lady back into my car in the parking lot of a small shopping center. She admitted fault and said she would pay out of pocket for all the damages. The damages were small and ended up being just a little over $800. She paid to get it fixed and wants me to sign a release of all claims, but i can't understand the document. I don’t mind signing a release of claims but I just want to make sure I am not signing something that may cause me trouble down the road. Here is what it says:

That "my name" of Knoxville, Tennessee (sometimes hereinafter called "Releasor"), for and in consideration of the sum of Eight Hundred and no/100ths Dollars ($800.00) and other good and valuable consideration, the receipt of which is herby acknowledge, hereby releases and discharges "their name" and each of their insurers, affiliates, agents, officers, directors, heirs, executors, administrators, successors, assigns, and all other persons, association and/or corporations, whether herein named or referred to or not, ( sometimes hereinafter collectively called "Releasee"), from all causes of action, suits, promises, damages, judgments, executions, claims, and demands whatsoever, in law and equity arising out of any act or occurrence or omission up to the present time and particularly on account of all personal injury, disability, property damage, losses, or damage of any kind sustained as a result of an automobile accident which occurred on or about "date", in the parking lot of "shopping center" which the said Releasor ever hard, now has or which his successors, assigns and personal representatives can, shall, or may have against "their name".

The Releasor does herby bind himself and his respective heirs, administrators, executors and assigns to repay, indemnify and hold harmless the Releasee of and from any additional loss, costs, damages, or expenses and/or any additional sum or sums of money that Releasor might hereafter be compelled to pay on account of an and all alleged injuries allegedly sustained in the occurrence of approximately "date". The Releasor states and affirms that he understands and agrees that this settlement is a compromise of a doubtful and disputed claim and that the payment referenced herein is not to be nor intended to be and is not construed to be, nor shall it constitute an admission of liability on the part of any of the Releasee.

In short, by the execution of this instrument, the undersigned expressly agrees to indemnify and hold harmless the Releasee for the responsibility of payment of any amount of money in addition to or in excess of the amount being paid to the Releasor by the Releasee.

Releasor represents and acknowledges that he has read and understood the meaning and intent of the language of this document and no other promise, inducement or agreement not herein expressed has been made to him and that this release constitutes the entire agreement between the parties hereto, and that the terms of this release involve material controlling conditions which is to the parties released are to be construed to be contractual and not mere recitals.

Then it asks me to sign.

Below the signing point it says:

Personally appeared before me, a Notary Public, in and for said state and county, the within named "my name", with whom I am personally acquainted, or proved to me on the basis of satisfactory evidence, and who acknowledged that he executed the within instrument for the purpose therein contained.

Witness my hand at office, this "dates"

Notary Public signatured "unsigned"

my commission expires:______________


She had the repair center leave this document in my car with a self adressed enveleope. I want to release the claim for I have no intentions of getting any more money (outside of the repair) from her. The car is fixed to my sastifactory, but I just want to make sure I am not signing something that gives her the right to get her money back or any money from me at all.

Is this document ok to signed?

Thanks for the help
 


moburkes

Senior Member
Evidently, she found a similar form drawn up by an insurance company's lawyer. You cannot, under any circumstances, unless your vehicle's safety on the road is concerned, come back later against her, her insurance company, and all the rest of the people listed.
 

Zigner

Senior Member, Non-Attorney
Why don't you just write a note saying:

I, "your name", hereby acknowledge that I have been fully reimbursed for all damages I have received from the accident on "date" caused by "her name".

Then sign it and send it to her in her envelope. Heck, if you're feeling generous, get it notarized :)
 

inimicaljords

Junior Member
so does that form seem legitimate? If all it is saying is that I release her from any further costs than I am o.k with signing it. Like I said, the repairs are complete and paid for and I am happy with them. I'm just not very good with all the legal terms to fully understand it.

I appreciate the help.
 

moburkes

Senior Member
What is the name of your state? TN

I had a lady back into my car in the parking lot of a small shopping center. She admitted fault and said she would pay out of pocket for all the damages. The damages were small and ended up being just a little over $800. She paid to get it fixed and wants me to sign a release of all claims, but i can't understand the document. I don’t mind signing a release of claims but I just want to make sure I am not signing something that may cause me trouble down the road. Here is what it says:

That "my name" of Knoxville, Tennessee (sometimes hereinafter called "Releasor"), for and in consideration of the sum of Eight Hundred and no/100ths Dollars ($800.00) and other good and valuable consideration, the receipt of which is herby acknowledge, hereby releases and discharges "their name" and each of their insurers, affiliates, agents, officers, directors, heirs, executors, administrators, successors, assigns, and all other persons, association and/or corporations, whether herein named or referred to or not, ( sometimes hereinafter collectively called "Releasee"), from all causes of action, suits, promises, damages, judgments, executions, claims, and demands whatsoever, in law and equity arising out of any act or occurrence or omission up to the present time and particularly on account of all personal injury, disability, property damage, losses, or damage of any kind sustained as a result of an automobile accident which occurred on or about "date", in the parking lot of "shopping center" which the said Releasor ever hard, now has or which his successors, assigns and personal representatives can, shall, or may have against "their name".

The Releasor does herby bind himself and his respective heirs, administrators, executors and assigns to repay, indemnify and hold harmless the Releasee of and from any additional loss, costs, damages, or expenses and/or any additional sum or sums of money that Releasor might hereafter be compelled to pay on account of an and all alleged injuries allegedly sustained in the occurrence of approximately "date". The Releasor states and affirms that he understands and agrees that this settlement is a compromise of a doubtful and disputed claim and that the payment referenced herein is not to be nor intended to be and is not construed to be, nor shall it constitute an admission of liability on the part of any of the Releasee.

In short, by the execution of this instrument, the undersigned expressly agrees to indemnify and hold harmless the Releasee for the responsibility of payment of any amount of money in addition to or in excess of the amount being paid to the Releasor by the Releasee.

Releasor represents and acknowledges that he has read and understood the meaning and intent of the language of this document and no other promise, inducement or agreement not herein expressed has been made to him and that this release constitutes the entire agreement between the parties hereto, and that the terms of this release involve material controlling conditions which is to the parties released are to be construed to be contractual and not mere recitals.

Then it asks me to sign.

Below the signing point it says:

Personally appeared before me, a Notary Public, in and for said state and county, the within named "my name", with whom I am personally acquainted, or proved to me on the basis of satisfactory evidence, and who acknowledged that he executed the within instrument for the purpose therein contained.

Witness my hand at office, this "dates"

Notary Public signatured "unsigned"

my commission expires:______________


She had the repair center leave this document in my car with a self adressed enveleope. I want to release the claim for I have no intentions of getting any more money (outside of the repair) from her. The car is fixed to my sastifactory, but I just want to make sure I am not signing something that gives her the right to get her money back or any money from me at all.

Is this document ok to signed?

Thanks for the help
I like Zig's idea better.
 

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