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Bodily Injury Release Form
"I need a Bodily Injury Release Form for my construction company in Manila, to be used when a visitor sustained minor injuries from a falling object at our building site on January 15, 2025, with a settlement amount of 50,000 PHP and including confidentiality provisions."
1. Parties: Identifies and provides full details of the Releasor (injured party) and Releasee (party being released from liability)
2. Background: Describes the context, including date, location, and nature of the incident that caused the injury
3. Definitions: Defines key terms used in the agreement including 'Claims', 'Incident', 'Injuries', and 'Released Parties'
4. Description of Incident and Injuries: Detailed description of the incident that occurred and the injuries sustained
5. Consideration: States the settlement amount or other consideration being provided in exchange for the release
6. Release and Discharge: Core section detailing the scope of the release and explicitly stating what claims are being waived
7. No Admission of Liability: Statement that the settlement and release do not constitute an admission of fault or liability
8. Finality of Settlement: Confirms that this is a final settlement and releases all current and future claims related to the incident
9. Governing Law: Specifies that Philippine law governs the agreement
10. Execution: Signature block with spaces for parties, witnesses, and notary public
1. Medical Expenses: Details any medical expenses being covered, used when medical costs are part of the settlement
2. Confidentiality: Prohibits parties from discussing the terms of the settlement, included when confidentiality is required
3. Future Medical Care: Addresses potential future medical needs and related expenses, used in cases of ongoing medical issues
4. Insurance Claims: Addresses the handling of any insurance claims related to the incident, used when insurance is involved
5. Third Party Claims: Addresses potential claims against third parties, used when multiple parties might be involved
6. Return to Work Provisions: Included when the injury was work-related and return to work terms need to be specified
7. Tax Implications: Addresses tax treatment of settlement amounts, used for larger settlements with tax implications
1. Schedule A - Medical Records: Itemized list of relevant medical records and diagnoses related to the injury
2. Schedule B - Medical Expenses: Detailed breakdown of medical expenses being covered or considered in the settlement
3. Schedule C - Incident Report: Official incident report or documentation of the event that caused the injury
4. Appendix 1 - Witness Statements: Statements from witnesses to the incident, if applicable
Authors
Bodily Injury
Claims
Consideration
Effective Date
Incident
Injuries
Legal Representatives
Medical Expenses
Parties
Release
Releasor
Releasee
Released Claims
Released Parties
Settlement Amount
Successors and Assigns
Loss
Damages
Future Claims
Related Claims
Medical Treatment
Incident Date
Liability
Settlement Payment
Governing Law
Settlement Terms
Medical Treatment
Liability Waiver
Consideration
Indemnification
Confidentiality
Future Claims
Legal Capacity
Severability
Governing Law
Dispute Resolution
Insurance
Representations and Warranties
Notice
Entire Agreement
Amendment
Assignment
Medical Records
Acknowledgment
Witness Requirements
Legal Fees
Tax Implications
Force Majeure
Construction
Manufacturing
Sports and Recreation
Healthcare
Transportation
Retail
Hospitality
Education
Events Management
Property Management
Industrial Services
Logistics
Fitness and Wellness
Legal
Risk Management
Human Resources
Compliance
Operations
Health and Safety
Insurance
Corporate Affairs
Facilities Management
Administrative Services
Risk Manager
Legal Counsel
Compliance Officer
Human Resources Manager
Safety Officer
Operations Manager
Facility Manager
Insurance Claims Adjuster
Corporate Secretary
Legal Administrator
Health and Safety Coordinator
Employee Relations Manager
Contract Administrator
Business Owner
General Manager
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