Hold Harmless Agreement

     Insurance companies often want language protecting them from lien holders claiming the insurance company should have protected their lien.  In some states, they are entitled to have one.  Either way, in most cases lawyers are making sure that the medical liens are being properly resolved.  Here is some sample language you can use (because, incredibly, the insurance companies never seem to have anything like this handy. 

 

ANA MAJANO- Plaintiff

v

MILES DIXON- Defendant,

 * * * * *
         CASE NO. 05-C-05-095553
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

 

Hold Harmless Agreement

     It is expressly understood and agreed, that in consideration of all bills paid to  _______________ which sum includes any and all MEDICARE/MEDICAID/TRICARE/Health Insurance lien(s) which have been, or which may be, presented for benefits paid to _________________________ as a result of injuries sustained in the automobile accident dated _____________________ which in connection with Claim Number ________________, the undersigned agree(s) to resolve the full amount of any and all liens, by accord and satisfaction or otherwise, and further agree(s) to save and forever hold harmless _____________________ Insurance Company from any and all liability therefrom.

 

 

_______________________________                                  ______________________________
(Client)                                                                         (Date)

 

_______________________________                                  ______________________________
(Attorney)                                                                     (Date)

 

 

 



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