[COUNTY] COUNTY / IN THE GENERAL COURT OF JUSTICE [DIVISION] COURT DIVISION
16 CVS ______
[MINOR PLAINTIFF], a Minor, by and through her Guardian ad Litem, [NAME OF GAL], and [PARENT PLAINTIFF], Individually,
Plaintiffs,
vs.
[DEFENDANT],
Defendant. / ))))))))
)
) / ORDER APPROVING MINOR SETTLEMENT AND DISMISSAL WITH PREJUDICE
THIS MATTER was heard before the undersigned Judge of the [DIVISION] Court of [COUNTY] County, North Carolina, for the approval of an agreed settlement, and the parties have consented to the Court’s findings of fact and determination of the rights of all parties in connection with this settlement between the parties. It appears to the Court as follows:
1. That [NAME OF GAL] was duly appointed as the Guardian ad Litem for the Minor, [MINOR PLAINTIFF]; that [MR./MRS/MS.] [LAST NAME OF GAL] has no interests that are adverse to those of the Minor; and that [MR./MRS/MS.] [LAST NAME OF GAL] is a disinterested, fit and proper person to represent the interests of the Minor.
2. Minor Plaintiff is a citizen and resident of [COUNTY] County, North Carolina.
3. On [MONTH] [DAY], [YEAR], [CIRCUMSTANCES GIVING RISE TO PLAINTIFF'S CLAIM(S).] As a result of the accident, the Minor Plaintiff sustained injuries.
4. Plaintiffs contend the Defendant was negligent in operation of her vehicle on the day of accident as set forth in the Complaint filed in this action.
5. Defendant has denied that she was negligent in the operation of her vehicle on the day of the accident as set forth in her Answer filed in this action.
6. The total amount of medical expenses incurred for the care of the Minor Plaintiff was [AMOUNT]. Of that amount, [AMOUNT] was for medical care provided by [PROVIDER], and [AMOUNT], was for medical care provided by [PROVIDER].
7. In order to terminate further controversy, [DEFENDANT'S INSURANCE PROVIDER], on behalf of the Defendant, has agreed to pay the amount of [SETTLEMENT AMOUNT], subject to the approval of this Court, in settlement of the Plaintiffs’ claims to be reduced as follows:
a. [AMOUNT] to be paid to [MEDICAL PROVIDER] as full and final payment for medical care provided to the Minor Plaintiff;
b. [AMOUNT] to be paid to [MEDICAL PROVIDER] as full and final payment for medical care provided to the Minor Plaintiff;
c. [AMOUNT] to be paid to [NAME OF GAL] as payment for his services as Guardian ad Litem for [MINOR PLAINTIFF] in this case; and
d. The remaining sum of [AMOUNT] is to be paid to the [COUNTY] County Clerk of Court to be held in trust for the use and benefit of the Minor Plaintiff until such time as permitted by law.
8. That the parties have agreed and do hereby agree to compromise and settle any and all past, present and future actions, claims, demands, damages, expenses, costs, attorneys fees and all claims of any nature or kind whatsoever now existing or which may hereafter arise between the Plaintiffs, Defendant, and [DEFENDANT'S INSURANCE PROVIDER], their heirs, agents, servants, representatives, successors, employees, employers, subsidiaries, affiliates, parent companies, corporations and all other related persons and entities, as it relates to the alleged events of [DATE OF ACCIDENT].
9. That the Court has investigated the matter and has familiarized itself with the evidence offered by the parties. The Court has also heard the contentions of the Plaintiffs and Defendant, and the Court finds as a fact that it is in the best interests of the Minor Plaintiff for her personal injury claim, to compromise, settle, and fully resolve all claims as set forth in this Order. The Court specifically finds as a fact that the settlement on this basis is fair, reasonable, and in the best interest of the Minor Plaintiff.
10. In consideration of the sum paid and received, as set forth herein, and other good and valuable consideration, the undersigned [NAME OF GAL], as Guardian ad Litem of the Minor Plaintiff, and [PARENT PLAINTIFF], as the natural parent of the Minor Plaintiff, have agreed to release and fully discharge Defendant and [DEFENDANT'S INSURANCE PROVIDER], as well as their heirs, executors, administrators, personal representatives, beneficiaries, predecessors, underwriters, insurers, successors, directors, officers, employees, agents, attorneys, affiliated companies and assigns of any and all past, present and future claims arising out of the accident described herein on [DATE OF ACCIDENT], and on account of which legal action was instituted on behalf of the Minor Plaintiff in [COUNTY] County, North Carolina.
11. That there is no just reason to delay the settlement between the participating parties.
THEREFORE, the Court approves of this settlement and the distribution of the settlement funds as set forth herein.
NOW, THEREFORE, IT IS ORDERED, ADJUDGED AND DECREED that this settlement shall be and is full, final and complete settlement of any and all claims which have arisen or may hereinafter arise on the part of the Plaintiffs against the Defendant and [DEFENDANT'S INSURANCE PROVIDER], on account of the accident of [DATE OF ACCIDENT]. Upon payment of the aforementioned funds in the manner set out above, this matter is DISMISSED WITH PREJUDICE.
This the ______day of ______, 2016.
______
HONORABLE [DIVISION] COURT JUDGE PRESIDING
CONSENT:
By: ______[NAME]
[RELATIONSHIP TO MINOR]
[ADDRESS]
[CITY/STATE/ZIP]
[TELEPHONE NUMBER] / By: ______
[COUNSEL FOR DEFENDANT]
[N.C. STATE BAR NUMBER]
[FIRM NAME]
[ADDRESS]
[CITY/STATE/ZIP]
[TELEPHONE NUMBER]
[FAX NUMBER]
Attorney for Defendant
By: ______
[NAME OF GAL], as Guardian ad Litem
for the Minor, [MINOR PLAINTIFF]
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