Car Accident Release of Liability Form, Free Download 2026

This Release of Liability and Settlement of Claims (this "Release") is made and entered into on [____________] by [____________] ("Releasor"), residing at [____________], in favor of [____________] ("Releasee"), residing at or with a principal address of [____________], [and Releasee's insurer, [____________] (the "Insurer"), Claim No. [____________]]. Releasor and Releasee are referred to collectively as the "Parties." As used in this Release, "Released Parties" means Releasee and Releasee's heirs, executors, administrators, agents, employees, insurers, successors, and assigns.

This Release arises out of a motor vehicle accident that occurred on [____________] at approximately [____] a.m./p.m. at or near [location: ____________], in the City of [____________], County of [____________], State of [____________] (the "Accident"). At the time of the Accident, Releasor was the [driver / passenger / owner] of a [year, make, model: ____________], license plate no. [____________], and Releasee was the [driver / owner] of a [year, make, model: ____________], license plate no. [____________]. [Police / incident report no.: ____________.]

In consideration of the release and other promises set forth herein, Releasee [and/or the Insurer] shall pay Releasor the total sum of [$__________] (the "Settlement Payment"), payable by [check / wire transfer / other: ____________] within [____] days of the date both Parties have executed this Release. Releasor acknowledges that the Settlement Payment constitutes full, complete, and final satisfaction of all claims released herein, and that no further payment of any kind is or will become due from any Released Party in connection with the Accident.

Upon receipt of the Settlement Payment, Releasor, on behalf of Releasor and Releasor's heirs, executors, administrators, and assigns, hereby fully and forever releases, acquits, and discharges the Released Parties from any and all claims, demands, actions, causes of action, damages, costs, expenses, and liabilities of every kind and nature, whether known or unknown, arising out of or in any way connected with the Accident. [Check all that apply:] [ ] This Release covers claims for BODILY INJURY, including medical expenses, lost wages, and pain and suffering. [ ] This Release covers claims for PROPERTY DAMAGE, including damage to Releasor's vehicle and personal property, loss of use, and diminished value. [ ] This Release covers ALL CLAIMS of every kind arising from the Accident, both bodily injury and property damage.

[If this is a property-damage-only release:] Notwithstanding any other provision of this Release, the Parties agree that this Release is limited to property damage claims only, and Releasor expressly reserves, and does not release, any claim for bodily injury or personal injury arising from the Accident. [Strike this Section if the Release covers all claims.]

The Parties acknowledge and agree that this Release is the compromise of a disputed claim and that the Settlement Payment is not to be construed as an admission of liability, fault, or wrongdoing on the part of any Released Party, by whom liability is expressly denied. This Release shall not be admissible in any proceeding as evidence of liability or fault.

Releasor acknowledges that injuries, damages, or losses arising from the Accident may exist that are unknown or unanticipated as of the date of this Release, and that known injuries may worsen or produce complications that are not now anticipated. Releasor expressly assumes the risk of all such unknown, unanticipated, or later-discovered injuries, damages, and losses, and agrees that this Release applies to them with the same force and effect as to injuries and damages now known. Releasor has not relied on any representation of any Released Party or any physician retained by any Released Party concerning the nature, extent, or permanence of Releasor's injuries.

[OPTIONAL, STATE-SPECIFIC: Some states have statutes providing that a general release does not extend to claims the releasing party does not know or suspect to exist at the time of the release. If the law of the governing state includes such an unknown-claims statute, insert here an express waiver of the protections of that statute, identified by its citation: "Releasor expressly waives all rights and benefits conferred by [cite the applicable state unknown-claims statute: ____________] and by any similar law of any other jurisdiction." Consult the law of the governing state before including or omitting this waiver.]

Releasor represents and warrants that: (a) Releasor is at least eighteen (18) years of age and legally competent to execute this Release; (b) Releasor has not assigned or transferred any claim released herein to any other person or entity; (c) no other person or entity has any interest in the claims released herein [except: ____________, e.g., a health insurer, Medicare/Medicaid, or medical provider holding a lien or subrogation interest, which Releasor agrees to satisfy from the Settlement Payment]; and (d) Releasor has read this Release, understands its terms, has had the opportunity to consult an attorney of Releasor's choosing, and signs it freely and voluntarily.

This Release shall be governed by, construed, and enforced in accordance with the laws of the State of [_____________], without regard to its conflict of laws principles. Any action to enforce or interpret this Release shall be brought in the state courts located in [____________] County, State of [_____________].

This Release contains the entire agreement between the Parties with respect to the Accident and supersedes all prior or contemporaneous negotiations, representations, and agreements, whether written or oral. No modification of this Release shall be effective unless in writing and signed by both Parties. If any provision of this Release is held invalid or unenforceable, the remaining provisions shall continue in full force and effect. This Release is binding upon and inures to the benefit of the Parties and their respective heirs, executors, administrators, successors, and assigns.