Private Car Accident Settlement Agreement — Word & PDF Template

This private settlement agreement template lets two drivers settle vehicle damage from a road accident between themselves, without an insurance claim. It deals with damage to the vehicles only.

Who is this template for?

It suits drivers who agree that one will pay the other for vehicle damage after an accident. As the document itself states, the payment does not cover any injury, damage to anyone else’s property, or any claim by a passenger or another road user, and the agreement does not change what either driver’s insurance policy requires or a driver’s legal duties after an accident.

What does the template include?

The document is made up of numbered sections:

• The Accident — the date, time, location, any police reference and what happened.
• Drivers, Vehicles and Damage — a block for each driver with contact, registration, make and model, owner, insurer, policy number and the damage to their vehicle.
• The Payment — who pays whom, the amount, method and what it covers, paid on signing, by a set date or by instalments, with a receipt for full payment.
• Personal Injury — tick boxes recording whether anyone may have been injured; injury claims are not released.
• Release on Payment — the payee releases the payer once paid in full, with an option for the payer to waive their own damage claim.
• Fault — a choice between no admission of fault and the payer accepting responsibility.
• Insurance and the Law — reminders to check reporting and admission terms in each policy, the position of finance or lease owners, and the drivers’ duties after an accident.
• Signatures — signature blocks for both drivers and for each vehicle owner who is not the driver.

Easy to customise

The template opens in Microsoft Word, Google Docs and LibreOffice. Fill in the highlighted fields, describe the accident and the damage, set the payment terms, tick the injury, release and fault options, and edit any clause to suit your agreement.

Format and scope

Download instantly as an editable Word (.docx) file and a PDF, formatted to A4. Written in plain British English and drafted for use in England and Wales.