Property Damage Release Generator
Safely settle your vehicle damage claim without waiving bodily injury rights
Insurance companies often try to sneak full-release clauses into property damage checks. Use this tool to generate an explicit "Property Damage Only" release that protects your right to sue for personal injuries.
Document Details
Fill out the fields below. The document preview on the right will update in real-time.
Document Styling
Releasor (Your Information)
Releasee (Insurance/Defendant)
Settlement Details
Vehicle Information
Live Preview
KNOW ALL MEN BY THESE PRESENTS, that I, [Your Name] ("Releasor"), residing at [Address], [City], [State] [Zip], for and in consideration of the sum of $0.00, the receipt and sufficiency of which is hereby acknowledged, do hereby remise, release, and forever discharge [Releasee Name] ("Releasee"), whose address is [Releasee Address], [City], [State] [Zip], and their agents, servants, successors, heirs, executors, administrators, and all other persons, firms, corporations, associations, or partnerships, of and from any and all claims, actions, causes of action, demands, rights, damages, costs, loss of service, expenses, and compensation whatsoever, which the undersigned now has or which may hereafter accrue on account of or in any way growing out of PROPERTY DAMAGE resulting or to result from the occurrence, accident, or casualty which occurred on or about [Date] at or near [Location].
This release is intended solely to cover the property damage sustained to the Releasor's vehicle, described as follows:
Year: [Year]
Make: [Make]
Model: [Model]
VIN: [VIN]
License Plate: [Plate]
IT IS EXPRESSLY UNDERSTOOD AND AGREED THAT THIS RELEASE IS LIMITED TO PROPERTY DAMAGE ONLY. RELEASOR EXPRESSLY RESERVES ANY AND ALL CLAIMS FOR PERSONAL INJURIES, BODILY INJURIES, MEDICAL EXPENSES, LOST WAGES, PAIN AND SUFFERING, AND ANY OTHER DAMAGES NOT DIRECTLY RELATED TO PROPERTY DAMAGE ARISING OUT OF THE AFOREMENTIONED ACCIDENT.
It is understood and agreed that this settlement is the compromise of a doubtful and disputed claim, and that the payment made is not to be construed as an admission of liability on the part of the party or parties hereby released, and that said Releasees deny liability therefor and intend merely to avoid litigation and buy their peace.
The undersigned further declares and represents that no promise, inducement, or agreement not herein expressed has been made to the undersigned, and that this Release contains the entire agreement between the parties hereto, and that the terms of this Release are contractual and not a mere recital.
THE UNDERSIGNED HAS READ THE FOREGOING RELEASE AND FULLY UNDERSTANDS IT.
Signature of Releasor
[Printed Name]
Date
Signature of Witness / Notary Public
Date
Claim Number: [Claim Number]