ARIAS (Asia) MEDIATION SCHEME
Pro forma Mediation Settlement Agreement
IN THE MATTER OF _______________________________________________________
BETWEEN:
______________________________________
First Named Party
-and-
_______________________________________
Second Named Party
___________________________________________________________________________
MEDIATION SETTLEMENT AGREEMENT
This Mediation took place on [Date]_________ and ended on [Date] __________.
The Parties to the Mediation have agreed as follows:
- This settlement agreement is in full and final settlement of all matters in this dispute and/or all claims arising out of ______________(Re)insurance contract number ___________/ periods _______________.
- [Name] __________ will pay HK$__________ to [Name] __________at
[Address]________________________ by no later than 4:00 p.m. on ____ / ____ / ____ by _______________________(Cheque/Cash/Bank transfer).
- This sum shall include simple interest of HK$/other_________, calculated at ____%pa. to run from [Date] ________ to ___________[Date].
- [Name]______________________ will deliver [……………………………………………………………………………………………….] to [Name] ________________________ at _______________________________by not later than 4 p.m. on ____ / ____ / ____.
- [Insert free text as needed]
- The action/arbitration proceedings will be stayed and the parties will
consent to an order in the terms of the attached Tomlin Order [see attachment], or
seek an award as to costs in terms of this agreement, or
each party agrees to bear its own costs to date, or
the Action will be dismissed with no order as to costs.
- [Confidentiality – insert appropriate text ………………………………………………………………..]
- The Mediation ended without any agreement as to settlement. [Delete if appropriate]
SIGNED:
For the First Named Party: ___________________________Date: ___________________
[Name:_________________________ Position:____________________________________]
[Address:___________________________________________________________________]
For the Second Named Party: ________________________Date: ____________________
[Name:__________________________Position:___________________________________]
[Address:__________________________________________________________________]
[Add other parties as needed]
Mediator: ____________________________________Date: ________________________
[Name: _____________________________________]
[Address: __________________________________________________________________]
Note: It is recommended that this pro forma is downloaded onto a laptop or other available computer as a “Word” document, and then amended/completed as appropriate by the Mediator at the end of the mediation in the presence of the parties and in accordance with the Parties’ agreement. Copies can then be printed as necessary for signature.