[Boutique] Traffic Accident Claims Agreement

Part 1: Traffic Accident Claims Agreement

Party A: name, gender, date of birth, ethnicity,

ID number: 12xxxxxxxxxxx

Address: xx province xxxxxxxx

Party B: name, gender, date of birth, ethnicity,

ID number: 42xxxxxxxxxxxx

Address: xx province xxxxxxxxx

On August 7, 2019, A drove the Guangdong BXXXXX vehicle to the X section. Because it did not ensure driving safety, it hit the pedestrian B, causing the traffic accident of the injured B. According to the traffic control department, A was responsible for the accident, and B had no responsibility. Both Party A and Party B have reached an agreement on compensation for traffic accidents. The compensation agreement is as follows:

First, the total amount of compensation: x yuan

Party A voluntarily compensates Party B for all losses totaling RMB x. The compensation includes Party B’s transportation expenses, nursing expenses, lost time, one-off accommodation, living expenses for the dependents, follow-up treatment fees, mental damages, disability compensation and other damages.

Second, the payment method and date:

Party A shall pay Party B a sum of compensation on the date of signing the compensation agreement.

3. The compensation involved in this Agreement is a one-time termination of compensation. After Party A pays Party B's expenses, Party B shall not file a claim for compensation or file a lawsuit with Party A and any third party for any reason.

4. At the time of signing this Agreement, both parties shall sign it under voluntary circumstances. There shall be no material misunderstanding or fairness. Party A and Party B shall not rebut the agreement for any reason.

Part 2: Traffic Accident Claims Agreement

Party A: ID number:

Party A's agent: ID number:

Party B: ID number:

Party B entrusted agent: ID number:

At 7:50 on the day of the month of 2006, Party A drove the Beijing No. 8 Polo Car from Ling to go to the county road 101KM+700M, and collided with the pedestrian crossing the road. After the collision, the car drove into the ditch. A traffic accident that causes injury and damage to the vehicle. After the accident, Party B paid Party A's medical expenses to the Party through the County Public Security Traffic Police Brigade. The County Public Security Traffic Police Brigade No. 0000 "Traffic Accident Certificate" determines that Party A is responsible for this accident and Party B is responsible for the secondary responsibility of this accident. Both Party A and Party B have presided over mediation by the county public security traffic police brigade, and they have voluntarily reached a one-time compensation agreement for the loss of Party A from traffic accidents and damage to Party B's vehicles. Now, according to national laws and relevant regulations, the specific compensation matters and the rights and obligations of both parties are as follows: Both parties must comply with:

1. Both Party A and Party B will mediate and reach an agreement under the auspices of the county public security traffic police brigade comrades. The mediation process of this agreement is in line with national laws and is the true meaning of the two sides' equal negotiation, mutual understanding and mutual accommodation. No regrets. At the same time, the two sides solemnly promised to renounce the right to file all lawsuits, arbitrations and other remedies with the judicial organs and other authorities.

2. Party A and Party B shall reach a one-time compensation agreement based on the general principles of traffic accident handling, and Party B shall compensate Party A for one-time compensation for RMB 10,000 yuan, including the previously paid RMB 10,000. The one-time damages have been deducted from Party A’s losses in respect of Party B’s vehicles, and Party A no longer needs to pay Party B compensation for vehicle losses. When this Agreement is signed, Party B shall be deemed to have fulfilled the agreement by the mediation of the police officer to pay the 50,000 yuan of the difference between Party A and Party A. The dispute in this case is immediately completed, and Party A confirms that Party B has no relationship with the case immediately. Party A, the agent and the adult family member shall, when receiving the payment, recover the previous payment of 10,000 yuan, and issue a receipt for the total amount of one-time damages to Party B. Party A and the agent and adult family members The fingerprint must be hand-printed at the receipt of the receipt, and the original receipt will be kept at Party B. The copy will be kept in the traffic police team file for future reference. Both parties have recognized and promised that the above total compensation is voluntary mediation and complies with the provisions of national laws. Party A promises not to bring any lawsuits and arbitrations related to the case, and also waives any right to sue against the judicial authorities for this agreement. Party B will no longer bear any legal responsibility for any change in the party’s injury.

3. When Party A collects Party B's one-time damages, it must deliver all the medical expenses bills, medical record materials, other expense bills, and related documents to Party B at the same time, and ensure the authenticity of the bill materials. Party B’s claim to the insurance company failed, and Party A shall double the false part of Party B. When insuring the insurance company's claim in the direction of B, Party A is obliged to assist Party B to provide relevant documents, bills and other information.

4. All terms of this Agreement shall be agreed upon by both parties and shall be in the form of a document prepared by the party specified in the Non-Contract Law. Both parties shall sign the right hand index finger under each page of this Agreement. This Agreement shall enter into force immediately after the signature of both parties is signed. Both parties undertake and confirm that this Agreement is a legal, true, irrevocable and irrevocable civil contract. It is protected by law and is a one-time solution to the statutory In the legal instrument for damages disputes, the commitments of the parties in the agreement cannot be violated. If there is a violation, the defaulting party must pay the breaching party a liquidated damages of RMB 10,000.

5. This Agreement shall be made in triplicate. Each Party A and Party B shall hold one copy and remain in the mediator's file. All three are originals of the agreement and have the same legal effect.

Signature of Party A: Signature of Party B:

Party A entrusts the agent: Party B entrusts the agent:

Contact number: Contact number:

Signing time: Signing time:

Part 3: Traffic Accident Claims Agreement

Party A: Name...Sex...age...current residence...ID number...work unit...systemAY...vehicle driver

Party B: name...sex...age...current residence...identity number...is the injured person

20XX....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... The traffic accident was confirmed by the Traffic Police Brigade of Donghu District of Nanchang Public Security Bureau. In this traffic accident, the vehicle was responsible for the traffic accident.

On the basis of equality and voluntariness, both Party A and Party B are based on the Law of the People's Republic of China on Road Traffic Safety, the Measures for Handling Road Traffic Accidents, the Regulations on Handling Procedures for Road Traffic Accidents, and the Applicable Law of the Supreme People's Court on the Trial of Compensation for Personal Injury The provisions of the Interpretation of Several Issues, under the witness of the Traffic Police Brigade of the Donghu District of Nanchang Public Security Bureau, reached an agreement on compensation for damage caused by traffic accidents as follows:

1. Party A shall voluntarily compensate Party B for the total amount of various statutory personal injury compensation items of Party B. ;

2. Party B agrees to accept the above compensation and waive all other rights to Party A, and no longer requires Party A to make any form of compensation or assume any other responsibility. If Party B submits any request to Party A, Party A shall decide how to handle the settlement;

3. After the signing of this Agreement, in order to facilitate Party A's insurance claims, both parties shall agree to cooperate with each other;

4. Party A shall pay Party B a one-time compensation on the date of the entry into force of this Agreement.

5. Party B expresses its understanding to Party A's actions, guarantees that no other lawsuits are filed with the legal department, and guarantees that when necessary, Party A and Party A's unit will explain the situation of this agreement to the relevant departments and issue relevant files or certificates. ;

6. Party B guarantees that Party A or the insurance company will not be required to compensate for any compensation other than the amount of compensation in this agreement. Therefore, the second accident will result in the payment of vehicle insurance, and Party A will make claims or claim. If necessary, Party B shall cooperate with Party A to make claims or claim, and all the insurance claims shall be owned by Party A;

7. Party B guarantees that this Agreement is legal and valid, and guarantees that no other rights holders or interested parties shall claim rights to Party A in this traffic accident. If this Agreement is confirmed to be invalid, Party B shall return all the compensations received to Party A. If Party A causes other losses, Party B shall bear full responsibility;

8. If either Party A or Party B violates the agreement of this Agreement, the breach of contract shall pay the breach of contract to the other party... Yuan Yuan;

9. This Agreement shall be signed by both parties immediately after the signature of the traffic police brigade of the Donghu District Traffic Police Brigade of the Nanchang Municipal Public Security Bureau and signed by the Traffic Police Brigade of the Donghu District of Nanchang Public Security Bureau;

X. This Agreement is made in triplicate. Party A and Party B and the Traffic Police Brigade of Donghu District of Nanchang Public Security Bureau hold one copy. If there is a conflict between the texts, the text of Party A's unmodified and altered version shall prevail.

Party A: _______________ Party B: _____________ Traffic Police Department: _____________