PERSONAL INJURY POWER OF ATTORNEY

AND

CONTRACT OF EMPLOYMENT

I/WE, THE UNDERSIGNED, INDIVIDUALLY AND AS NEXT FRIEND OF ANY MINOR OR INCOMPETENT PERSON(S) NAMED NEXT:  __________________________________, HEREBY EMPLOY LEONARD E.  COX AS MY/OUR ATTORNEY TO PROSECUTE AND COLLECT ANY AND ALL CLAIMS FOR PERSONAL INJURIES, PROPERTY DAMAGE AND/OR WRONGFUL DEATH SUSTAINED ON OR ABOUT THE ____________ DAY OF __________________, 20____.  THESE CLAIMS ARE AGAINST _________________________________________________ AND ANY OTHER LIABLE PARTY.  IN THE EVENT I/WE HAVE PERSONAL INSURANCE, INCLUSIVE OF BUT NOT LIMITED TO UNINSURED MOTORIST, UNDERINSURED MOTORIST AND/OR PERSONAL INJURY PROTECTION BENEFITS, MY/OUR ATTORNEYS ARE EMPLOYED TO PROSECUTE AND COLLECT ANY AND ALL CLAIMS FOR SUCH COVERAGE BENEFITS THAT I/WE MAY BE ENTITLED TO RECEIVE AS A RESULT OF THE ABOVE LISTED INCIDENT(S) OR CLAIM(S).

I/WE AUTHORIZE MY/OUR ATTORNEYS TO FILE PLEADINGS, APPEAR IN COURTS OF LAW, NEGOTIATE, INCUR EXPENSES. AND TO PERFORM ANY AND ALL FUNCTIONS WHICH ARE REASONABLY NECESSARY FOR THE PROSECUTION OF MY/OUR CLAIM(S).  I/WE ALSO GIVE MY/OUR ATTORNEYS COMPLETE AUTHORITY TO SIGN MY NAME TO ALL DRAFTS, RELEASES, AUTHORIZATIONS AND ALL OTHER PAPERS IN THE PROSECUTION AND CONCLUSION OF MY/OUR CLAIM(S). IF I/WE DO NOT PROVIDE MY/OUR ATTORNEYS WITH WRITTEN NOTICE OF ANY CHANGES OF ADDRESS FROM THE ONE LISTED BELOW, THEN I/WE SPECIFICALLY AUTHORIZE MY/OUR ATTORNEYS TO SETTLE MY/OUR CASE, SIGN MY/OUR NAME(S) TO RELEASES, SETTLEMENT AGREEMENTS TO ENDORSE DRAFTS, CHECKS, INCLUSIVE BUT NOT LIMITED TO SETTLEMENT CHECKS, OR ANY OTHER METHOD OF PAYMENT TO TAKE THEIR ATTORNEYS’ FEES, COSTS, EXPENSES, MAKE REIMBURSEMENTS FOR ANY ADVANCE OR LOAN AND PAY ANY INTEREST THAT MAY HAVE ACCRUED ON ANY ADVANCE LOAN OR MEDICAL EXPENDITURE. AND TO DEPOSIT MY/OUR PORTION CF ANY SETTLEMENT IN A TRUST FUND ON MY/OUR BEHALF.  I/WE SHALL PAY MY/OUR ATTORNEYS ANY AND ALL-REASONABLE ATTORNEYS FEES, COSTS AND/OR EXPENSES INCURRED BY THEM IN ANY DISPUTE ARISING OUT OF THE COLLECTION OF THEIR ATTORNEYS’ FEES, COSTS, EXPENSES, ADVANCES, LOANS, MEDICAL EXPENDITURES AND/OR INTEREST THAT IS OWED.

MY/OUR ATTORNEYS ARE UNDER NO OBLIGATION TO ADVANCE ME/US ANY MONEY AGAINST MY/OUR CLAIM(S) OR PAY OR BECOME OBLIGATED TO PAY FOR ANY MEDICAL TREATMENT FOR OR ON MY/OUR BEHALF. HOWEVER, IF THEY DO, I/WE UNDERSTAND THAT I/WE WILL REPAY SAID MONEY TOGETHER WITH SIMPLE INTEREST THEREON AT THE RATE OF TEN PERCENT (10%) PER ANNUM.  MY/OUR ATTORNEYS HAVE THE ELECTION OF REPAYMENT OF SUCH MONIES FROM THE BALANCE OF MY/OUR PORTION OF ANY SETTLEMENT OR RECOVERY MADE FOR OR ON MY/OUR BEHALF AND/OR FROM ANY OTHER ASSETS, REALTY OR ACCOUNTS AVAILABLE TO ME/US OR FROM ANY COMBINATION OF MY/OUR SETTLEMENT OR RECOVERY OR MY/OUR PERSONAL ASSETS, REALTY OR ACCOUNTS UNTIL SUCH MONIES ARE COLLECTED IN FULL.

MY/OUR ATTORNEYS ARE UNDER NO OBLIGATION TO GUARANTEE ANY LOAN FOR ME AT A BANK.  HOWEVER, IF THEY DO, I AGREE TO PAY INTEREST TO THAT BANK AT THE PREVAILING INTEREST RATES AND HEREBY AUTHORIZE MY/OUR ATTORNEYS TO REPAY SUCH LOAN(S) AND INTEREST THEREON FROM MY SHARE OF ANY SETTLEMENT OR RECOVERY MADE ON MY BEHALF.  I/WE HEREBY FURTHER AGREE THAT IF ANY SUCH LOAN(S) OR NOTE(S) BECOME DUE,  MY/OUR ATTORNEYS HAVE FULL AUTHORITY TO SIGN MY/OUR NAME(S) UPON SAME.

I/WE HEREBY GIVE MY ATTORNEYS THE RIGHT TO WITHDRAW FROM MY/OUR CASE AT ANYTIME BY SENDING NOTICE TO MY/OUR LAST KNOWN ADDRESS. THEREBY WAIVING ANY CLAIM BY THEM FOR ATTORNEY’S FEES.  MY/OUR ATTORNEYS RESERVE THE RIGHT TO STOP REPRESENTING ME/US IF IT APPEARS TO MY/OUR ATTORNEYS THAT CONTINUED REPRESENTATION IS NOT IN THE BEST INTEREST OF ME/US OR MY ATTORNEYS OR MY/OUR ATTORNEYS ARE NOT ETHICALLY ALLOWED TO UNDERTAKE OR CONTINUE SUCH REPRESENTATION.  I/WE UNDERSTAND THAT IN THE EVENT MY/OUR ATTORNEYS WITHDRAW FROM REPRESENTATION, I/WE REMAIN OBLIGATED AS STATED ABOVE TO REIMBURSE THE ATTORNEYS FOR MEDICAL EXPENDITURES, ADVANCES AND LOANS WITH INTEREST AS STATED IN THIS AGREEMENT.  I/WE UNDERSTAND THAT IF I/WE DISCHARGE MY/OUR ATTORNEYS, THEY ARE ENTITLED TO THEIR FEES, EXPENSES, COSTS ADVANCES, LOANS, MEDICAL EXPENDITURES AND INTEREST AS STATED IN THIS AGREEMENT.

AS COMPENSATION FOR THE SERVICES TO BE PROVIDED BY MY/OUR ATTORNEYS IN THE PROSECUTION AND OR COLLECTION OF MY/OUR CLAIM(S), I/WE ASSIGN TO MY/OUR ATTORNEYS AN UNDIVIDED INTEREST IN MY/OUR CLAIM(S) AS FOLLOWS:

1.) 33 AND 1/3 PER CENT (33 1/3%)INTEREST OF ANY CLAIM(S) IF CONCLUDED BEFORE FILING SUIT,       PLUS REIMBURSEMENT OF ALL LOANS, ADVANCES, MEDICAL EXPENDITURES WITH INTEREST, AND ALL OTHER COSTS AND EXPENSES.

2.) 40 PER CENT INTEREST (40%) OF ANY CLAIM(S) IF CONCLUDED AFTER FILING SUIT PLUS REIMBURSEMENT OF ALL LOANS, ADVANCES, MEDICAL EXPENDITURES WITH INTEREST, AND ALL OTHER COSTS AND EXPENSES.

3.) 45 PER CENT (45%) INTEREST OF ANY CLAIM(S) IF CONCLUDED AFTER FILING OR RESPONDING TO ANY APPEAL FROM A FAVORABLE OR ADVERSE JUDGMENT, PLUS REIMBURSEMENT OF ALL LOANS, ADVANCES, MEDICAL EXPENDITURES WITH INTEREST, AND ALL OTHER COSTS AND EXPENSES.

4.) FOR MY LONGSHORE AND HARBOR WORKER’S COMPENSATION ACT CLAIM, ATTORNEYS’ FEES AS APPROVED BY THE DEPARTMENT OF LABOR OR AS DETERMINED BY AND ADMINISTRATIVE LAW JUDGE.

I/WE UNDERSTAND THAT ATTORNEYS FEES ARE PAID FROM THE TOTAL SUM RECOVERED OR COLLECTED BEFORE ANY LOANS, ADVANCES, MEDICAL EXPENDITURES, INTEREST, AND ALL OTHER COSTS OR EXPENSES ARE DEDUCTED, PAID OR REIMBURSED. COSTS AND EXPENSES, OTHER THAN MENTIONED ABOVE I/WE SHALL PAY INCLUDE BUT, ARE NOT LIMITED TO, COURT COSTS, INVESTIGATIVE FEES, COSTS OF OBTAINING MEDICAL RECORDS, REPORTS AND BILLS, DEPOSITION AND VIDEO COSTS, EXPERT FEES, LONG DISTANCE TELEPHONE CHARGES, CERTIFIED AND REGULAR MAIL EXPENSES, OVERNIGHT AND COURIER DELIVERIES, COPYING CHARGES AND TRANSPORTATION AND TRAVEL EXPENSES.

I/WE UNDERSTAND THAT SETTLEMENTS ARE USUALLY MADE IN THE FORM OF A SINGLE PAYMENT FOR EACH DEFENDANT. OCCASIONALLY. SETTLEMENT AGREEMENTS PROVIDE FOR INSTALLMENT PAYMENTS INTO THE FUTURE FUNDED BY ANNUITIES OR OTHER MEANS.  IN THE EVENT SUCH A STRUCTURED SETTLEMENT IS MADE, THE FEES. LOANS, ADVANCES, MEDICAL EXPENDITURES, INTEREST AND ALL OTHER COSTS AND EXPENSES OWED MY/OUR ATTORNEYS SHALL BE PAID IN A LUMP SUM AT THE TIME OF SETTLEMENT.  UNLESS THE PARTIES AGREE OTHERWISE ATTORNEY’S FEES SHALL BE COMPUTED AS A PERCENTAGE OF A REASONABLE ESTIMATE OF THE COST OF THE STRUCTURED SETTLEMENT TO THE SETTLING PARTY.

I/WE AGREE THAT MY/OUR ATTORNEYS MAY ASSOCIATE ANY ATTORNEY TO HELP REPRESENT ME/US AND THAT MY/OUR ATTORNEY MAY REFER MY/OUR CLAIM(S) TO OTHER ATTORNEYS AS THEY DEEM NECESSARY, AS LONG AS THE FEES OWED BY ME/US ARE NOT INCREASED.

IF ANY PORTION OF THIS AGREEMENT IS RULED INVALID OR UNENFORCEABLE. SUCH RULING SHALL NOT EFFECT ANY OTHER PROVISIONS AND THIS AGREEMENT SHALL BE CONSTRUED AS IF IT DID NOT CONTAIN THE INVALID OR UNENFORCEABLE PROVISION.

I/WE HAVE READ AND UNDERSTOOD THE TERMS AND CONDITIONS OF THIS

AGREEMENT AND KNOW THAT BY SIGNING MY/OUR NAME(S) BECOME BOUND BY THE TERMS AND CONDITIONS EXPRESSLY STATED. NO ONE HAS MADE ANY OTHER ORAL OR WRITTEN PROMISES OR GUARANTEES OTHER THAN THOSE STATED IN THIS DOCUMENT. THIS AGREEMENT MAY NOT BE CHANGED OR ADDED TO EXCEPT IN WRITING, SIGNED BY ALL PARTIES.

                                                        

SIGNED THIS THE ___________DAY OF _____________________, 20______, IN ______________________ COUNTY, TEXAS.  I/WE UNDERSTAND AND AGREE THAT THIS AGREEMENT SHALL BE CONSTRUED UNDER THE LAWS OF THE STATE OF TEXAS.

 

  SIGNATURE(S):  _____________________________________________________________

ADDRESS:  _______________________________________________________________

CITY:  _______________________________________________________________

STATE:  _______________________________________________________________

ZIP CODE:  _______________________________________________________________

PHONE #: ___________________________

 

 

ATTORNEY APPROVAL SIGNATURE: ____________________________________

 

NOTICE TO CLIENT(S)

THE STATE BAR OF TEXAS INVESTIGATES AND PROSECUTES PROFESSIONAL MISCONDUCT COMMITTED BY TEXAS ATTORNEYS. ALTHOUGH NOT EVERY COMPLAINT AGAINST A LAWYER INVOLVES VIOLATIONS OF ETHICAL RULES, THE STATE BAR GENERAL COUNSEL WILL PROVIDE YOU WITH INFORMATION ABOUT HOW TO FILE A COMPLAINT. FOR MORE INFORMATION, YOU MAY CALL TOLL FREE AT (800) 932-1900.