TriCare DD Form 2527 Letters Pertaining to an Illness or Injury Caused by the Negligence of a Third Party
TriCare is a healthcare insurer for veterans of the United States Armed Forces. Oftentimes, when a TriCare patient is injured due to a preventable injury caused by a third party, TriCare will mail a letter to the patient’s family, asking them to fill out a DD Form 2527, ‘Statement of Personal Injury – Possible Third Party Liability Defense Health Agency’. This is a roundabout way of Tricare asking you if you are pursuing a case. This is because TriCare is interested in pursuing a subrogation claim to recover some of the money TriCare spent on the preventable injury, which we explain further below.
Essentially, if you received a letter from TriCare asking about injuries caused by third party liability, you likely have a potential case against the facility or person who caused your loved one’s injury.
This is all that we do. We can help unpack what happened. Speak with Senior Justice Law Firm today for a completely free case consultation by calling us at 888-375-9998, live chatting with our office now, or submitting your potential case facts below. The more information you provide us about the injury and who caused it, the better we can assist you.
Common Injuries Which Result in Actionable Claims
If your loved one suffered any of the below injuries while a patient at a nursing home, hospital or healthcare facility, call or chat with Senior Justice Law Firm today. You likely have a case:
- Bed sores
- Brain bleeds / skull fracture
- Broken hips
- Falls resulting in fracture
Receive a completely free case consultation from our nationwide elder abuse and neglect law firm by calling us now at 888-375-9998.
What Does the TriCare Letter Say Regarding Possible Third Party Liability for Injuries
Usually, the TriCare subrogation letter says something along these lines, and encloses a Third Party Liability form:
Dear [name]:
We recently received a claim for the above patient, which reflects at least one diagnosis code in the 800 to 999 range (1CD9) or starting with an S or T (ICD10). These codes often, but not always, indicate that the patient suffered an accidental injury or illness. This range includes fractures, dislocations, sprains, strains, wounds, and complications to injury. It also includes complications associated with surgical or medical care.
If the patient’s illness or injury was caused by the negligence of a third party, the government may be able to recover money spent for treatment from the responsible party. We are required to determine if a third party may be liable and are unable to make this determination based solely on the information on the claim.
Therefore, we are asking you to complete the enclosed DD Form 2527 Statement of Personal Injury.
Possible Third Party Liability (“TPL form”)
The information you provide will not impact your legal right to any claim or action you pursue against the responsible party for your injury. However, do not furnish the responsible party any information with might impact your case. Do not sign any release or agree to any settlement without first discussing it with a Uniformed Services Legal officer or your attorney.
Please carefully read and follow the instructions on the enclosed TPL form, being sure to complete all applicable sections and sign in the designated box. An immediate family member or legal representative/guardian may complete the form for the patient. Family members should indicate their relationship to the patient. A legal representative/guardian must include documentation naming the signer as the representative. Even if there was no accident, please explain what happened on the attached form. Use box 13 if no other boxes apply. Please return the form in the enclosed self-addressed envelope within 35 days of the date of this letter.
Understanding TriCare’s Subrogation Interest in a Civil Lawsuit
Subrogation liens play a crucial role in the realm of nursing home abuse lawsuits, providing a mechanism for TriCare to recover some of the medical bills it paid for that were caused by a third party.
For example, let’s say your loved one was a resident at Happy Hills Nursing Home, suffered a fall, broke their hip, and was taken to the hospital for a hip repair. You can, and should, sue Happy Hills Nursing Home for the hip fracture. If Tricare paid $10,000 for the hip repair, and you subsequently sue Happy Hills Nursing Home and recover a $200,000 settlement, Tricare is entitled to recoup some of the $10,000 it paid for the hip surgery.
Defining TriCare’s Subrogation Lien
Subrogation, in a legal context, refers to the substitution of one person or entity in place of another with respect to a claim or right. Subrogation liens specifically pertain to the right of a third party, typically an insurer or a healthcare provider like Tricare, to step into the shoes of the injured party and seek reimbursement from the party responsible for the damages.
How TriCare Can Claw Back Some of its Payments for an Injury Caused by a Facility or Third Party
Health insurance companies often assert subrogation liens to recover medical expenses they covered for injuries caused by a third party.
When an individual is harmed due to the negligence of a third party, their insurance company or healthcare provider may cover the costs of medical treatment or property damage. Subsequently, the entity that paid for these expenses may assert a subrogation lien to recover the funds from the responsible party. This ensures that the burden does not solely fall on the injured party or their insurer.
Subrogation liens play a crucial role in civil lawsuits by ensuring that those responsible for causing harm bear the financial consequences. This mechanism promotes fairness and prevents the injured party from being unjustly enriched by receiving double compensation for their losses.
Will TriCare Take All of my Settlement?
No, traditionally, our attorneys will engage a lien resolution team to contest TriCare’s claimed lien and reduce it. Additionally, you would never authorize a settlement without knowing the exact amount Tricare is claiming as a lien.
Using the above example, before you authorize our attorneys to accept the $200,000 settlement from Happy Hills Nursing Home, you would understand that TriCare is going to take $10,000 out of the settlement as payment for the hip repair.
Should I Pursue a Case for the Subject Injury if I got a Letter from Tricare?
Ultimately, this is a family decision that you must make. You are certainly not obligated to sue the facility or person that caused the injury. However, if you would like to learn more about your legal rights, possible avenues of justice, and why your loved one’s injury was likely caused by negligence, call Senior Justice Law Firm now at 888-375-9998. We provide completely free case consultations and, as a nationwide law firm focusing on elder abuse and neglect cases, we can probably help you understand what happened to your family member.
We look forward to hearing from you.
