Seeking advice on Medical bill repayment to TriCare

[ArmyMedic84]

Back in June of 2008 I was critically hit by a drunk driver while on active duty. Driver only had liability which was about $50,000, but my hospital bills after hospital stay and two extensive surgeries was approx. $130,000. Now, Tricare is taking care of the bills since i am active duty, but my lawyer is telling me that Tricare only takes care of the bills initially keeping a lien on the medical bills expecting payment through said drivers insurance company. Well the MAX his insurance company(state farm) can pay, which is the maximum for his coverage is the 50,000. This insanely small amount leaves me with 80,000 in medical bills plus lawyer fees. Now I know that tricare isnot goingto make me pay for all of that, but then again they arent going to pay all of that themselves either. does anyone know how these situations usually play out and how tricare works.

[mistake-prone]

Assuming you were also driving at the time of the accident, is your auto insurance company not involved and/or assisting you?

 

My co-worker's daughter was driving the wrong way down a road and t-boned another car. Her insurance was capped relatively low (as in your example) and the other driver sued her (at-fault driver's) insurance company and her (at-fault driver's) family for > $1 mil. Injuries in this case were relatively limited (I believe limited to back and neck pain, but nothing requiring surgery).

 

Case was settled out-of-court for 10% of what was originally asked, but about 250% of what the max insured policy amount was.

 

Not sure if this is at all helpful for your situation, but perhaps something to consider.

 

Good luck!

[clambert1273]

now I haven't been active duty in the Army for about 6 years now, but being on active duty any medical you received should be covered by the military (tricare or not). Were you not being treated at an army medical center? If not, then they should cover 100% of the bill because if you were too critical and had to proceed to a civilian hospital then they required to pay the full amount. You need to speak to someone else there because I just dug this up:

 

The Federal Medical Care Recovery Act (FMCRA) (42 U.S.C. 2651-2653)

Provides for the recovery of the costs of medical care furnished by the United States

to a person suffering a disease or injury caused by the action or negligence of some third

person. Under this act, the United States has a right to recover the reasonable value of the

care and treatment from the person(s) responsible for the injury. For TRICARE beneficiaries,

this includes care that may be received by the beneficiary at a Uniformed Services facility or

under TRICARE, or both. The FMCRA applies only to illness or injury (including workrelated

injuries) caused by a third party, either intentionally or negligently, or injuries caused

by a third party’s failure to act when a duty to act could be implied.

EXAMPLE: A beneficiary is injured as a result of an automobile accident caused by another

person and the beneficiary’s medical care is paid for by TRICARE. Under this Act,

the Government may recover the amounts paid by TRICARE from the negligent

party.

 

Which basically means they are entitled to the 50K from the others insurance but still have to cover you.

 

I am going to post this link however it may get removed so if it does just PM me:

 

http://www.tricare.mil/to02/C11S5.PDF

Edited February 20, 2009 by clambert1273