If you have ever been in a car wreck, you know that insurance companies get involved immediately. After all, it is likely that someone’s insurance is going to be called upon to pay for the damage to vehicles and property, as well as medical expenses in many cases. To the greatest extent possible, these LIABILITY insurance companies try to REDUCE what they pay out. After all, they are profit-making businesses, and their employees are rewarded for paying out as little as possible.
What many servicemembers and retirees in our community do not think about is that TRICARE is government-managed health insurance, which is usually managed by a FOR PROFIT company. So, what happens when an Active Duty military member or dependent is involved in a vehicle wreck where insurance gets involved? If they receive medical treatment at a military medical facility or if TRICARE is otherwise footing the bill, does the injured party need to let anyone else know?
The answers are “yes” and “maybe!” If there is any chance of a settlement or award being recovered by the injured soldier or family member, then the Judge Advocate General (JAG)’s Office should be notified as soon as possible. We will explain why after touching a bit more on TRICARE and personal injury claims. We work with the JAG Office at Ft. Benning for most cases in our area to coordinate the benefits so the soldier or his family is not left owing more after a settlement than they are paid.
Who and What Does TRICARE Cover?
As the DoD’s “premier health care program,” TRICARE covers an astonishing 9.6 million Active Duty, Guard, and Reserve servicemembers, dependents, retirees, and survivors. As noted by Health Net Federal Service, LLC, “Active Duty service members (including activated National Guard and Reserve members) can’t use other health insurance as their primary insurance. TRICARE is the primary payer and coordination of benefits with other insurance carriers does not occur.” (Don’t tell me that the government couldn’t run an efficient healthcare system if it wanted to—TRICARE is a perfect example of how it can be done!)
Among the numerous types of services that TRICARE covers, it pays medical bills of military servicemembers injured in car wrecks. Indeed, it pays first, before any additional payors or settlements. That is where things can potentially get tricky, because sometimes injured parties receive payments through settlements or jury awards later.
When Injured Parties Receive Personal Injury Settlements or Awards
TRICARE can’t be used to cover damages to vehicles or property. It also doesn’t cover costs above those of the required medical treatment. However, in cases where someone else causes the injury—and auto-related incidents—an injured party is still entitled to file a personal injury claim against the at-fault people or company to seek damages that TRICARE doesn’t cover. This compensation typically falls into three categories: general damages, special damages, and punitive damages.
General damages may cover such things as pain and suffering or disfigurement, while special (or “economic”) damages cover actual medical costs and lost earnings.
Punitive damages, as the name suggests, are frequently awarded to basically punish an exceptionally negligent party and to discourage similar behavior by others. An example of punitive damages we deal with often is awards to punish a driver who is intoxicated, or a company that keeps a bad driver on the road despite notice of his or her dangerous behavior. Our office has collected punitive damages in countless cases where the at-fault party didn’t just make a mistake but acted with a wanton disregard for the safety and rights of others.
In cases where an insurance company or a business pays out a settlement claim that includes medical expenses to the victim, or when a jury awards compensation in a civil trial, it is possible that TRICARE will want to be reimbursed for the medical expenses they paid already. That is where the Judge Advocate General’s Office comes into the picture.
What Does the JAG Have to Do with Injury Settlements and Awards?
If a servicemember, dependent, or retiree is injured in a car wreck and has any medical bills paid for by TRICARE, and then that recipient later receives a personal injury settlement or award, they may be required to reimburse TRICARE. After all, just as the person who was injured was entitled to compensation, TRICARE is entitled to get back the funds they paid out for that individual’s medical expenses. It has been my experience that many times a “quick settlement” with the insurance company does not account for this obligation and the adjuster does not disclose the rights of the government, leaving the injured party in an even worse situation after the check is paid.
To be clear, TRICARE is NOT going to ask for money back if an injured person does not receive a settlement or award. However, in situations where the injured person does get a settlement or award, there is a distinct possibility TRICARE will come knocking. Actually, the JAG Office will do the knocking, as it is tasked with the unenviable duty of collecting the reimbursement.
That is why it is incumbent on military personnel to immediately notify their base JAG Office when they suspect that a personal injury settlement or lawsuit award could be a possibility. The JAG, on TRICARE’s behalf, can only come after the amount TRICARE paid, but they almost certainly will come after it.
It can be intimidating when the Judge Advocate General’s Office starts requesting payment on behalf of the government. Fortunately, injured service members and their families do not have to handle such frustrating situations on their own. A personal injury attorney with experience in these cases can help navigate the process and advocate on behalf of the injured party. The key is to be proactive and be prepared!
It is also important to know that working with the JAG Office helps EXPEDITE the gathering of records, obtaining values for services rendered on post and helps in establishing impairments and loss of earnings claims. It has been our experience for over 30 years working near Fort Benning that it is best to deal with the issue up front. In fact, many times we are able to get the entire obligation waived or reduced.
The other good news few lawyers—even in Phenix City or Columbus—know or will tell you is that a lawyer cannot charge a fee for collecting money for the government. So, it doesn’t cost the injured soldier or his family anything to retain a lawyer to deal with the matter, and the lawyer has a real incentive to get a reduction on the claim from the government, which helps the injured soldier or dependent as well!
Get Gary Bruce If You Need Help with Your Personal Injury Claim and the JAG Office or TRICARE
If you have been injured in a vehicle wreck and TRICARE is covering your medical expenses, it may be critical to connect with a seasoned personal injury attorney as soon as possible.
Our firm has been proudly serving military families stationed at Ft. Benning for many years, and we know our way around the complexities surrounding all types of injury claims involving TRICARE and the Judge Advocate General’s Office.
Contact our firm today for a free consultation and learn how we can help you get—and keep—the full compensation you are entitled to after an injury that wasn’t your fault.
We don’t charge anything to discuss your case, your options, and your rights when dealing with an insurance company or the government.