I have an Air Force client with Tricare for health insurance. We have settled his UM claim for policy limits with USAA which has asked whether there is a Tricare lien or Military lien. I told them per Provident v. Ridenour, I did not believe the Tricare lien would attach to the UM settlement but only to the proceeds of the tortfeasor's policy. Any thoughts?
Answer: The basis for the government’s right to recover is the Federal Medical Care Recovery Act, 42 U.S.C. Sec. 2651(a): “In any case in which the United States is authorized or required by law to furnish or pay for hospital, medical, surgical, or dental care and treatment (including prostheses and medical appliances) to a person who is injured or suffers a disease, after the effective date of this Act, under circumstances creating a tort liability upon some third person (other than or in addition to the United States and except employers of seamen treated under the provisions of section 249 of this title) to pay damages therefore, the United States shall have a right to recover (independent of the rights of the injured or diseased person) from said third person, or that person's insurer, the reasonable value of the care and treatment so furnished, to be furnished, paid for, or to be paid for and shall, as to this right be subrogated to any right or claim that the injured or diseased person, his guardian, personal representative, estate, dependents, or survivors has against such third person to the extent of the reasonable value of the care and treatment so furnished, to be furnished, paid for, or to be paid for.”
Their used to be a split in authority whether the above statute caused such liens to attach to UM coverage. In 1990, Congress amended another applicable statute, 10 U.S.C. Sec. 1095, adding new sections “H” and “I” such that it now appears clear the government’s lien attaches to UM and other first-party insurance coverages.
Posted on Sun, July 18, 2010
by Sharon Coleman