Third-Party Liability

Third-Party Liability (TPL) exists when another person or entity is legally responsible for paying medical costs resulting from an injury or illness they caused. When TRICARE pays for care that should be covered by a liable third party, the government has the right to recover those costs.

Common third-party liability situations: • Motor vehicle accidents caused by another driver • Slip-and-fall injuries on someone else's property • Product liability injuries from defective products • Medical malpractice by non-military providers • Workplace injuries covered by workers' compensation

TRICARE's right of recovery: • TRICARE initially pays for covered healthcare services • The government then seeks reimbursement from the responsible party • Beneficiaries must cooperate with recovery efforts • Failure to cooperate may result in denial of future claims • Legal settlements must account for TRICARE's recovery rights

Beneficiary responsibilities: • Report any injuries caused by a third party to your regional contractor • Provide information about the incident and any insurance claims • Notify TRICARE of any legal proceedings or settlements • Do not sign settlement agreements without considering TRICARE's interests

The Federal Medical Care Recovery Act gives the government the right to recover medical costs from liable third parties. Beneficiaries should consult with their regional contractor when pursuing injury claims.