Short Answer

In North Carolina, you confirm TriCare or VA repayment claims by asking the federal agency that paid your accident-related care for a written lien or “rights of recovery” statement. Notify the Defense Health Agency (for TriCare) or the U.S. Department of Veterans Affairs (for VA care) about your claim, then obtain and review their itemized conditional payment letter and final demand before any settlement money is disbursed. Federal reimbursement rights often apply even when North Carolina’s provider lien limits would not.

Understanding the Problem

In North Carolina, if TriCare or the VA paid for your accident-related medical care, you want to know: can they take money from my personal injury settlement, and how do I find that out? The decision point is whether a federal program paid injury-related bills. If it did, you—or your attorney—must contact the correct agency to verify any claim and amount before distributing settlement funds.

Apply the Law

Under North Carolina practice, personal injury settlements must account for valid statutory or contractual claims to the funds, including government payers. When a government program pays accident-related bills, it typically has a right to be reimbursed from a third-party recovery. For TriCare (Defense Health Agency) and the VA, those rights arise under federal law, and you confirm them by direct notice to and written confirmation from the agency. The main forum is administrative: you communicate with the Defense Health Agency for TriCare or the VA’s Office of Community Care/Revenue operations for VA-paid care. Timing matters because agencies issue a conditional payment amount first and a final demand later, and payment is due by the deadline in that demand.

Key Requirements

• Identify the payer: Confirm whether TriCare or the VA paid any accident-related bills (check EOBs, insurance cards, treatment locations).
• Give notice and request a lien statement: Send written notice of your claim to the Defense Health Agency (TriCare) or the VA and request a conditional payment/rights-of-recovery letter.
• Verify itemization: Review the itemized charges to ensure they relate to the accident and dispute unrelated items in writing.
• Obtain a final demand: After settlement, request the final demand and pay it by the agency’s stated deadline before client funds are disbursed.
• Document and close: Keep the demand, proof of payment, and any release/closure notice in your file.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical provider liens) — Creates lien rights for certain providers on personal injury recoveries.
• North Carolina Gen. Stat. § 44-50 (Distribution and fees) — Addresses attorney’s fees and distribution mechanics when paying medical liens from settlements.
• North Carolina Gen. Stat. § 108A-57 (Medicaid subrogation) — Gives the State a recovery right against third-party settlements when Medicaid paid related care.
• North Carolina Gen. Stat. § 28A-18-2 (Wrongful death) — Limits wrongful-death medical expense payments, with important exceptions for certain government recoveries.

Analysis

Apply the Rule to the Facts: If TriCare paid your ER and follow-up bills, you notify the Defense Health Agency and request a conditional payment letter to confirm what was paid for your accident. Before disbursing your settlement, you obtain and pay the final demand by its due date. If the VA covered your treatment at a VA facility, you contact the VA’s recovery unit for an itemized statement, dispute any unrelated care, and resolve the final demand before issuing client funds.

Process & Timing

1. Who files: The injured person or their North Carolina personal injury attorney. Where: Defense Health Agency (TriCare) and U.S. Department of Veterans Affairs recovery offices. What: Send notice of claim/representation, signed authorization, accident details (date, cause), and request for a conditional payment or rights-of-recovery letter. When: Do this early in the claim and again immediately after settlement to request a final demand.
2. Agency review and itemization: The agency assigns a case number and issues a conditional payment summary. Review it and promptly dispute any unrelated charges; updates typically take several weeks, and timing can vary.
3. Final demand and payment: After settlement, request a final demand. Pay it by the stated deadline and retain proof of payment and closure/release before disbursing settlement funds to the client.

Exceptions & Pitfalls

• Mixing programs: TriCare (military beneficiary program) and the VA (veterans’ care) are separate; verify which one actually paid. Care at a military or VA facility often signals government payment.
• Unrelated charges: Conditional summaries can include non-accident care. Dispute promptly with documentation.
• Wrongful death differences: North Carolina limits certain wrongful-death medical payments, but government reimbursement rights can operate outside those caps. Confirm the case type before negotiating reductions.
• Missing notice: If you fail to notify the correct agency or provide a HIPAA-compliant authorization, you may face delayed final demands and settlement disbursement.
• Pay-by date: Agencies impose strict payment deadlines in final demands. Late payment can trigger interest or further action.

Talk to a Personal Injury Attorney

If you’re dealing with a settlement and need to verify and resolve TriCare or VA reimbursement claims, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at 919-313-2737.

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney–client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.