Short Answer

Military health plans like TRICARE can assert a federal reimbursement claim when they pay for injury-related treatment. To confirm a lien, identify whether TRICARE or a military hospital/clinic paid any bills, then contact the appropriate TRICARE/DHA recovery office to open a recovery file and request a written conditional payment (lien) amount. In North Carolina, you must address valid reimbursement claims before settlement funds are disbursed, and federal claims may not follow state lien limits.

Understanding the Problem

You want to know, in North Carolina, how you can confirm whether a military health plan has a lien on your personal injury case. The decision point is whether injury-related care was paid by TRICARE or provided at a military hospital or clinic. If so, the plan can seek repayment from your recovery, and you need a clear, written payoff figure before settlement is disbursed.

Apply the Law

Under North Carolina personal injury practice, any third-party payer that covered accident-related care should be identified and contacted early. Military health benefits (TRICARE/Defense Health Agency and military treatment facilities) assert federal reimbursement rights when they pay for care tied to a third-party claim. In North Carolina, attorneys must resolve valid reimbursement claims before distributing settlement funds. State law governs how medical liens created by state statute are paid from settlements, but federal military health claims are created by federal law and can operate outside some state lien limits.

Key Requirements

• Identify coverage: Determine if TRICARE paid any bills or if you treated at a military hospital/clinic for accident-related care.
• Give notice and open a file: Contact the TRICARE/DHA recovery unit or the military facility’s legal office to report the claim and obtain a recovery file or claim number.
• Submit documentation: Provide a personal injury questionnaire, proof of representation/authorization, and itemized bills so the payer can match charges to the injury.
• Obtain a conditional payment amount: Request a written statement listing injury-related payments (a “conditional payment” or “lien” letter).
• Request a final demand before disbursement: Before settlement funds are distributed, request a final payoff and pay it by the deadline stated in the demand letter.
• Apply North Carolina distribution rules: State-created medical liens are subject to North Carolina’s allocation rules; federal claims may preempt those limits.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical provider lien) - Creates a lien for certain medical providers on personal injury recoveries.
• North Carolina Gen. Stat. § 44-50 (Enforcement; priority; 50% cap) - Sets priority for attorney’s fees and limits total payout to state-created medical liens.
• North Carolina Gen. Stat. § 108A-57 (Medicaid third-party liability) - Example of a statutory reimbursement framework; separate from military health claims created by federal law.

Analysis

Apply the Rule to the Facts: With no specific facts provided, consider two scenarios. If your emergency room visit and follow-up were billed to TRICARE, you likely have a federal reimbursement claim; you would open a TRICARE/DHA recovery file and request a conditional payment letter. If your care was at a military clinic but later billed to a private plan, confirm whether any part was paid by TRICARE or the clinic itself; only those injury-related payments by the military plan would be included in a military reimbursement claim.

Process & Timing

1. Who files: You or your attorney. Where: The TRICARE/Defense Health Agency recovery unit or the legal office for the military hospital/clinic. What: Submit the payer’s personal injury questionnaire and proof of representation/authorization; request a recovery file/claim number and a conditional payment amount. When: Do this as soon as you know military benefits paid accident-related bills and before any settlement is disbursed.
2. The recovery unit reviews bills and issues a conditional payment letter. Update them with new treatment so the total stays accurate. Response times vary; follow up periodically until you receive a final demand.
3. Before disbursement, send settlement details to request a final demand. Pay the final demand by the stated deadline and obtain written confirmation of satisfaction for your file.

Exceptions & Pitfalls

• Assuming no lien because you used a civilian doctor. TRICARE often pays civilian providers; those payments still trigger a reimbursement claim.
• Relying only on explanations of benefits. Always get a written conditional payment letter from the recovery unit to confirm the official amount.
• Overlooking pharmacy, imaging, or referred care. Ask the recovery unit to check all related claim codes and date ranges.
• Applying North Carolina’s 50% cap to federal claims. State caps limit certain state-created liens; federal military reimbursement rights may not be limited by those caps.
• Missing notice or payment deadlines in the final demand letter. Late payment can lead to added charges or collection actions.

Talk to a Personal Injury Attorney

If you're dealing with a possible TRICARE or military treatment facility reimbursement claim on your North Carolina injury case, our firm has experienced attorneys who can help you understand your options and timelines. Reach out today at (919) 341-7055.

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.