Third-Party Liability | TRICARE Your regional contractor will send you the Statement of Personal Injury-Possible Third Party Liability (DD Form 2527) if a claim is received that appears to have third-party liability involvement You must complete and sign this form within 35 calendar days
Statement of Personal Injury-Possible Third Party Liability Use this form to explain if your care is due to an accident caused by someone else Download DD Form 2527 (PDF) Third party liability occurs when someone else (an individual, organization, or business) may have been responsible for your injury or illness
Third Party Liability (TPL) - Humana Military Beneficiaries will receive the Statement of Personal Injury-Possible Third Party Liability (DD Form 2527) if a claim is received that appears to have TPL involvement The beneficiary must complete and sign this form within 35 calendar days and return the form to the address below
DD Form 2527, STATEMENT OF PERSONAL INJURY - POSSIBLE THIRD PARTY . . . PRINCIPAL PURPOSE(S): To collect information necessary to determine when third parties may be held liable for medical care resulting from your injuries and to permit TRICARE to seek recovery for the cost of such care from those parties
DD Form 2527 – Statement of Personal Injury - DD Forms DD Form 2527 is a document issued by the Defense Health Agency (DHA) to military members and their dependents This form serves as an official statement of injury or illness, which can be used in cases where third-party liability may be possible
Where to Send TRICARE DD Form 2527? - UCMJ But don’t worry, you’re about to get clear, straightforward guidance on where to send your DD Form 2527 to move forward with your claim Let’s dive into the specifics and make sure your form reaches the right hands, ensuring your peace of mind and swift handling of your medical expenses
Medical Claims | TRICARE Statement of Personal Injury-Possible Third Party Liability (DD Form 2527) You'll need to use this form when you submit claims for an injury or illness caused by a third party:
DD Form 2527, Statement of Personal Injury - Possible Third Party . . . Information requested is used in reviewing claims to obtain additional information to determine proper liability of third parties for claims and to facilitate possible recovery by the United States for improperly paid claims
DD2527 - Executive Services Directorate Form Number: DD 2527 Title: Statement of Personal Injury - Possible Third Party Liability, Defense Health Agency Edition Date: 03 01 2020 For use of this form please contact: The Defense Health Agency (DHA)