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Sample NAVJAG Form 5890/12, Report of Hospital and Medical Care—Third Party Liability, Supplemental Statement (front) - 14134_340
settled,  or  waived  only  with  the Department  of  Justice. . Initial action. JAG designees MCRA  claims  from  several  sources. approval  of  the learn  of  potential . Investigations. When a military member, retiree, or  dependent  receives,  either  directly  or  indirectly, federal medical care for injuries or disease for which another   party   may   be   legally   responsible,   an investigation   is   required.   One   exception   to   this requirement  is  when  the  inpatient  care  does  not  exceed 3 days or outpatient care does not exceed 10 visits. The responsibility for conducting the investigation of a possible MCRA claim normally lies with the CO of the  local  naval  activity  most  directly  concerned,  usually the  CO  of  the  personnel  involved  in  the  incident  or  of the  activity  where  the  incident  took  place.  This responsibility may be assigned to another CO under certain  circumstances. An investigation into a possible MCRA claim is conducted according to the JAG Manual and JAGINST 5890.1. An investigation of the same incident that was convened for some other purpose usually may be used to determine possible MCRA liability, provided it is complete. If any investigation, regardless of its origin or initial purpose,  involves  a  potential  MCRA  claim,  a  copy should be sent to the cognizant JAG designee. Reports of Care and Treatment The second major way that the JAG designee learns of a possible MCRA claim is by a report from the facility providing medical care. Military health care facilities are required to report medical treatment they provide when it appears that a third party is legally responsible for the injuries or disease. In the Navy, this reporting requirement is satisfied  by  submission  of  NAVJAG  Form  5890/12, Report of Hospital and Medical Care - Third Party Liability Case (fig. 12-5) to the cognizant JAG designee. A NAVJAG 5890/1 2 is submitted when it appears that the patient will require more than 3 days’ inpatient care or  more  than  10  outpatient  visits.  Preliminary,  interim, and final reports are prepared as the patient progresses through  the  treatment. This report is, in essence, a hospital bill because it will reflect the value of the medical  care  provided  to  date,  computed  according  to OMB  rates. Military health care facilities in other services use forms similar to NAVJAG 5890/12. Statements of CHAMPUS payments on behalf of the   injured   person   are   available   from   the   local CHAMPUS  carrier  (usually  a  civilian  health  care insurance  company  that  administers  the  CHAMPUS program  under  a  government  contract),  Statements  are sent automatically to JAG designees in cases involving potential third-party liability. District medical officers arc required to submit reports to cognizant JAG designees whenever they pay emergency medical expenses incurred by active duty personnel  at  a  civilian  facility  and  the  circumstances indicate possible MCRA liability. Injured Person’s Responsibilities The JAG designee advises the injured person of his or  her  legal  obligations  under  the  MCRA.  These responsibilities arc as follow: . Furnish the JAG designee with any pertinent information  about  the  incident . Notify the JAG designee of any settlement offer from the liable part y or that party’s insurers . Cooperate in the prosecution of the government’s claim against the liable party . Give the JAG designee the name and address of any civilian attorney representing the injured party, since the civilian attorney may represent the government as well as the injured person if the claim is litigated in court . Refuse to execute a release or settle any claim concerning the injury without the prior approval of the JAG  designee . Refuse to provide any information to the liable party, that party’s insurer, or attorney without prior approval of the JAG designee At  first,  these  restrictions  and  obligations  may appear unfair. But,  it  must  be  remembered  that  the government’s  rights  under  the  MCRA  are  largely derivative from the injured person’s legal rights. If the injured person makes an independent settlement with the  liable  party,  the  government’s  rights  could  be prejudiced. Also, if the injured person settles the claim independently  and  receives  compensation  for  medical expenses,  the  government  is  entitled  to  recover  its MCRA claim from the injured person directly out of the proceeds  of  the  settlement. JAG Designee Action The   JAG   designee   formally   asserts   the government’s  MCRA  claim  by  mailing  a  Notice  of 12-31

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