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Do I need a lawyer? I have paid premiums and had my claims paid, but am being told I wasn't eligible for the benefits.

Livonia, MI |

I had Tricare Reserve Select insurance during my time as a Michigan National Guard Member. I seperated willingly and Honorably last year. I continued to pay my Tricare premiums and continued to have my insurance claims paid by Tricare. I found out recently that upon my separation, my old unit should have submitted paperwork through the state to tricare to show that I was no longer eligible.(I thought I was eligible after separating and was never told anything different.) The Tricare/Deers office has told me that if they receive paperwork from the state showing that I have not been eligible for a year then they will refund me my premiums and force me to pay any claims. We're talking several MRIs, x-rays, a birth, etc. Am I royally screwed? 100,000$ +

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Attorney answers 5

Posted

Have a local insurance lawyer investigate.

Posted

You need an insurance attorney. Contact your local veteran's group office and get a recommendation.

The information provided is for general informational purposes only and is not intended to be legal advice. I am only licensed in the Commonwealth of Pennsylvania and I am not providing you with specific legal advice. The law changes frequently and varies from jurisdiction to jurisdiction. Being general in nature, the information provided may not apply to any specific factual and/or legal set of circumstances and/or the jurisdiction where you reside. No attorney-client relationship is formed nor should any such relationship be implied. The information provided is of a general nature is not intended to substitute for the advice of an attorney, especially an attorney licensed in your jurisdiction. Your question, although you may believe is simple, it is not simple. You require legal advice, please consult with a competent attorney licensed to practice in your jurisdiction.

Posted

Your insurance attorney will investigate the case and will be able to help you.

Posted

I would agree with my colleagues that you should consider contacting the VA for assistance and consulting with local counsel HOWEVER, I would also strongly encourage you to consider reaching out to the insurance commissioner in your state and even the attorney generals office to see if they can provide some insight and assistance.

This comment is provided for informational purposes only and not for the purpose of providing legal advice. You should contact your attorney to obtain advice with respect to any particular issue or problem. Use of and access to this comment does not create an attorney-client relationship between and the reader. The opinions expressed at or through this site are the opinions of the individual author.

Posted

Yes you are. It's your suggestion that you may need an attorney's assistance, I'd follow that unless you have a better idea. Indeed, the other Avvo attorneys have made some valuable contributions in their posts.

The above response is general information ONLY and is not legal advice, does not form an attorney-client relationship, and should NOT be relied upon to take or refrain from taking any action. I am not your attorney. You should seek the advice of competent counsel before taking any action related to your inquiry.

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