Document
Submission for OMB Review; Comment Request
The Department of Defense has submitted to OMB for clearance the following proposal for collection of information under the provisions of the Paperwork Reduction Act.
SUPPLEMENTARY INFORMATION:
Title; Associated Form; and OMB Number:
Statement of Personal Injury: Possible Third Party Liability; DD Form 2527; OMB Control Number 0720-0003.
Type of Request:
Extension.
Number of Respondents:
188,090.
Responses per Respondent:
1.
Annual Responses:
188,090.
Average Burden per Response:
15 minutes.
Annual Burden Hours:
47,022.5.
Needs and Uses:
When a claim for TRICARE benefits is identified as involving possible third party liability and the information is not submitted with the claim, the TRICARE contractors request that the injured party (or a designee) complete DD Form 2527. To protect the interests of the U.S. Government, the contractor suspends claims processing until the requested third party liability information is received. The contractor conducts a preliminary evaluation based upon the collection of information and refers the case to a designated appropriate legal officer of the Uniformed Services. The responsible Uniformed Services legal officer uses the information as a basis for asserting and settling the U.S. Government's claim. When appropriate, the information is forwarded to the Department of Justice as the basis for litigation.
Affected Public:
Individuals or households.
Frequency:
On occasion.
Respondent's Obligation:
Voluntary.
OMB Desk Officer:
Ms. Julie Wise.
You may also submit comments and recommendations, identified by Docket ID number and title, by the following method:
Instructions:
All submissions received must include the agency name, Docket ID number, and title for this
Federal Register
document. The general policy for comments and other submissions from members of the public is to make these submissions available for public viewing on the internet at
http://www.regulations.gov
as they are received without change, including any personal identifiers or contact information.
DoD Clearance Officer:
Ms. Angela Duncan.
Requests for copies of the information collection proposal should be sent to Ms. Duncan at
whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil.
Dated: April 25, 2022.
Aaron T. Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.