When someone is hurt in a car accident or other personal injury case, medical bills can pile up quickly. But what happens if you cannot afford treatment while waiting for a settlement? In Florida, many injured people turn to a Letter of Protection (LOP) to get the care they need.

This guide explains what an LOP is, how it works, the 2023 tort reform law that reshaped its use, and the real-world risks and benefits that injured people should know about.

What Is a Letter of Protection for Medical Services in Florida?

A Letter of Protection (LOP) in a personal injury case is a written agreement between an injured person, their lawyer, and a medical provider that allows the injured person to receive medical treatment without paying upfront. The medical provider agrees to wait for payment until the personal injury case is resolved, and the injured person agrees to pay the medical bills from any settlement or verdict.

For many, LOPs, or letter of protection for medical services, essentially function as a lifeline, giving people access to treatment without having to pay upfront.

How a Letter of Protection Auto Accident Helps You Access Care in Florida

LOPs are common in auto accident cases and other personal injury claims where the injured person lacks health insurance or cannot afford co-pays and deductibles. Many victims rely on a letter of protection auto accident to access care while waiting for a settlement. Providers may be more willing to agree when liability is clear, such as in a rear-end collision, because they feel confident they will eventually be paid.

One attorney shared that in the past, LOPs were issued in nearly every case, but after recent legal changes, they are used far less frequently. If your case involves a car crash, having your Florida Crash Portal number on hand can make it easier for your attorney to pull the official accident records and coordinate with medical providers.

The 2023 Florida Tort Reform Act (HB 837) Law Change and Its Impact on Letters of Protection

A law passed in 2023 changed how LOPs are treated in Florida courts. If treatment is provided under an LOP, the plaintiff must now disclose a wide range of information to the defense, including:

  • A copy of the LOP itself
  • Itemized medical bills with proper coding
  • Whether the bill was sold to a third party and at what price
  • Whether the patient had health insurance and the name of the insurer
  • Whether the lawyer referred the patient to the doctor, which can open the door to questions about financial relationships

This means defense attorneys can argue that doctors are biased because they only get paid if the case succeeds. Many lawyers and medical providers now avoid formal LOPs and instead rely on informal agreements or deferred payment arrangements that do not tie payment directly to the outcome of the case.

Benefits of a Letter of Protection

Even with the risks, LOPs can still provide key advantages:

  • Immediate medical care when patients cannot pay upfront
  • Access to providers who might not otherwise treat without insurance
  • Flexibility in payment until settlement funds arrive
  • The chance to negotiate medical bills at the end of the case, sometimes reducing them significantly

In one case, a client had $15,000 in chiropractic bills. After PIP coverage paid part of it, the attorney negotiated the remaining balance down to about $5,000 or $6,000. Even when providers charge high private-pay rates, these negotiations often help clients keep more of their settlement.

Risks and Downsides of LOPs in Florida

LOPs come with drawbacks that should not be overlooked:

  • Insurance companies often use them as evidence of bias, arguing that doctors have a financial stake in the case outcome.
  • Doctors typically charge higher rates than they would under health insurance contracts.
  • The new law forces disclosure of sensitive information that can weaken a case.
  • Large unpaid bills can eat into a client’s recovery if the settlement is smaller than expected.

In one case, the medical bills were about $200,000, but the lawsuit was settled for only $60,000 due to problems with liability. The attorney had to persuade doctors to accept a fraction of their billed amounts, with some agreeing to a prorated share and others reserving the right to pursue the client for the balance.

Alternatives to Letters of Protection

With the risks now associated with LOPs, some personal injury attorneys in Florida look for alternatives, such as:

  • Deferred payment agreements: These require the patient to pay regardless of settlement outcome but allow collection to be delayed, often with interest starting after a set period.
  • Using health insurance: Whenever possible, health insurance is still the most straightforward way to handle medical costs.
  • Negotiating before settlement: Attorneys sometimes work with providers ahead of time to reduce bills, especially if the case is weak or the insurance coverage is low.

The Doctor’s Perspective of LOPs

Even though agreeing to a Letter of Protection means they might not get paid as quickly for their services, medical providers agree to LOPs in part because they can charge more than they would receive from insurance companies. For example, bills under an LOP may be five to eight times higher than Medicare rates. Even after negotiation, they often end up with more than they would have been paid by an insurer.

This creates tension in cases where the settlement is low. Doctors may need to take steep cuts, which makes negotiations a critical part of the attorney’s role.

What You Should Know About Disclosing Letters of Protection in Florida

If you’ve signed a letter of protection to receive medical treatment after an injury, it’s important to understand your legal obligations under Florida law. Current rules require that any LOPs be disclosed when you file a personal injury lawsuit seeking compensation for medical expenses. This ensures that the court and the other parties are aware of any arrangements you made with your health care providers.

For example, if you agreed to a letter of protection for $1,500 in physical therapy, the court will typically limit any award for that treatment to that $1,500 amount. If your provider later transfers the claim to a third-party company for $1,200, the court would limit the award to $1,200.

Failing to disclose a letter of protection can create serious consequences, potentially preventing you from recovering any medical costs through your lawsuit. Keep in mind that these disclosure rules generally apply only to medical bills. They do not affect claims for lost wages, property damage, or other non-medical expenses.

Because the rules around LOP disclosure can be complex, it’s wise to speak with an experienced Florida personal injury lawyer before filing your case. They can help you ensure that all letters of protection are properly documented and disclosed, avoiding unnecessary legal complications.

Should You Use a Letter of Protection in Florida?

LOPs can provide access to treatment for those who otherwise could not afford it, but they come with significant risks under Florida’s current legal environment. If you are injured in an auto accident or other personal injury situation and need medical care, it is important to speak with an experienced Florida personal injury lawyer before agreeing to an LOP.

The right approach will depend on your injuries, the available insurance, and the likelihood of settlement. For some, a letter of protection may be the only path to getting treatment. For others, it may create unnecessary complications.

FAQs About Letters of Protection in Florida

Does a letter of protection affect my settlement?

Yes. Medical bills under an LOP can take up a large portion of a settlement. For example, if your case settles for $60,000 but you owe $100,000 in medical bills, your lawyer must negotiate those bills down with the providers.

Can an insurance company use an LOP against me?

Yes. Insurance companies often argue that doctors are biased because they only get paid if the case is successful. Since the 2023 law change, defense attorneys can request disclosure of the LOP and use it to question the credibility of your medical treatment.

Is an LOP the same as a medical lien?

No. A medical lien is simply a right for the provider to be paid for services already rendered. An LOP specifically ties payment to the outcome of a lawsuit and pauses collection efforts while the case is pending.

Can creditors take my personal injury settlement in Florida?

Once the money is in your hands, creditors may pursue it to satisfy debts. If your settlement must be used to pay medical providers under an LOP, that payment typically comes before any money is disbursed to you.

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