Imagine you were hurt in a Florida crash. You don’t have health insurance, or your PIP benefits have run out. The treatment your doctor recommends is necessary, but the upfront cost is out of reach. Many people delay care in this situation, even when they should not.
A letter of protection can help fill that gap. This article explains what a letter of protection is and how it allows you to receive medical treatment without paying upfront. It also explains how medical providers get paid later from a settlement or judgment, and how recent changes under Florida’s 2023 tort reform may affect how these agreements are handled.
If you are considering treatment under a letter of protection, it may help to review your situation with a Sarasota car accident lawyer before moving forward.
What Is a Letter of Protection?
A letter of protection is an agreement where a medical provider agrees to treat you now and wait to be paid later from your personal injury settlement. It is not health insurance, and it is not a loan. You do not pay anything upfront when it is issued.
Florida law defines it as:
“‘Letter of protection’ means any arrangement by which a health care provider renders treatment in exchange for a promise of payment for the claimant’s medical expenses from any judgment or settlement of a personal injury or wrongful death action.” — Fla. Stat. §768.0427
The definition is deliberately broad. Any “treat now, pay from the case” deal counts, no matter what the paperwork is called.
How a Letter of Protection Helps You Get Treatment After a Crash
A letter of protection helps by removing the upfront cost barrier, so you can start treatment immediately rather than waiting for your claim to resolve.
This matters most when you have no health coverage or have used up your PIP and MedPay benefits. Serious crash injuries often need imaging, specialist visits, physical therapy, or surgery. Delaying that care can harm your recovery.
It can also weaken your claim. A provider who is working under a letter of protection agrees to treat you and to hold the bill until your case is resolved. For many injured people, it is the difference between getting the care a doctor recommends and going without it.
How Does the Provider Get Paid Under a Letter of Protection?
The provider is paid from your settlement or verdict. The unpaid bill is treated as a lien and is satisfied from the recovery before you receive your share.
Your attorney tracks all medical providers who treated you under a letter of protection. When the case resolves, those bills are paid directly from the settlement proceeds.
Because these balances are paid out of the recovery, the total amount of medical debt can affect how much remains for the injured person after the case is closed.
In many cases, medical liens can also be negotiated after settlement. Attorneys can frequently reduce letter-of-protection balances by 20% to 40% after a settlement, which puts more of the recovery back in your pocket.
What Florida’s 2023 Tort Reform Changed About Letters of Protection
Florida’s 2023 tort reform law, HB 837, added new rules that govern how letter-of-protection treatment is disclosed and valued in a personal injury case.
The law created Fla. Stat. §768.0427. It took effect on March 24, 2023, and applies to cases filed after that date. Two changes matter most for crash victims. First, using a letter of protection now triggers mandatory disclosures before you can claim those medical expenses.
Second, the value of your care may be capped if you have no health coverage. In that case, the admissible evidence is generally limited to 120% of the Medicare reimbursement rate, not the full billed amount. That cap can shrink the medical-damages figure a jury is allowed to consider.
What You Must Disclose When You Use a Letter of Protection
Florida law requires specific disclosures as a condition for claiming any medical expenses for treatment provided under a letter of protection.
Under §768.0427, you must disclose:
- A copy of the letter of protection
- Itemized medical bills with standard medical codes
- Whether the bill was sold to a factoring company and for how much
- Whether you had health insurance at the time of treatment
- Whether your lawyer referred you to the doctor
That last point has teeth. If the attorney made a referral, that fact may be introduced as evidence in the case, particularly when evaluating the relationship between the law firm and the medical provider.
The Risks and Limits of a Letter of Protection
A letter of protection carries real risk because the medical bills must still be paid, even if the settlement is not large enough to cover them. Say your treatment costs more than your case is worth. You are still responsible for the unpaid balance in full. There are also valuation issues. In some cases, the admissible amount for medical treatment may be lower than the provider billed, especially when the care is not covered by insurance.
Defense attorneys often also closely review treatment under a letter of protection. They may argue that the care was influenced by the lawsuit rather than medical necessity.
This does not mean a letter of protection is a bad option. It simply means it should be used with a clear understanding of the financial risks involved. An attorney can help evaluate it in light of your coverage and the strength of your claim.
Letter of Protection at a Glance
|
Question |
Answer |
| What is it? | A promise to pay medical bills from your settlement |
| Is it insurance or a loan? | Neither; no upfront payment is required |
| Who is it for? | Crash victims with no health coverage or exhausted PIP |
| How is the provider paid? | From the settlement, as a lien paid before your share |
| What does Florida law require? | Disclosures under Fla. Stat. §768.0427 |
| What is the main risk? | Owing the balance if treatment exceeds your recovery |
FAQ
What is a letter of protection in simple terms?
A letter of protection is a written agreement. A medical provider treats you now and agrees to be paid later from your injury settlement. It lets you get care without paying upfront and without using health insurance. The bill is then repaid from your recovery when the case resolves.
Do I need health insurance to use a letter of protection?
No, and that is often the point of using one. Letters of protection are most common for crash victims who have no health coverage or have exhausted their PIP and MedPay benefits, because they provide access to treatment when no other payment source is available.
Will a letter of protection hurt my car accident claim?
No. It does not automatically hurt your claim. However, it may be closely reviewed by the defense under Florida’s disclosure rules. They can look at the billing, whether the bill was sold to a factoring company, and whether your lawyer referred you to the provider. Clear and accurate records are important.
What happens if my settlement is smaller than my medical bills?
You remain responsible for the unpaid balance. If treatment under a letter of protection costs more than your case recovers, the difference is owed out of pocket, although attorneys can often negotiate the balance down after a settlement.
Can I set up a letter of protection myself?
No. It is usually arranged through your attorney, who negotiates with the provider and secures payment from your settlement or verdict.
Conclusion
A letter of protection can make medical treatment possible after a crash when you cannot pay upfront. It also creates a financial obligation that depends on the outcome of your case.
Understanding how providers get paid, what §768.0427 requires, and the risks involved is important before agreeing to treatment under this arrangement. It helps you see the full picture, not just the immediate access to care.
If you are dealing with treatment access, medical liens, or letter-of-protection issues after a Sarasota crash, the attorneys at Buckman, Buckman & Castellano P.A. handle these matters as part of personal injury claims. You can contact the firm to discuss your situation and possible next steps.
