A letter of protection is a promise, usually from your lawyer, that a doctor or clinic will be paid from your settlement if they treat you now without insurance. It lets uninsured people get care after a crash, but the defense can challenge those bills, so they need to be reasonable.
Many people hurt in crashes have no health insurance, or a plan with a deductible they cannot meet. A letter of protection, often called an LOP, lets them see a doctor, get imaging, or have surgery now, with payment coming out of the recovery later.
In practice your lawyer sends the provider a letter agreeing to protect the bill from the settlement. You remain responsible for the charges, and if the case does not recover enough, the provider can still bill you, depending on the agreement. Read it before you sign.
LOP bills draw scrutiny. Providers working under letters of protection often charge full list prices. Civil Practice and Remedies Code section 41.0105 limits recovery of medical expenses to amounts actually paid or incurred, and in In re K & L Auto Crushers (2021) the Texas Supreme Court held that the rates a provider negotiates with insurers are discoverable when its charges to an uninsured plaintiff are disputed. A defense lawyer will use that to argue the bills are inflated.
That does not make an LOP a bad idea. It means the treatment should be medically necessary, the provider credible, and the charges defensible. A lawyer can also negotiate LOP balances down at settlement so more of the money reaches you.
Ask about other sources first, such as PIP, which Texas policies include unless you rejected it in writing under Insurance Code section 1952.152, and hospital charity programs. Owsley Law Firm helps clients find care and coordinates every bill and lien at settlement.
What to do, step by step
- Ask whether PIP, MedPay, or health insurance can pay first.
- Choose a provider whose treatment and pricing you can defend.
- Read the provider’s agreement before treatment.
- Keep copies of every bill and record.
- Let your lawyer negotiate the balance at settlement.
Defense lawyers may ask how a client was referred to a provider. Choosing reputable, independent doctors makes the treatment more persuasive.
A treating doctor’s explanation of why care was needed is often more important to a jury than the amount on the bill.
Letters of protection can be reduced at the end of a case. When coverage is limited, providers often accept less than the full balance so the case can close. Your lawyer negotiates those reductions as part of finishing the settlement.
If you later get health insurance, tell your lawyer and the provider. Switching how a bill is paid in the middle of treatment can raise questions, but coverage you have should generally be used.
Ask the provider for an itemized bill early and periodically, not just at the end. Seeing the charges as treatment goes on lets your lawyer raise concerns about pricing before the balance becomes a problem at settlement.
Mistakes that cost people money
- Treating with a provider whose charges far exceed common rates.
- Assuming you owe nothing if the case does not recover.
- Getting care you would not otherwise need.
- Hiding the letter of protection from the defense, which can learn of it in discovery.
Related questions
Is a letter of protection the same as a lien?
Not exactly. A hospital lien comes from Property Code chapter 55; a letter of protection is a contract between you, your lawyer, and the provider.
Can I get surgery under a letter of protection?
Some surgeons and surgery centers accept them. The charges will be closely examined, so price and necessity matter.
Does using an LOP lower my settlement?
Not inherently, but inflated charges can be cut under section 41.0105. Reasonable charges hold up better.
Can a provider stop treating me under a letter of protection?
A provider can decide whether to accept an LOP and on what terms. Ask about that before treatment starts.
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