What is a letter of protection?
A letter of protection is an arrangement in which a doctor or clinic treats you now in exchange for a promise that its bill will be paid from your future injury settlement or court award. It is common when you have no health insurance or your plan will not cover crash injuries.
Last checked November 9, 2026 · Official sources (3)
How does a letter of protection work? An example
Example: you are rear-ended and your neck hurts for weeks. You have no health insurance. A chiropractor agrees to treat you under a letter of protection, and the bill reaches $6,000. You pay nothing at the visits. A year later you settle for $20,000. The chiropractor’s $6,000 comes out of the settlement first, along with fees and any other liens, and you get what is left.
If the case brings in less than expected, the bill does not shrink on its own. Unless the letter says otherwise, you can still owe the full $6,000.
Why does a letter of protection matter to you?
It gets you care when you could not otherwise pay. The tradeoff is price: providers working under a letter of protection often bill their full rate, not the lower rate an insurer would pay, and that full rate comes out of your settlement.
Before you sign, ask what the total will likely be, whether the provider will reduce the bill if the settlement is small, and what happens if there is no settlement at all. Keep a copy of the letter.
Do states regulate letters of protection?
Florida does, in detail. Its law defines the arrangement, and in an injury lawsuit you must hand over a copy of the letter and itemized bills before claiming those medical expenses. If the provider sells its right to be paid to a factoring company, the amount that company paid can be used as evidence of what the care was worth. That can lower the medical damages a jury sees.
We did not find a Texas or Arizona statute that regulates letters of protection the same way. In those states, hospital and provider liens are the more common tool; see the medical lien entry.
Letter of protection vs. medical lien
A letter of protection is a private agreement you sign, usually before treatment. A medical lien is a legal claim on your settlement that a statute may give a hospital whether or not you signed anything. Both get paid from the same pot of money.
Questions
Do I have to pay if I lose my case?
Usually yes, unless the letter says otherwise. Read the payment terms before you sign.
Can I use a letter of protection if I have health insurance?
Sometimes, but in Florida a claimant with coverage who treats under a letter of protection may face evidence of what the health plan would have paid.
Who writes the letter of protection?
It is often sent by the injured person’s lawyer to the provider, but the agreement binds you, so read it yourself.
Find out if you are owed money.
A free case review. $0 upfront. No fee unless you win.
See if I’m owed moneySources (3)
- Fla. Stat. § 768.0427, checked 2026-11-09. ““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, checked 2026-11-09. “as a condition precedent to asserting any claim for medical expenses for treatment rendered under a letter of protection, the claimant must disclose: (a) A copy of the letter of protection.”
- Fla. Stat. § 768.0427, checked 2026-11-09. “the health care provider subsequently transfers the right to receive payment under the letter of protection to a third party, evidence of the amount the third party paid or agreed to pay the health care provider”