Letter of protection

What is a letter of protection?

A letter of protection is a written agreement in which a healthcare provider agrees to treat an injured person without upfront payment, in exchange for a promise that the provider will be paid from any eventual settlement or judgment.

It exists to solve a specific problem. Someone may have exhausted PIP benefits, lack health insurance, or face coverage gaps, yet still need ongoing treatment.

Without it, a person in that position might stop treatment entirely, which creates exactly the kind of gap that damages a claim.

It is typically arranged through your attorney, who coordinates directly with the provider's office.

How does the arrangement work?

The provider agrees to treat now and be paid later, contingent on the outcome of the claim.

• Treatment continues without requiring payment at the time of service
• The provider is paid directly from settlement proceeds at the end
• Payment is generally contingent on a successful recovery
• The letter identifies the case and confirms the payment arrangement
• It does not affect the medical necessity or documentation of treatment

Why does this matter to your claim?

Because it can prevent an interruption in care that would otherwise become a defense argument. Continuous, medically appropriate treatment supports both causation and the value of the claim.

It also means treatment decisions are being made based on medical need rather than on what you can currently afford, which is the situation the arrangement is designed to address.

Providers offering this arrangement understand that payment depends on the case, which is a legitimate business arrangement in personal injury practice.

What should you understand before using one?

The amount owed depends on the treatment received rather than a fixed figure, so it is worth understanding roughly what continued care will cost as you go.

These arrangements are factored into settlement negotiations and are subject to review and negotiation similar to other liens, so the final amount deducted from a settlement is not automatically the full billed amount.

Not every provider offers this arrangement, and availability depends on the type of treatment and the specific practice.

Common questions

Do I have to pay if my case does not settle?

Terms vary by agreement, so review the specific letter of protection you sign. Confirm whether payment is contingent on a successful outcome.

Can the amount owed be negotiated later?

Often yes, similar to negotiating other liens against a settlement. This is typically handled as part of finalizing the case.

Does this affect my medical treatment decisions?

It should not. Treatment should be based on medical necessity, and the arrangement simply addresses how the provider will eventually be paid.