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Understand How a Letter of Protection (LOP) Can Help You

on  Personal Injury

Healthcare has been one of the topics widely discussed and debated, especially across the political climate. The Affordable Care Act, created under the Obama administration, was largely meant to reduce or, in an ideal state, eliminate uninsured individuals in the U.S. Although the number of uninsured people has shrunk since the Act’s inception, it hasn’t disappeared. Unluckily, not everyone has readily available perfect healthcare plans.

For people with excellent health insurance plans, it can be easy to get the necessary treatment after a car accident or any other injury due to another person’s negligence by using their insurance plan and Personal Injury Protection (PIP). These people often don’t have to worry about owing their medical bills out of their own accounts. However, those without quality insurance plans might be hesitant to get the necessary health care for fear that they might end up paying the bills out of their pockets if they don’t win the case. Letters of Protection help people in this situation.

What is a Letter of Protection?

A letter of protection, LOP, is a letter written or approved by a victim’s injury attorney to the medical professional to offer the victim medical care that they can’t afford to pay for from their pockets. It is a legally binding contract between you, your attorney, and the medical professional.  The letter guarantees payment for the services offered from any lawsuit settlement or jury verdict award of the case.

A letter of protection simply indicates that the issuing attorney or law firm promises to protect a doctor’s outstanding treatment balance and that the bill will be settled upon the resolution of the victim’s case. As a result, the medical professional agrees to hold all bill collection until the car injury case is finalized.

When would I need to sign a letter of protection?

In many cases, medical professionals, hospitals, or clinics will not accept the victim’s health insurance as it can be out of network. The medical provider may ask that you pay the medical bills from your pocket and then submit the bills to your health insurer. However, this can be risky if your health insurer refuses to provide reimbursement. More often than not, the medical provider will send the unpaid bill into collections if no payment is received within the contracted payment period.

Many injury victims would be unable to get the treatment they need after an injury if it were not for doctors who are willing to offer them medical services under a LOP.

Signing a letter of protection helps you receive medical care without going out of pocket to pay bills until your injury case is resolved.  This letter will assure hospitals and medical providers of receiving payment for services rendered after your claim is concluded.

If your health insurance plan covers 100% of the medical bills, there’s no reason to sign a LOP. However, most plans do not pay 100% of medical expenses.

Should I sign a letter of protection if I have insurance?

This will depend on your circumstances. Often, when a person sustains injuries due to someone else’s negligence or destructive nature, the victim’s medical insurance carrier may be unwilling or hesitant to cover any medical expenses and instead attempt to place the financial liability on the other parties involved.  For example, if you get injured at work, the insurance carrier may claim that your employer is liable for paying your medical care from the workers’ compensation insurance. Similarly, in a car accident, your insurance may want the at-fault driver to cover your expenses.

If you have a quality health insurance plan, it may be unnecessary to sign a letter of protection with a medical provider who is unwilling to accept your insurance. It’s best to find another provider that will accept your health insurance. This is often the best option since you will not owe your insurer any money for the injury benefits paid in the event that you lose your case.

However, if you are injured in a car accident and are using a no-fault insurance plan such as Florida personal injury protection (PIP), signing a letter of protection may be a good idea since personal injury protection benefits often only covers up to 80% of the medical expenses leaving you with an unpaid medical bill balance equal to 20% of the bill.

Are there any risks in signing a letter of protection?

Yes! One of the main drawbacks of signing a LOP is that your defense lawyer or insurance company will most likely use it to attack your treating medical professionals’ credibility in court. The letter can be used as evidence that your medical providers have a vested financial interest in the outcome of your case.

Although doctors take a risk when they accept a letter of protection as they won’t be paid anything for the services they offer, and in most cases, there is no compensation large enough to cover all of a victim’s medical bills, the main risk often involves their motives being questioned.

Since successful cases involving letters of protection often result in doctors receiving payments that significantly exceed insurance rates, insurance companies and defense attorneys will often treat the LOP as unassailable evidence that the provider’s opinion about the necessity and reasonableness of the offered medical services is biased and tainted.  If the jury is convinced that your treating medical professional is not credible, you could easily lose the case and still be responsible for your medical bills.

Generally, this argument fails as most victims who sign the LOP have no other option- either they sign the LOP and receive treatment, or they don’t receive medical attention because they can’t afford it.

Do I still need to pay my medical bills if I lose my case?

Yes! If you do not win your case, you are still responsible for your medical bills. The hospital or medical provider has the right to pursue the debt, and you must pay the expenses like any other debt. Therefore, it is crucial that you retain professional and experienced lawyers who can fight your case and ensure you get reasonable compensation for any accident injuries.  Your attorney can also work with your medical professional to negotiate the medical bill down to a manageable, reduced rate if you lose the case.

While a letter of protection can be a valuable tool to use if you’ve sustained severe injuries in a motor accident or any other injury situation caused by another party’s negligence and aren’t in a position to pay your medical bills, its still best to discuss this LOP option with a professional attorney. Like any contract, LOP comes with risks too. So, you must ensure you receive expert opinions and legal advice. At Prosper Shaked Accident Injury Attorneys, PA, our attorneys can offer you professional guidance and help you decide how best to proceed with the case. Contact us now to schedule a free consultation on your case.