Getting Medical Care After a Crash When You Cannot Pay Up Front
Key Takeaways: A letter of protection (LOP) is a written agreement in which a health care provider treats a crash victim now in exchange for payment from a future settlement or verdict, as defined under Fla. Stat. § 768.0427(1)(d). Tallahassee drivers often turn to an LOP after Florida’s no-fault PIP benefits, typically capped at $10,000, are exhausted. An LOP is a contract rather than insurance, so if the case does not resolve favorably, the patient generally still owes the balance, with enforcement generally measured by the five-year written-instrument limitation. Claimants must disclose the LOP, itemized coded billings, factoring company details, coverage status, and any referral as a condition precedent to claiming those medical expenses. Florida law limits what juries may hear about past medical bills in many LOP cases, using benchmarks such as 120% of the Medicare rate or 170% of the Medicaid rate. Because most negligence actions accruing after March 24, 2023 must be filed within two years, timing may matter as much as treatment.
A letter of protection is a written agreement in which a health care provider treats an injured person now and waits for payment from a future settlement or verdict. Florida statutory law defines it broadly under Fla. Stat. § 768.0427(1)(d), covering any arrangement by which a provider renders treatment in exchange for payment from a judgment or settlement. For Tallahassee drivers whose PIP benefits have run dry, this arrangement may be the difference between continuing treatment and stopping care too soon.
If you are weighing deferred medical billing after a collision, the team at Salpeter Gitkin, LLP can help you understand how an LOP may affect your claim. Call (866) 203-2911 or contact us now to discuss your situation.
Why a Letter of Protection Car Accident Florida Claim Often Starts With PIP
Florida is a no-fault state, so personal injury protection is generally the first line of medical coverage after a crash. Owners of motor vehicles registered in Florida must generally maintain PIP coverage under Fla. Stat. §§ 627.733 and 627.736. PIP medical benefits are typically capped at $10,000 in total benefits, and limited to $2,500 when a qualified provider determines the claimant did not have an emergency medical condition under Fla. Stat. § 627.736(1)(a)4. Many accident victims exhaust coverage well before treatment is complete.
PIP funds can be earmarked faster than expected. Upon receiving notice of an accident, the insurer must reserve $5,000 of benefits for physicians or dentists providing emergency services or hospital inpatient care, holding that reserve until 30 days after notice, per Fla. Stat. § 627.736(4)(c). Patients needing orthopedic follow-up, imaging, or physical therapy may find little left.
Florida law also protects your right to understand what PIP covers. Insurers must provide notice describing specific medical services paid, exclusions, limitations, when payments are due, and how benefits coordinate with other insurance within 21 days under Fla. Stat. § 627.7401(1)-(2). If your benefits are denied, reviewing what happens when PIP is denied after a car crash can help you understand your options.
What a Letter of Protection Actually Promises
An LOP is a contract, not an insurance policy. The provider agrees to defer billing, and the patient agrees the bill will be paid from the recovery. Nothing guarantees a recovery, and unless the agreement specifies otherwise, the patient generally remains responsible for the balance if the case does not resolve favorably.
The Debt Does Not Simply Disappear
Unpaid medical balances can remain enforceable long after a case concludes. Because a letter of protection is a written instrument, provider enforcement rights are generally measured by the five-year limitation under Fla. Stat. § 95.11(2)(b) (2024). If a provider obtains a judgment, Florida’s limitations statute allows action on that judgment within twenty years, per Fla. Stat. § 95.11(1) (2024).
How LOP Bills Fit Into Your Damages
Medical expenses incurred under an LOP may form part of your economic damages. Florida’s comparative negligence statute defines "economic damages" to include past and future lost income, medical and funeral expenses, and other economic loss that would not have occurred but for the injury, under Fla. Stat. § 768.81(1). Whether those amounts are fully recoverable depends on the evidence rules discussed below, any comparative fault attributed to the claimant, and the facts of each case.
The Disclosure Rules Every Tallahassee Patient Should Know
Using an LOP generally triggers mandatory disclosures before you can claim those medical expenses. As a condition precedent to asserting any claim for medical expenses for treatment rendered under a letter of protection, the claimant must generally disclose a copy of the letter and all itemized, coded billings, per Fla. Stat. § 768.0427(3)(a)-(b). Coding is generally expected to follow standard CPT, HCPCS, ICD, APC, EAPG, or DRG systems.
Additional disclosures reach the financial arrangements behind the treatment. The statutory disclosure obligations under Chapter 768 evidence rules generally include:
- The identity of any factoring company that purchased the provider’s accounts receivable and the dollar amount paid, under Fla. Stat. § 768.0427(3)(c)
- Whether the claimant had health care coverage at the time of treatment, under Fla. Stat. § 768.0427(3)(d)
- Whether the claimant was referred for LOP treatment, including the identity of the referring person, under Fla. Stat. § 768.0427(3)(e)
Attorney referrals may carry particular significance. Under Fla. Stat. § 768.0427(3)(e), referral disclosure is permitted and admissible notwithstanding s. 90.502, and the statute provides that the financial relationship between a law firm and a medical provider is relevant to the issue of a testifying provider’s bias.
💡 Pro Tip: Keep every itemized bill, coding sheet, and signed LOP document in one folder from day one. Reconstructing coded billing records months later is one of the most common practical headaches in these claims.
Limits on What the Jury May Hear About Your Bills
Florida law caps the evidence of past medical expenses that a jury may consider in many LOP cases. For a claimant who lacks health care coverage and treats under a letter of protection, admissible evidence of past unpaid expenses is generally limited to benchmarks such as 120% of the Medicare reimbursement rate in effect on the date of the claimant’s incurred medical treatment or services, or 170% of the applicable Medicaid rate where no Medicare rate applies, under Fla. Stat. § 768.0427(2)(b)3. Insured claimants who obtain LOP treatment instead of using available coverage are generally measured by the amounts the coverage would have paid.
The purchase price paid by a factoring company can also become evidence. Where a provider’s accounts receivable are sold, the amount the third party paid may be admissible as evidence of the value of care under Fla. Stat. § 768.0427(2)(b)4.
| Situation | General Evidence Benchmark |
|---|---|
| Uninsured claimant treating under an LOP | Up to 120% of Medicare rate |
| No applicable Medicare rate | Up to 170% of Medicaid rate |
| Insured claimant who bypassed coverage | Amount coverage would have paid |
| Accounts sold to a third party | Amount the third party paid |
Deadlines That Shape Every Tallahassee Injury Claim
A letter of protection generally only works if there is a viable case to pay it from. Under the current version of Fla. Stat. § 95.11(5)(a), an action founded on negligence that accrued after March 24, 2023 must generally be commenced within two years; claims accruing before that date are generally governed by the prior four-year period. Missing the deadline can bar recovery entirely, leaving the LOP balance without a settlement source.
Exceptions Are Narrow, Not Automatic
Tolling and delayed accrual doctrines exist, but Florida courts generally interpret them narrowly. They may apply in limited circumstances, such as claims involving minors or a defendant’s absence from the state, and are highly fact-dependent. Claims involving governmental entities also carry separate pre-suit notice requirements under Fla. Stat. § 768.28.
Talking with a Florida injury attorney early may help align treatment with case timing. A Tallahassee car accident lawyer can review whether an LOP is appropriate, whether other coverage should be pursued first, and how the disclosure rules may affect your file.
Frequently Asked Questions
1. Is a letter of protection the same as health insurance?
No. An LOP is a private agreement for deferred billing, not coverage. It allows treatment to continue after PIP is exhausted, and the patient generally remains responsible for the balance.
2. Do I have to hand over my LOP to the other side?
Generally, yes. Disclosure of the letter of protection and itemized, coded billings is generally a condition precedent to asserting a claim for those medical expenses under Fla. Stat. § 768.0427(3).
3. What happens to LOP bills if I lose my case?
The debt typically remains owed to the provider. Because an LOP is a written instrument, enforcement is generally governed by the five-year contract limitation in Fla. Stat. § 95.11(2)(b).
4. Can my attorney refer me to an LOP provider?
Referrals are generally permitted, but must be disclosed. Under Fla. Stat. § 768.0427(3)(e), the financial relationship between the firm and the provider may be treated as relevant to provider bias.
5. How long do I have to file after a Tallahassee crash?
Negligence claims accruing after March 24, 2023 generally must be commenced within two years under Fla. Stat. § 95.11(5)(a), subject to limited exceptions.
Protecting Your Health and Your Claim at the Same Time
A letter of protection may keep necessary care moving forward when PIP benefits run out, but it comes with statutory strings: mandatory disclosures, evidence limits on what a jury may hear, and a continuing personal obligation if the case does not resolve favorably. Understanding those tradeoffs before signing is easier than untangling them later.
If you were hurt in a collision and are considering LOP medical treatment, the attorneys at Salpeter Gitkin, LLP are ready to review your options. Call (866) 203-2911 or schedule a case review today.
Disclaimer: This content is for informational purposes only and is not legal advice. Every case is unique, and results may vary. Consult an attorney about your specific circumstances.
