What is a letter of protection, and should I treat under one?

How a letter of protection works

When a crash victim has no health insurance, an unpayable deductible, or specialists who will not touch a liability claim, treatment stalls exactly when it is most needed. The letter of protection solves the access problem: your attorney sends the provider a written assurance that reasonable charges will be protected out of any settlement or judgment, and the provider treats now and waits. It is how uninsured Texans get the MRI, the injections, and sometimes the surgery their injury requires while the case is pending. What it is not is charity. The charges are a genuine obligation against your recovery, and if the case fails, the debt does not automatically vanish, though providers commonly negotiate, which is a conversation to have with eyes open before treatment begins.

What the defense does with LOPs now

Texas defense practice has organized itself around attacking letter-of-protection billing. Under the paid-or-incurred statute, recovery of medical expenses is limited to what was actually paid or incurred, and it must also be reasonable; the Texas Supreme Court's K&L Auto Crushers decision then armed defendants with discovery of what your providers accept from insurers and government payors for the same procedures, precisely to argue the LOP rates are inflated. The practical consequences are two. First, the days of unexamined chargemaster bills are over, and a file built on them invites a beating. Second, provider selection matters: treatment driven by genuine medical judgment, at rates that survive comparison, from physicians who will defend their care in deposition, produces a damages case that holds; a referral-mill file produces cross-examination material.

When the LOP is the right tool, and when it is not

If usable health insurance exists, running treatment through it is often the stronger play, since the paid-or-incurred rule means the recoverable amount is the negotiated rate anyway and the reasonableness fight largely disappears. The LOP earns its place where insurance does not exist or does not reach: the uninsured client, the specialist outside every network, the surgery no health plan will schedule on a liability timeline. The choice is strategic, it affects both treatment access and what a jury will ultimately hear, and it should be made deliberately with counsel, not defaulted into.

The endgame: reductions and the settlement statement

LOP balances are negotiated at settlement, routinely and substantially, and every reduction goes to you. At Silver Key Law, every protected bill appears on your settlement statement with the original charge, the negotiated figure, and the difference, before you sign anything. If you are treating under letters of protection now, or being told you must, a free consultation will tell you whether the structure is serving your recovery or someone else's.

Injured in Arizona? Some rules on this page are Texas-specific. Arizona differs on points that change outcomes, including pure comparative fault and government-claim deadlines. See our Arizona answers or call (888) 508-6967.

Related: Medical Bills While Your Case Is Pending · Health Insurance Payback · Submit Your Case · All Common Questions

This page is general information about Texas law, not legal advice about your specific situation. Deadlines and outcomes depend on facts; talk to a lawyer about yours.