What Is a Letter of Protection (LOP) for Chiropractic Care in Florida?

A Letter of Protection is a written agreement in which a provider treats you now and waits to be paid out of your settlement or judgment. Florida defines it in Fla. Stat. 768.0427(1)(d) as any arrangement where a provider renders treatment in exchange for a promise of payment from a personal injury recovery, whatever it is called.

That last clause matters more than anything else on this page. Under Florida law it does not matter whether the document says Letter of Protection, medical lien, or deferred payment agreement. If a provider is treating you in exchange for a promise of payment out of your case, Florida treats it as an LOP and specific disclosure rules apply.

Hurt in a crash with no way to pay right now? Call Spine & Injury Associates at 407.434.7246  Eight clinics across Florida.

How does a Letter of Protection work in Florida?

Your attorney sends the provider a signed letter agreeing that your medical bills will be paid from your settlement. The provider treats you with no payment at the time of service. When the case resolves, the bill is paid out of the recovery before you receive your share.

Three parties are involved and each one takes on something different.

Party	What they do	What they risk
You	Get treated now, pay nothing up front	You still owe the balance if the case recovers less than the bill, or recovers nothing
Your attorney	Signs the letter and holds the funds in trust at settlement	Their fee depends on the same recovery
The provider	Delivers care and waits, often for a year or more	Gets paid late, partially, or not at all

 

An LOP is a contract, not a guarantee. No honest clinic can promise you that treatment under an LOP will cost you nothing in the end, because that depends on an outcome nobody controls.

Do I need a Letter of Protection if I have PIP?

Usually not at first. Florida requires $10,000 of Personal Injury Protection on every registered vehicle, and PIP is the first payer after a crash. An LOP becomes relevant when PIP has been exhausted, when PIP is unavailable to you, or when you need care beyond what PIP will cover.

There is a sequence here, and most people get it backwards.

Step	What applies
1	PIP medical benefits, if you were seen within 14 days of the crash under Fla. Stat. 627.736
2	Health insurance or MedPay, if you have it
3	Letter of Protection against the liability claim, for what remains

 

Note the condition in step one. PIP medical benefits are payable only if you receive initial services and care within 14 days of the accident. Miss that window and you have lost the first payer entirely, which makes an LOP the fallback rather than the supplement. If you were in a crash recently, that clock is the most urgent thing on this page.

What has to be disclosed if I treat under an LOP in Florida?

Five things, and disclosure is a condition precedent to recovering those medical expenses. Under Fla. Stat. 768.0427(3), if you want to claim the cost of treatment rendered under a Letter of Protection, these must be produced.

Must be disclosed	Detail
A copy of the Letter of Protection	The agreement itself
All billings	Itemized and coded, using CPT or HCPCS codes at provider level, and ICD codes at facility level, as in effect on the date of service
Any sale of the account	If the provider sold the right to payment to a factoring company or other third party, the buyer’s name and the amount paid, including any discount below invoice value
Your health care coverage	Whether you had coverage when treated, and what it was
Who referred you	Whether you were referred for treatment under an LOP, and by whom

 

The last row is the one that changed the landscape. If your attorney referred you to the provider, that has to be disclosed, and the statute makes that evidence admissible notwithstanding the attorney-client privilege in s. 90.502. The law firm’s financial relationship with the clinic, including how many patients it sends and what it gets out of it, is treated as relevant to the provider’s bias.

This came in with HB 837, signed March 24, 2023, and codified at ch. 2023-15.

Does an LOP change how much my medical bills are worth in the case?

Yes, and this is the part almost nobody explains. Under Fla. Stat. 768.0427(2)(b), the evidence of what unpaid medical charges are worth is capped by formula, and treating under an LOP puts you in a specific category.

Your situation	What the jury may be shown for unpaid past charges
You have health coverage and used it	What that coverage is obligated to pay the provider, plus your share
You treated under an LOP, or did not submit to your coverage	What your health coverage would have paid, plus your share, as if you had used it
You have no coverage, or are on Medicare or Medicaid	120% of the Medicare reimbursement rate on the date of treatment, or 170% of the state Medicaid rate where no Medicare rate applies
The provider transferred the right to payment to a third party	What that third party paid or agreed to pay for it

 

Read the highlighted row carefully. If you have health insurance and choose an LOP instead of using it, Florida measures the value of those bills by what your insurance would have paid anyway. That is a deliberate policy choice by the legislature, and it means an LOP is not a way to make a claim bigger. It is a way to get treated when you otherwise could not.

 

Any clinic or firm that tells you an LOP will increase your settlement is describing a version of Florida law that stopped existing in March 2023.

How long will I wait to be paid, and how long do I have to file?

Treatment under an LOP typically runs until the case resolves, which is often a year or more. Separately, Florida gives you two years to file a negligence action under Fla. Stat. 95.11(5)(a), reduced from four years by the same 2023 law.

Those two facts belong together. Your treatment timeline and your filing deadline are different clocks, and the shorter one is now two years from the crash. Anyone still deciding whether to pursue a claim should know that the window closed by half in 2023.

Can a chiropractor treat under a Letter of Protection in Florida?

Yes. Florida’s definition of an LOP covers any health care provider, and chiropractic physicians licensed under chapter 460 are health care providers. The arrangement is contractual, so it depends on the clinic agreeing to it, not on a special license or certification.

What determines whether a clinic will accept one is usually case strength, not paperwork. A provider agreeing to an LOP is extending credit against an uncertain outcome, so most will want to see that liability is reasonably clear and that an attorney is involved.

What does Spine & Injury Associates need to start you on an LOP?

What we need	Why
Date of the crash	Determines whether your 14-day PIP window is still open
Your attorney’s name and office	The letter comes from them, not from you
The crash report number if you have it	Speeds up verification
Any insurance information you have	PIP, health coverage, MedPay, and the at-fault driver’s carrier

 

If you do not have an attorney yet, say so when you call. That is a normal starting point and not a reason to delay getting evaluated, because the 14-day PIP clock does not pause while you look for one.

Spine & Injury Associates is a chiropractic injury practice. We evaluate and treat soft tissue and spinal injuries from motor vehicle crashes. Where findings call for imaging, a specialist, or an emergency medical condition determination, which under Florida law only a physician, osteopathic physician, physician assistant, advanced practice registered nurse, or dentist may make, we coordinate the referral.

Call 407.434.7246 or request an appointment.

FAQs

Is a Letter of Protection legally binding in Florida?

An LOP is a contract between you, your attorney, and the provider, so it binds the parties who sign it. It does not bind the insurance company and it does not guarantee a recovery. If the case resolves for less than your bills, you may still owe the balance.

Can I get chiropractic care with no insurance after a car accident in Florida?

Often yes, through a Letter of Protection, which lets a clinic treat you now and be paid from the settlement. It generally requires an attorney, and acceptance is at the provider’s discretion based on the strength of the liability claim.

Does a Letter of Protection increase my settlement?

No. Since 2023, Fla. Stat. 768.0427(2)(b)2 measures unpaid charges incurred under an LOP by what your health coverage would have paid. An LOP is a way to access care you could not otherwise afford, not a way to raise the value of a claim.

Who pays if my case loses?

You do. The provider’s agreement is to wait for payment, not to forgive the bill. Read the letter your attorney sends, because the terms governing what happens with no recovery are in that document and they vary.

Do I need an attorney to get a Letter of Protection?

In practice, almost always. The letter comes from the attorney’s office and the attorney holds and disburses the settlement funds. Without one, there is no mechanism to protect the provider’s payment, which is the entire point of the arrangement.

About the clinic

Spine & Injury Associates treats auto accident injuries at eight locations across Florida, including Orlando, Altamonte Springs, Kissimmee, Haines City, Plant City, Ocala, Fort Myers, and Jacksonville.

Related reading:  Auto accident care   Payment options   Auto accident care   Our locations

Author and review

Reviewed by Dr. Khan, DC. Dr. Khan is the owner and treating chiropractic physician at Spine & Injury Associates, a Florida injury care group operating eight clinics statewide with a focus on auto accident and soft tissue injury recovery.

Sources

1. Florida Statutes section 768.0427, Evidence to prove medical treatment and services expenses. Florida Senate
2. Florida Statutes section 627.736, Personal Injury Protection benefits. Florida Senate
3. Florida Statutes section 95.11, Limitations other than for the recovery of real property. Florida Senate
4. Chapter 2023-15, Laws of Florida (CS/CS/HB 837), signed March 24, 2023.

Find an auto accident doctor near you

Hurt in a crash? Florida PIP requires care within 14 days. Learn what an auto accident doctor does, then book at the Spine & Injury Associates clinic closest to you: Orlando, Altamonte Springs, Kissimmee, Haines City, Plant City, Ocala, Fort Myers, Jacksonville. Call 407-434-7246 to schedule.