How a Letter of Protection Gets You Medical Care

A letter of protection (LOP) is a legal document sent by a personal injury attorney to a healthcare provider. It guarantees that the provider will be paid for treating the attorney's client from a future settlement or verdict. The LOP creates a medical lien — the provider's legal right to be repaid from the settlement. In practice, "LOP" and "medical lien" are often used interchangeably, but technically the LOP is the document and the lien is the legal claim it creates. LOPs are a three-party agreement involving the attorney (who guarantees payment), the medical provider (who delivers treatment and defers payment), and the patient (who receives care without upfront costs). Common provider types who treat on LOP include chiropractors, orthopedic surgeons, pain management specialists, and physical therapists.

LOPs are the mechanism that funds medical treatment in most personal injury cases. Without them, injured patients who lack insurance or funds would go untreated — weakening both their health and their case. For providers, LOPs provide a steady stream of patients referred by PI attorneys, though they take on the risk that the case might not settle favorably. For attorneys, LOPs ensure their clients get the documented treatment that builds a stronger case. The LOP ecosystem connects attorneys, providers, and sometimes lien companies into a treatment-funding loop that makes PI litigation possible.