What Is a Letter of Protection, and How Did Georgia’s 2025 Law Change It?

When an injured person needs medical treatment but cannot pay upfront, a letter of protection can allow them to get care now and pay later from any settlement or judgment. These arrangements are common in injury cases, but Georgia’s 2025 tort reform made them subject to new disclosure rules. This guide explains what a letter of protection is, how it works with providers, the new disclosure rules under SB 68, and the practical effect.

What a Letter of Protection Is

A letter of protection, often called an LOP, is an arrangement in which a medical provider agrees to treat an injured person and defer payment, with the understanding that the provider’s bill will be paid out of any eventual recovery in the person’s injury case. Instead of demanding payment at the time of treatment or billing health insurance, the provider holds the bill against the future settlement or judgment.

For an injured person without the means to pay or without insurance, an LOP can make necessary treatment possible. It connects the medical care to the legal claim: the provider is essentially betting on the case, agreeing to wait for payment until the claim resolves.

How It Works With Providers

Under a typical LOP, the injured person (often through their attorney) and the provider agree that the provider will furnish treatment and be paid from the proceeds of the case. The provider continues treatment based on that promise, and the outstanding balance is satisfied when the case settles or a judgment is paid, before the injured person receives their net recovery.

These arrangements can be valuable, but they have also drawn scrutiny. Critics have raised concerns that LOP billing can inflate the medical charges presented in an injury case, because the amounts billed under an LOP may differ from amounts that would have been accepted through insurance. That concern is part of what drove the 2025 changes.

New Disclosure Rules Under SB 68

Georgia’s 2025 tort reform addressed letters of protection as part of its broader changes to how medical damages are handled, codified in O.C.G.A. § 51-12-1.1. Under the reform, letters of protection and similar arrangements for treatment in exchange for a promise of payment from a judgment or settlement are now relevant and discoverable.

This is a meaningful shift. Previously, the existence and terms of an LOP arrangement were not necessarily exposed to the same scrutiny. Making them relevant and discoverable means the defense can obtain information about the LOP and present it, allowing a jury to consider the nature of the billing arrangement when evaluating the reasonableness of the claimed medical expenses. The change sits alongside the reform’s broader treatment of medical-expense damages, which is addressed in the related collateral-source post that covers a different aspect of the same statute. These medical-damages provisions apply going forward based on the reform’s effective-date rules.

Practical Effect

The practical effect is greater transparency around LOP arrangements in Georgia injury cases. For injured people, letters of protection remain a tool to obtain treatment when paying upfront is not possible. But the arrangement is no longer shielded from view: the defense can discover it, and the jury may learn that the treatment was provided under an LOP rather than billed in the ordinary course.

This can affect how medical bills are evaluated at trial, since the reasonableness of the charges is now examined with the LOP context available. For an injured person, the takeaway is that an LOP can still enable needed care, but the arrangement and its terms may become part of the case rather than remaining a private matter between patient and provider. As with the other 2025 reforms, how these rules play out in any given case depends on the specific facts and the timing under the effective-date provisions.

Key Takeaways

• A letter of protection (LOP) lets an injured person receive treatment now and pay the provider later from any settlement or judgment.
• Under an LOP, the provider defers payment and holds the bill against the future recovery, which can make care possible for those who cannot pay upfront.
• Under Georgia’s 2025 reform (O.C.G.A. § 51-12-1.1), LOPs and similar arrangements are now relevant and discoverable.
• The change increases transparency, allowing the defense to discover the LOP and the jury to weigh it when assessing the reasonableness of medical charges.

This article provides general information about Georgia law and is not legal advice. Statutes and court decisions change, and how the law applies depends on the specific facts of a situation. For advice about a particular matter, consult a licensed Georgia attorney.