Business groups target letters of protection for upcoming 2023 Session
William Large of the Florida Justice Reform Institute is concerned about liability in deciding to perform 'elective' surgeries.

william large
'If you ask me what is the most important thing you can do on civil justice or lawsuit abuse, it’s solving this issue.'

Now that the long-running lobbying over AOB (assignment of benefits) has been resolved, business interests are targeting another thorny issue with an acronym they want tackled: LOP.

A letter of protection (LOP) is a letter sent to a medical professional by a plaintiff’s attorney representing the patient. LOPs guarantee the provider payment for medical treatment from a future lawsuit settlement or verdict award. Therefore, if the patient is insured, providers don’t bill the insurers Medicare or Medicaid.

“If you ask me what is the most important thing you can do on civil justice or lawsuit abuse it’s solving this issue,” Florida Justice Reform Institute President William Large said at the Associated Industries of Florida Florida Business Forum event in Tallahassee.

Large said letters of protection enable plaintiff attorneys to inflate the value of past medical bills and, moreover, allow plaintiffs to “get around” the set-off rule.

Large hypothesizes the use of LOPs artificially inflates the costs of settlements by four times the amount.

Because the providers are going outside the insurance system, the costs of care are higher. 

The higher the costs of past care, the higher the costs of future care, and the higher the amount of pain and suffering juries are willing to award. Large said his analysis shows lawsuits with past medical costs of $90,000 or more can yield big verdict returns.

“There’s a real incentive to increase the past medicals,” Large told the crowd.

Additionally, the use of an LOP allows plaintiff attorneys to circumvent the “set-off rule” which allows the amount paid by the insurer and accepted by the health care providers to be deducted from past medical bills.

Because the medical bills are outstanding and payment has been made, there is no set off.

LOPs, Large said, increase costs by “five or sixfold” every time they are used.

Florida Trucking Association President & CEO Alix Miller said LOPs are a reason the 10 insurance carriers for the trucking industry have been driven out of the market. Many trucking companies have seen their insurance rates double and their coverage reduced by half.

She said the trucking companies, many of which she called mom-and-pop businesses, earn 6 cents on the dollar, and “have no choice but to cover our legal expenses of frivolous lawsuits onto the movement of goods.”

Miller said FTA estimates that the tort tax translates up to $5,000 annually.

LOPs have been a priority issue for the business community over the last several years with Publix throwing its weight behind changes.

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.


  • david koenig

    February 14, 2023 at 2:28 pm

    Your story on the lOP issue is well taken, but for the other side; So the trucker that may have created a serious injury by his own fault now wants private health insurance to cover the costs, or medicare, or medicaid. No lop, means the treatment is forced to go to private/public insurance for payment. The trucker has, most often, liability insurance in place for the times he creates a medical injury. So, who’s premiums go up? His or yours?

  • cassandra

    February 15, 2023 at 1:07 pm

    This one-sided, slanted advertisement for “Business groups” should have included a statement from a plaintiff attorney for those of us who are not familiar with LOPs.

    From the article, it appears that: The sentence: “LOPs guarantee the provider payment for medical treatment from a future lawsuit settlement or verdict award.” Injured people should NOT have this right taken away from them! LOPs do not “inflate” costs; they reflect *actual* costs. Saying that cost of past medical care should be based on an insurance payment to a provider rather than actual medical costs would make the plaintiff unable to afford future medical care! It would also force the injured to remain with the job-provided insurance plan whether they are able to work there or not—impossible to do!

    “The higher the costs of past care, the higher the costs of future care”. No kidding! Business groups want to zero-out medical costs that have been paid by insurance so that it appears to the jury that there were no medical bills! These people want the jury to believe that there will be no future medical bills!

    Businesses complaining about “past medical costs of $90,000 or more can yield big verdict returns….pain and suffering juries are willing to award.” –As they should when they find a business responsible for causing someone’s pain and suffering! It’s the jury’s job to decide decide the award amount.

    Let juries make the decisions, not a bunch of negligent business opportunists.

    • cassandra

      February 15, 2023 at 1:12 pm

      * “decide” This site needs a two minute edit option!

  • Daniel Horowitz

    February 22, 2023 at 12:17 am

    How many people are uninsured? How many people who are insured don’t have the money on hand to pay their out of pocket deductible, co-pays, patient responsibility? How many people get turned away from medical providers when the provider finds out they need treatment as a result of a wreck? How many providers won’t take Medicare or Medicaid because they can’t pay their employees or make a living on those rates? What’s the time value of money when a provider has to wait years to get paid because the responsible trucking company/insurance company denies the claim? I guarantee FTA can show any actual proof LOPs are reason 10 carriers have allegedly been driven out of the market. Maybe carriers left the market because the trucking companies don’t enforce safety rules and it results in catastrophic crashes. This is the same BS argument the trucking industry made in Texas and the corporate lobbyist convinced the legislature of same. If trucking companies, health care providers, home owners, corporate real estate owners, etc. would all wake up and realize the problem is insurance companies. Insurance being a for profit/shareholder driven industry is the problem. When the stock market drops, carriers blame lawsuits for their losses. When the stock market booms, you never see the carriers return their gains to policy holders.

Comments are closed.


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