Letter of Protection in Florida: What a Jury Is Allowed to See Now
By Richard P. Pravato, Board Certified in Civil Trial Law Published October 16, 2026
You were hurt in a Florida accident. You need treatment, and you cannot pay for it right now. So your lawyer sends your doctor a letter that says: treat this person, and you will be paid out of the settlement when the case ends. That letter is called a letter of protection, and it is how a lot of injured people here get care.
In March 2023 Florida changed the rules for those bills. Two other changes from that year got most of the attention: you now have two years to file a lawsuit instead of four, and you recover nothing if a jury finds you more than half at fault. The third change got almost none, and it is the one I explain to clients most. It controls what a jury is allowed to hear about what your treatment cost.
By the end you will know what signing a letter of protection commits you to, what number the jury hears instead of the bill, the five things you have to hand over before you can claim those bills, and one question worth asking any firm before you hire them. I am Richard P. Pravato, Board Certified in Civil Trial Law, and Florida injury claims are the only work I have taken since 1996.
Key takeaways
- A letter of protection is any deal where a provider treats you now and gets paid out of your settlement later. Florida defines it by what it does, whatever the paperwork is called.
- Since March 2023 the jury usually hears what was paid or what insurance would have paid, not the amount printed on the invoice.
- Five disclosures are mandatory before you can claim treatment billed under a letter of protection. Miss one and that part of the claim does not go forward.
- If your lawyer sent you to the doctor, that is no longer private. The law made the referral admissible and the firm’s financial relationship with the provider fair game.
- The rules reach suits filed after March 24, 2023. An appeal court has confirmed they do not reach back to older cases.
What a letter of protection is
A letter of protection is an arrangement where a health care provider treats you in exchange for a promise of payment out of any settlement or judgment in your case. Florida writes it that broadly on purpose, and the definition catches any arrangement that works this way, whatever anyone calls it.
Most people who sign a letter of protection in a personal injury case have no health insurance. Some have insurance and use one anyway, for three common reasons: the deductible is brutal, the plan will not cover the specialist they need, or no doctor in the plan will see a car accident patient for months. Our guide to how medical bills get paid after a crash covers the other ways to pay.
Here is the part people miss when they sign. A letter of protection is a debt, not forgiveness of the bill and not insurance. If your case ends with no money, you still owe the bill. Many providers write it off at that point, and many is not all.
What Florida’s 2023 law changed about your medical bills
Before 2023, the jury saw what your doctor actually billed. The full billed amount was the starting point, and the argument was over whether it was reasonable. A $50,000 bill went to the jury as $50,000, and the other side argued it down from there.
Now Florida Statute 768.0427 spells out what evidence of medical bills is admissible, and it caps what you can recover. The statute arrived inside a Florida House bill called HB 837, the civil remedies package Governor DeSantis signed on March 24, 2023. Insurance companies and the big groups behind Florida tort reform in 2023 pushed hard for it. The result is that injured people in Florida have a much harder time showing a jury what their treatment really cost, and their claims are worth less because of it.
How the bills get sorted
Here is how it works. The statute sorts every medical bill into one of seven categories, and the category your bill falls into decides what number the jury hears. Find your row below.
| Your situation | What the jury may hear | Statute |
|---|---|---|
| The bill has been paid | The amount actually paid, whoever paid it | 768.0427(2)(a) |
| Unpaid, and you have health insurance that is not Medicare or Medicaid | What your coverage is obligated to pay the provider, plus your copays and deductible | 768.0427(2)(b)1 |
| Unpaid, you have insurance, but you were treated on a letter of protection or never submitted the bill | What your coverage would have paid, plus your share, had the bill been submitted | 768.0427(2)(b)2 |
| Unpaid, and you have no insurance, or you are on Medicare or Medicaid | 120 percent of the Medicare rate, or 170 percent of the Medicaid rate where there is no Medicare rate | 768.0427(2)(b)3 |
| The provider sold your letter of protection to a third party | What that third party paid or agreed to pay for it | 768.0427(2)(b)4 |
| Any unpaid bill | Reasonable amounts billed for medically necessary treatment | 768.0427(2)(b)5 |
| Care you still need | Insurance rates, or 120 percent of Medicare, plus reasonable future amounts to be billed | 768.0427(2)(c) |
The sixth row is more useful than it looks. The statute says the evidence “shall include, but is not limited to” those categories, and reasonable amounts billed is still on the list. So your actual bill is not banned from the courtroom. It is one piece of evidence next to the others, and judges are still working out how much weight to give it.
The five things you have to disclose
Disclosure is the part that catches people out, and it is not a formality. Before you can claim a single dollar of treatment billed under a letter of protection, the statute requires you to hand over five things:
- A copy of the letter of protection itself.
- All the billing, itemized and coded to the standards the statute names.
- If the provider sold your account to a factoring company, that company’s name and the price it paid.
- Whether you had health coverage when you were treated, and what it was.
- Whether you were referred for treatment under a letter of protection, and by whom.
The statute calls these a condition precedent, a legal term for something you have to do first, before anything else happens. Without all five, the claim for those medical expenses does not go forward. It is not reduced and it is not argued over. It simply does not go forward.
The referral question nobody asks their lawyer
The fifth disclosure, the one about who referred you, is the one attorneys argue about. Before this statute, whether your lawyer sent you to a particular doctor was private. The Florida Supreme Court had ruled it was protected by attorney-client privilege, the rule that keeps what you tell your lawyer confidential. The statute reversed that.
Now, if your lawyer sent you to the doctor, that fact can be disclosed and a jury can hear it. The statute goes further. The money side of the relationship between the firm and the doctor comes in too: how many patients that firm sends, how often, and how much the doctor earns from it. All of it counts toward the bias of a doctor who testifies for you.
Any firm you are thinking of hiring should be able to answer one question out loud: how do you handle medical referrals? You are allowed to ask it, and a firm that treats the question as rude has told you something.
The limit on what you can recover
A second rule caps what you can actually collect for medical care. Your medical damages cannot exceed the evidence the jury was allowed to hear under the sorting rules above, and they cannot exceed the sum of three things.
Three amounts make up that cap. What was actually paid on your behalf. What is still due and unpaid when you reach trial. And the reasonable cost of the care you will need in the future. Nothing else counts, whatever the bill says. This statute only touches medical expenses, so the rest of your claim is unaffected, and our explainer on what counts as compensatory damages covers that part.
Does this apply to your case?
If your lawsuit was filed after March 24, 2023, expect these rules to apply. Note what the date attaches to: the day the lawsuit was filed, not the day you were hurt. An older accident can still fall under the new rules. In November 2024 Florida’s Fifth District Court of Appeal confirmed the limits do not reach back to lawsuits filed before that date, in a case called Wolf v. Williams, which is a coincidence and not one of ours.
The rules may still change, so check the date on anything you read about this. Lawmakers filed two bills to amend the statute in the 2026 session, one in each chamber, and both died on March 13, 2026. So what you have read here is the law as it stands in October 2026. Our guide to the other half of the 2023 reform covers the fault rules that changed at the same time.
What I tell someone who was just hurt
See a doctor, and keep going to your appointments, because the treatment is what the whole medical claim is built on. Tell every provider what coverage you have, and be thorough, because the statute counts health insurance, workers’ compensation and personal injury protection all as health care coverage. People assume it means health insurance only. It does not.
Talk to a lawyer before you decide how your treatment gets paid for, and do not sign a letter of protection that nobody has explained to you. Keep every bill and every insurance statement. And be straight about your coverage and about any referral. The statute requires both disclosures, and a jury that finds out something was left out will hold it against you.
How we build a medical claim under this statute
Under this statute a medical claim is won with documents, not with a bill and an argument. So that is how we build one. We sort every bill into its category before the other side does. We chase down what was actually paid and what your coverage was obligated to pay. And we document your future care carefully, because that is one of the three amounts you can still recover in full.
The five disclosures we make correctly the first time. A claim for treatment under a letter of protection should never fail over paperwork, and an incomplete file is exactly how that happens.
Questions people ask me about letters of protection
Does a letter of protection hurt my case?
It does not disqualify your claim. It does two things: it changes what the jury hears about those bills, and it adds the five required disclosures. If you cannot get treated any other way, that trade is usually worth making, as long as a lawyer looks at it first.
What if I have health insurance but used a letter of protection anyway?
The jury hears what your insurance would have paid, plus your copays and deductible, as if the bill had gone through the plan. There are good reasons to treat outside your plan. Make sure you have one, and that your lawyer knows it.
Can I get out of a letter of protection after signing it?
It is a contract with the provider, so the answer is in that document and in what the provider will agree to. Here is what to do in the meantime. Watch the itemized billing, because the statute requires every charge to carry a standard medical code, the numbered codes insurers use for each procedure and diagnosis, before you can claim it. A provider who bills loosely creates a problem that becomes yours.
Talk through your own medical bills
Wolf & Pravato represents injured people across Florida from offices in Fort Lauderdale, Miami, West Palm Beach, Boynton Beach and Fort Myers. If you want to know how your own medical bills would be handled under this statute, bring us what you have and we will walk you through it.
Request a free case review. There is no fee unless we win money for you.
This article is general information about Florida law, not legal advice, and every case turns on its own facts. Prior results do not guarantee a similar outcome.
