Protection file

Accident victims (and their doctors) sometimes get fooled by letters of protection

There’s a lot to love about Texas. Texans are known to be down to earth, helpful and friendly. The Texas style barbecue is famous all over the world. And who hasn’t heard In the heart of Texas?

However, the state ranks among the top killers of vehicles, with Houston earning the dubious distinction of being the city with the most deaths in red-light wrecks from 2004 to 2018, according to the National Coalition for Safer Roads.

“That’s why I’ll always count one two three before entering an intersection when my light turned green,” “Art” wrote to me, adding, “and you can’t imagine how many red light runners I saw in those three seconds!

A serious accident leads to hiring a law firm specializing in personal injury

One day, while Art was counting at a red light, the driver behind him was texting, didn’t slow down and rammed into him, totaling both cars and leaving Art with severe neck and lower back trauma. .

“His insurance company said I caused the accident by not leaving quickly when my light turned green! Also, while I had auto medical insurance, the limits were not adequate for my needs.

“So I hired a lawyer from Houston — whose ad I saw on TV — and he assured me there would be no problem getting the care I needed.” We will send our letter of protection (LOP) to the doctors you deal with. This assures them of getting paid when the case is settled,” they told me, but none of the doctors I have seen will take my case as long as I am represented by this law firm. What is happening?”

How a Protection Letter is Supposed to Work

A protective letter, also called a medical privilege, is commonly defined as:

  • A contract between the lawyer, the doctor and the client/patient that provides payment for professional services provided to the patient upon financial recovery, by settlement or by lawsuit.
  • The attending physician agrees to wait for payment until the case is resolved.
  • If there is no monetary recovery, the client who was injured is still obligated to pay the doctor’s bill, but sometimes the lawyer may try to negotiate with the doctor.

It’s pretty simple, don’t you agree? In reality, ethical opinions of the State Bar of Texas – and just about every other state bar – makes it clear that the LOP creates a fiduciary relationship in which the lawyer is obliged to protect the financial interests of the attending physician.

Lawyers who pay themselves first!

But then spend a few minutes talking with attorney Rebecca Pennington, who is an office manager at MedCenter Pain Management in San Antonio, Texas, and you too will end up shaking your head in disbelief, like I did, wondering how some lawyers can justify completely ignoring their legal obligation to protect the doctor’s financial rights that the LOP creates.

“I just read your article When lawyers refuse to pay a client’s bill. Our pain management clinic in San Antonio sees a large number of injured patients. The LOPs have, over the past two years, lost almost all their meaning. These are NOT letters of protection. In fact, they decline any responsibility to pay. Here is the typical wording of an LOP we received today:

“THIS COMPANY ASSUMES NO RESPONSIBILITY FOR PAYMENT OF FEES OR SERVICES RENDERED TO OUR CUSTOMER. However, if an indemnity is recovered on behalf of our client, your fees will be reimbursed from any sum recovered, provided that such recovery is reasonable. The reasonableness or otherwise of such recovery will be determined in the sole discretion of such law firm.

“They say, ‘We don’t have to pay you, Doctor, unless we want to!’

“It’s so unfair, so wrong! Do you have any ideas on how to handle this type of non-LOP? It seems this has become the norm, and our clinic is considering refusing to accept PI (personal injury) cases now. It’s a waste of time to have thousands of bills for very expensive procedures only to recover less than enough to pay for the medical assistant’s time, let alone pay the doctor or cover the cost of drugs and the equipment. Thanks for any input you may have.

I’ve seen LOPs from several Texas attorneys that clarify one thing. They pay each other first and in full. Doctors must, on a pro rata basis, reduce their bills, but lawyers do not impose such an obligation on themselves!

Every request I’ve had to speak with lawyers whose LOPs have similar language has been ignored.

Difficult for patients to find doctors who will treat them

My reader Art told me that he was referred to multiple doctors and none will treat him if he stays at the same law firm. Attorney Pennington confirmed that many doctors reject referrals from attorneys with LOPs for the same reasons.

Texas is not alone with these problems. Florida is a carbon copy and in many cases much worse.

And the remedy? On condition of anonymity, a professor at a Texas school of law and legal ethics told me: “Part of the problem is greed – doctors who repeatedly charge reasonable fees and lawyers who ignore their legal obligation under the LOP. It’s time for the state bar and medical board to get involved and set proper standards.

What patients should do

  • Read the lien or LOP carefully. To determine that you are dealing with a legitimate protection letter, look for wording that says, in as many words, “We agree to pay reasonable and customary charges for medical services.”
  • Also be sure to read the LOP with the doctor or office manager, and if you see language that says something like “We decide whether to pay or not pay the doctor” then that’s not a real LOP. (And if you’re having this problem, the section below outlines the next steps to take.)
  • Know that you, as the patient, are still responsible for the bill in the event that there is no settlement or you lose in court.
  • People who do not have private insurance or other means to pay for treatment related to bodily injury should be referred to the appropriate public hospital.

One last thing: medical payment coverage isn’t that expensive and the high limits of PIP coverage, if available in your state, can be money well spent.

What healthcare providers should do

Be aware that you are not required to agree to a lien or LOP that gives the lawyer the exclusive right to pay you or not to pay you. If you accept such a privilege, expect trouble. Instead, it never hurts to cross out the offending language on the document, initial it, have your patient initial it, and insist that the attorney initial it as well and return it to you before planning. medical procedures.

Don’t trust the lawyers to do the right thing unless it’s written in black and white and they’ve signed it. If you’re asked for a discount on your bill, insist on seeing a full breakdown of the case’s settlement or jury verdict. Does the lawyer take a cut or treat you like a sucker?

If you have a case where the attorney failed to protect your bill despite a signed lien, file a complaint with your state bar.

Lawyer at the bar, author of “You and the Law”

After attending law school at Loyola University, H. Dennis Beaver joined the Kern County District Attorney’s Office in California, where he established a consumer fraud section. He is into the general practice of law and writes a column in a syndicated newspaper, “You and the Law”. Through his column, he offers free help to readers who need down-to-earth advice. “I know it sounds corny, but I love being able to use my education and experience to help, just to help. When a reader contacts me, it’s a gift.”