Letters of Protection in Georgia Personal Injury Cases
On this page
A letter of protection is an arrangement under which a doctor or other provider treats an injured person now and is paid later from a settlement or judgment. Georgia now addresses these arrangements by statute: for causes of action arising on or after April 21, 2025, O.C.G.A. § 51-12-1.1(d) makes the letter, the itemized and coded charges, any sale of the account to a third party, and any referral for treatment “relevant and discoverable”. What the patient owes if the case recovers too little depends on the letter’s own terms.
What the statute covers
Section 51-12-1.1(d), added by Senate Bill 68, applies to any claim for medical expenses “rendered under a letter of protection or any other arrangement by which a healthcare provider renders treatment in exchange for a promise of payment for the plaintiff’s medical and healthcare expenses from any judgment or settlement” of a civil action, whatever the arrangement is called. For those expenses, four things are relevant and discoverable:
| Item | What the statute describes |
|---|---|
| The letter | "A copy of the letter of protection" |
| The charges | All charges, itemized and, where applicable, coded "according to generally accepted medical billing practices" |
| A sale of the account | If the provider sells the account receivable to a third party for less than the invoice price, the buyer's name and the price paid |
| The referral | Whether the claimant was referred for treatment under the arrangement, and if so, by whom |
The same section limits medical special damages to “the reasonable value of medically necessary care, treatment, or services”, with the amount determined by the trier of fact, and lets either side challenge the reasonableness of the charges or the necessity of the treatment (§ 51-12-1.1(b), (f)). For a crash before April 21, 2025, Section 9 of the act keeps § 51-12-1.1 from applying, and prior law governs.
Why the statute matters to a patient
A letter of protection keeps treatment going when a person has no health insurance, or coverage does not reach the needed care. Under § 51-12-1.1, the defense can now see the charges, any discounted sale of the account, and how the patient came to the provider, and it can argue that the reasonable value is less than the charges. When the injured person has health insurance, the evidence also includes what the insurance would have required to satisfy the charges, “regardless of whether the health insurance has been used, is used, or will be used” (§ 51-12-1.1(c)). Choosing a letter of protection over available health insurance does not keep that comparison out.
How the medical expense rule works overall is explained in how SB 68 changed medical damage calculations in Georgia.
When the recovery is smaller than the bills
The statute does not say what happens to the patient’s balance if the case is lost or settles for less than the charges; the letter and any agreement with the provider do. Read it for:
- Whether the patient remains responsible for any unpaid balance.
- Whether the provider agreed to reduce its bill in proportion to the recovery.
- Whether the provider may sell the account, and to whom the patient would then owe it.
For example, imagine a $75,000 settlement, a one-third attorney’s fee of $25,000, and $5,000 in case expenses, leaving $45,000, against $60,000 in charges under letters of protection. Unless the providers reduce their bills, $15,000 of the charges is not covered by the net recovery. The figures are illustrative only.
A recovery can also be reduced or barred by the injured person’s own share of fault, which ends recovery at 50 percent under O.C.G.A. § 51-12-33(g). Hospital liens and other reimbursement claims are separate, covered in how medical liens affect your Georgia car accident settlement.
Before signing one
- Ask whether the provider will bill your health insurance instead, if you have it.
- Read who owes the balance if there is no recovery.
- Ask whether the provider sells accounts to third parties.
- Keep your own copy of the letter and every bill.
Sources
- Senate Bill 68 (2025), as passed, § 7 (O.C.G.A. § 51-12-1.1) and § 9; Office of Legislative Counsel, 2025 Summary of General Statutes Enacted.
- O.C.G.A. § 51-12-33 (text of the Official Code of Georgia Annotated, November 2022 release).
This page describes Georgia law as of October 2026 for general information. It is not legal advice and does not create an attorney-client relationship.